Marketplace Premium Tax Credit Organizer

An organizer for a Marketplace health plan with premium tax credits. Keep your plan and household, your income month by month, every change you report to the Marketplace, your Form 1095-A numbers, and your tax time documents in one place.

Starting with tax year 2026, the IRS says that if your advance credit payments were more than the credit you qualify for, the extra has to be paid back in full, with no repayment cap (IRS, checked November 10, 2026). Keeping your income and the changes you report on record helps you see where you stand during the year.

WHAT YOU GET (7 pages)

1. My Plan and Household: plan, Marketplace and policy numbers, months covered, and the people on your tax return

2. Income Estimate vs Actual by Month: wages, self-employment, unemployment, Social Security, retirement, and other income, next to your estimate

3. Changes Reported to the Marketplace: date of change, what changed, date reported, how, and the confirmation number

4. Advance Credit by Month Record: Form 1095-A Part III, columns A, B, and C, for each month

5. Form 1095-A Check: each item on the form compared with your records, errors found, and corrected forms requested

6. Tax Time Checklist: documents to gather

7. Call Log

Plus a Read Me First page.

Bonus: Where the Official Rules Live, a two-page list of the official IRS and HealthCare.gov sources on full repayment starting with tax year 2026, reporting changes, Form 1095-A timing and errors, when Form 8962 is required, what counts as income, and free help, each checked November 10, 2026

SPREADSHEET VERSION (Excel or Google Sheets)

Tabs for Plan and Household, Income by Month, Changes Reported, Advance Credit 1095-A, 1095-A Check, Tax Time, Call Log, and a Summary tab. It:

• adds up each month's income and keeps a running year-to-date total
• shows the difference between your year-to-date income and your yearly estimate
• lets you type an income amount you want to watch, and flags it when year-to-date income goes over it
• counts the days between each change and the date you reported it

Your copy comes blank, with one grey example row in the logs.

FILE FORMATS

• Fillable PDF you can type into, or print and fill in by hand
• Word (.docx) for Microsoft Word and Google Docs
• Spreadsheet (.xlsx) for Excel or Google Sheets
• US Letter and A4 sizes
• Two looks: Classic (navy, plain office style) and Modern (soft blue and cream)

GOOD TO KNOW

• This is a digital download. Nothing will be mailed to you.
• These are blank forms for your own records. No letters or step-by-step guides are included.
• The spreadsheet adds and counts what you type. It does not figure your premium tax credit, poverty-level limits, or anything you may owe.
• This is not an IRS form and does not replace Form 1095-A or Form 8962. Always go by your own Marketplace notices and the IRS instructions.
• I'm not a tax preparer, a lawyer, or an insurance agent, and this is not tax, legal, financial, or insurance advice.
• Not affiliated with or endorsed by the IRS, HealthCare.gov, CMS, any state Marketplace, or any insurance company.

• Your download link appears right after payment and is emailed to you.
• Free updates: when a rule or date changes, your download link gets the updated file.
• Can't pay right now? Email thedenialdesk@gmail.com with the subject "Free kit" and the name of the kit you need. No reason needed. Please don't include medical details, bills, tax forms, or insurance numbers. Limit one free code per email address, good for one kit.
• Returns or a problem with a file: email thedenialdesk@gmail.com.
• AI disclosure: This kit was drafted with help from AI tools, then reviewed and fact-checked by our founder, a certified medical coding professional.

PLEASE DON'T SHARE

These files are for your own personal use. Please don't resell, share, or post them.