Quote Valley Insurance

Covered California 1095 A / 3895 Tax Form

Request your Covered California 1095 A or 3895 form here. Upon completion, Quote Valley Insurance will send you the form requested.

Fill the Form

    Form 1095-A, also known as the Health Insurance Marketplace Statement, is an essential document provided by the Health Insurance Marketplace (such as Covered California) to individuals and families who enrolled in a health insurance plan through the marketplace. This form outlines details about the coverage purchased, including the premium amount, the second lowest cost Silver plan in your area (used to calculate potential premium tax credits), and the months during which you and your household members had coverage. The information from Form 1095-A is crucial when filing your federal tax return, as it helps determine if you qualify for premium tax credits and ensures that you meet the requirements of the Affordable Care Act’s individual mandate. This form simplifies the process of accurately reporting your health insurance coverage and related financial aspects during tax season.


    1. Check Your Mailbox: The Health Insurance Marketplace sends Form 1095-A to individuals who enrolled in a health insurance plan through the marketplace. It is typically mailed out by the end of January each year. Keep an eye on your mailbox for this form.
    2. Access Online: You can obtain your Form 1095-A by requesting it directly through our portal or by calling 855-547-8683. 1095 A request 
    3. Contact Marketplace Customer Service: If you have not received your Form 1095-A by early February or need a copy, you can contact the customer service of the Health Insurance Marketplace you enrolled in (e.g., Covered California). They can provide you with information on how to obtain a copy of your form. 855-547-8683
    4. IRS Online Resources: The IRS also has resources to assist you in obtaining Form 1095-A. You can visit the official IRS website and use their “Get Transcript” tool to request a transcript that includes your Form 1095-A information.
    5. File Without the Form: If you are unable to obtain your Form 1095-A before the tax filing deadline, you can still file your taxes. You can use other information you have, such as your monthly premium and the SLCSP (Second Lowest Cost Silver Plan) premium information available on the Form 1095-A.

    Remember that Form 1095-A is used to calculate the Premium Tax Credit and reconcile any advance payments of the Premium Tax Credit you received during the year. It’s important to have this form when filing your taxes to ensure the accuracy of your tax return. If you have any doubts or questions, consider consulting a tax professional or using tax software that can guide you through the process.



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