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MEWA 1500 100 B 2024
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AultCare

Phone:
800-344-8858
330-363-6360

TTY:
711

24-Hour Nurse Line:
866-422-9603
330-363-7620

Compliance/FWA Hotline:

1-866-307-3528 or online

Customer Service Hours:
Monday - Friday
7:30 am - 5:00 pm EST

Mailing Address:
2600 Sixth St S.W.
Canton, OH 44710

IRS Form 1095-B

AultCare Insurance Company will not be automatically mailing 2024 Form 1095-B or 1095-Cs to members (1095-Cs must be obtained from your employer). However, upon request, any applicable members can have their 2024 Form 1095-B.

To receive your 2024 IRS Form 1095-B, submit the request via our CONTACT US on our website or send the request to:
AultCare Insurance Company
2600 Sixth ST SW
Canton, OH 44710

You can also call us at 330-363-6360 or 800-344-8858 with any questions. Your request will be furnished within 30 days of receipt.

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AultCare/Aultra complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sexual orientation, gender identity, or sex. AultCare/Aultra does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. AultCare/Aultra provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). AultCare/Aultra provides free language services to people whose primary language is not English, such as: Qualified interpreters and information written in other languages.If you need these services, or if you believe that AultCare/Aultra has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can contact or file a grievance with the: AultCare/Aultra Civil Rights Coordinator, 2600 6th St. S.W. Canton, OH 44710, 330-363-7456, CivilRightsCoordinator@aultcare.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Civil Rights staff is available to help you.You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

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