Check the box for FULL YR coverage (12 months of coverage)
If there was a gap in coverage, check the boxes for EACH month individual had coverage under an employer plan, marketplace plan and/or government sponsored plan. Every month a member had insurance for “at least 1 day”, check box for that month. Any month there was NO insurance, leave it blank.
In addition to completed checklist, ALL taxpayers must provide proof of insurance coverage which may include:
Any Form 1095 (A,B,C),
Medical Insurance Card(s)
Medical Insurance Statement
Employer Statement confirming health coverage
Visit the following link for more info on Proof of coverage