1095-C Corrections

If you believe that the 1095-C form you received from TAMUS contains an error, please fill out this form so we can research the problem.

UIN*
Name*
First Last
Email*
Phone*
What kind of problem are you experiencing?*
Please Describe Your Issue. This form is not secured; please do not include any protected health insurance related information.*
If applicable, please include a list of any months that are in error. If there is a problem with a dependent's coverage (in Part III), please include their name and UIN (or date of birth).