1095-A Form Information

What is Form 1095-A?

The Affordable Care Act, also known as Obamacare, requires most U.S. residents to have health insurance.  It also offers a tax break, the Premium Tax Credit commonly known as APTC to help offset the costs of health coverage. You should receive a copy of Form 1095-A if you bought your plan from a state exchange.  If you bought your plan direct from a carrier, you’ll receive a Form 1095-B.  These forms provide information needed to claim the tax credit on your tax return.

Form 1095-A Health Insurance Marketplace Statement 

If enrolled in a health plan through the Health Insurance Marketplace in 2015 you will receive a Form 1095-A, Health Insurance Marketplace Statement from the Marketplace, not the IRS.

The Form 1095-A will tell you the dates of coverage, and the total amount of monthly premiums for your insurance plan.

If you set-up a HealthCare.gov account, Covered CA or Washington Healthplanfinder account, you can get a copy of the Form 1095-A, Health Insurance Marketplace Statement online.

*** you may receive multiple 1095-A forms for each policy ID

More information is available for Marketplace members at the following website:


Form 1095-A Disputes

If you dispute the coverage information provided from their 1095-A form(s) here is what you need to do:

The member will need to file a HICS Case.

  • FL, MI, NM, OH, TX, UT, and WI - the Member needs to contact the Marketplace Exchange directly.
  • CA - The member will contact Covered CA.
  • WA - The member will contact WA Healthplanfinder.

Once the HICS case is reviewed, a determination will be made.

The Marketplace is responsible for consumer outreach and the generation of a corrected 1095-A form back to the you.

Good Luck!