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What Information Is Provided on Form 1095-A?

Form 1095-A has three parts:

  1. Part I provides basic information about you and your family, and your health insurance start and end dates.
  2. Part II provides information about each member of your “coverage household” – those members of your family who were covered under the same policy.
  3. Part III provides information for every month of the year for three items:
    1. The monthly cost of the health plan you selected;
    2. The monthly cost of the Second Lowest Cost Silver Plan (SLCSP) available through BeWell in your rating area; and
    3. The tax credit amount you used to pay for your monthly health coverage.

There may be a very small difference between the monthly premium shown in column A from Form 1095-A and your actual monthly bill. This is because BeWell is required to report only the “essential health benefits” (EHB) portion of the premium on Form 1095-A. If the difference exceeds $5.00 per month, please call us at 1-833-862-3935 (TTY: 711). The premium amount of the Second Lowest Cost Silver Plan (SLCSP) is included because the law requires that we use the cost of this plan to calculate your premium tax credit.

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Where Do I Start?

Browse and Compare
Insurance Plans

Before you apply for coverage, you can see the health and/or dental insurance plans available and the estimated cost you will pay plus any subsidies you may qualify for to reduce the cost.

Schedule an Appointment

with a Certified Assister
or Enrollment Counselor

Certified assisters and enrollment counselors can help you understand your options and enroll in a health insurance plan. Their help is free!

Submit
Your Application

When you’re ready to enroll, you can apply online in about an hour. You can also save your application and come back to it, so you can go at your own pace. Create your BeWell log in to get started.