1095-A Customer Correction Request

The premium amount listed in column A of your IRS form 1095-A combines both health and dental premiums (if there was pediatric dental enrollment) and only the premium allocated to the cost of the Essential Health Benefits (EHB). Find more information about essential health benefits (EHB) on our Health Plans page or at www.healthcare.gov/coverage/what-marketplace-plans-cover.

Submit one 1095-A Customer Correction Request per year

  • Enter 1095-A Correction in the subject field
  • Enter a description of the error on your 1095-A form
  • Enter the email address used for your Healthplanfinder account
  • Enter information about you and your Healthplanfinder Application ID
  • Check the box for coverage year
  • Select the Policy Issuer's name (Insurance Carrier Name)
  • Check boxes next to the part of the 1095-A form that is incorrect (check all that apply)
  • Click Submit one time
  • Check your email for updates

You will receive email updates with the status of your request within two weeks.

Provide a brief description of the issue. Ex: 1095-A Correction

Please provide a detailed description of your correction request. A member of our support staff will respond via email as soon as possible.

Name of customer this request is in regards to. Enter either Unknown or N/A if appropriate.

Healthplanfinder Application ID Number (Not Client ID). Enter 0 if unknown or not-applicable. Enter numbers only.

Check this box if your question is related health insurance for 2019

Check this box if your question is related health insurance for 2018

Check this box if your question is related health insurance for 2017

Check this box if your question is related health insurance for 2016

Carrier Name from Part I.3 (Policy Issuer's name) on IRS form 1095-A

Check this box if there is a mistake in Part I, field 3 of your IRS form 1095-A

Check this box if there is a mistake in Part I, field 11 of your IRS form 1095-A

Check this box if there is a mistake in ALL of Part II, or Part II A or B, of your IRS form 1095-A

Check this box if there is a mistake in Part II, column D of your IRS form 1095-A

Check this box if there is a mistake in all of Part II, column E of your IRS form 1095-A

Check this box if there is a mistake in ALL of Part III of your IRS form 1095-A

Check this box if there is a mistake in Part III, section A of your IRS form 1095-A

Check this box if there is a mistake in Part III, column B of your IRS form 1095-A

Check this box if there is a mistake in Part III, column C of your IRS form 1095-A

Check this box if there are other types of mistakes on your IRS form 1095-A. Please list in the description field.