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  • Anthem Blue Cross Summary Plan Description Instructions Form

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If you bought your plan through Covered California, you should receive a 1095-A form from Covered California, whether or not you received premium assistance.

Yes, you can obtain a copy of your Form 1095-A through the Health Care Marketplace website https://www.healthcare.gov/ or through the State HealthCare Marketplace you purchased it from.

If you had a BCBSTX plan through the Marketplace, the Marketplace sends you a 1095-A form. If you have not yet received your form, you can find a copy by logging in to your Marketplace online account, or call them at 1-800-318-2596 (TTY: 1-855-889-4325).

Mailing Address: Grievances & Appeals Department PO Box 60007 Los Angeles, CA 90060-0007 PDR form is found on www.anthem.com/ca >Provider Home>Answers@ Anthem>Provider Forms.

Log in to your HealthCare.gov account. Under "Your Existing Applications," select your 2020 application not your 2021 application. Select Tax Forms from the menu on the left. Download all 1095-As shown on the screen.

Your 1095-A is available online in your healthcare.gov account. You won't get a 1095-A if you bought a catastrophic or dental-only plan.

The Group acknowledges that it is a fiduciary under ERISA and that Anthem has no fiduciary duties under this Agreement. The Group agrees to complete and execute any and all documents necessary to open and initiate payment for the HRA and/or HIA.

The BlueCard Program is a national program that enables members obtaining healthcare services while traveling or living in another Blue Plan's area to receive all the same benefits of their contracting Blue Plan and access to providers and savings.

The bottom line is that most group health plans are subject to ERISA. Other employer-sponsored plans such as dental, vision, life, disability, Health FSAs and HRAs are also subject to ERISA in most instances.

If the plan is funded by contribution from the employer and employee, it is a self-funded ERISA plan and pre-empts state law. If the plan is funded by purchased insurance coverage, it is a fully insured ERISA plan and is subject to state law.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232