ACA Team Contact

To request a duplicate Form 1095, make corrections to your Form 1095, or to ask questions related to ACA requirements, enter the requested information below. When completed, press the button "Submit to ACA Team". Your information will be automatically forwarded.
  All 1095 Forms will be mailed by the required date of January 31, 2023, unless that date is extended by the IRS.
attention  Before requesting a duplicate, please allow ample time for mail delivery as the Forms are mailed outside of Iowa.
*Response required

   NOTE: Your Form 1095 is mailed from outside the state of Iowa via USPS. Please allow ample time for mail delivery.

NOTE: ***If selecting Email as a contact method, you are granting the State of Iowa permission to email confidential information.