This form may be temporarily unavailable between 12 a.m. on February 20 and 7 a.m. on February 21.

Request a Duplicate Form 1095-A

Complete the form below to request a duplicate 1095-A Form. All fields are required.

Note: You may be able to access your Form 1095-A through your online account.

If you need immediate assistance, call our Contact Center at 651-539-2099 (855-366-7873 outside the Twin Cities).