1095 Form Notice

Your 1095 form provides important tax information about your health coverage. If you receive your health insurance through Georgia Access or HealthCare.gov, please reach out to the Exchange for your 1095 form. How can you tell if you’re on an Exchange health plan? If your member ID on your Member ID Card begins with “000” you are on an Exchange health plan.

If you purchased your health plan off market directly from us or if your employer provides you with health insurance as an employee benefit, you may request a copy of your 1095 from us. Here are the steps to request a copy of your 1095:

  • Submit a request using our online form: 1095 Form Request
  • Complete all required fields with your information.
  • Include your Member ID along with your email address or phone number so we can reach you if needed.
  • If you have any questions, call Client Services at (866) 403-2785.