Notice of Data Security Incident
About
Broker Resources
Provider Resources
330-363-6360
Account Login
Member Employer Broker Provider Vendor
Contact Us
I'm a Member I'm a Non-Member I'm an Employer I'm a Broker I'm a Provider

Find a Plan
Individuals & Families Losing Medicaid - Individuals & Families Employers Medicare MEWA
Member Resources
Member Forms Explanation of Benefits FAQ Pharmacy Services Telehealth Health & Wellness Health & Wellness Resources Individual & Family Plan Information Health Insurance 101 Generic Incentive Program
Employer Resources
Employer Documents Pharmacy Services Workers' Comp AultCare Wellness Occupational Services Employer Plan Information
Find a Provider
Notice of Data Security Incident
About
Broker Resources
Provider Resources
330-363-6360

Home

Search Results

You searched for "over 16.4 feet water trampoline for lake"

HIPAA Access Request Form AultCare
Read more about "HIPAA Access Request Form AultCare"...
AC Short Term DD Form AultCare
Read more about "AC Short Term DD Form AultCare"...
Dependent Ver Form 2022
Read more about "Dependent Ver Form 2022"...
Flex Spending Form
Read more about "Flex Spending Form"...
Vision Claim Form
Read more about "Vision Claim Form"...
Medical Rx Claim Form
Read more about "Medical Rx Claim Form"...
Dental Claim Form
Read more about "Dental Claim Form"...
Fillable Form Spanish Accident Questionnaire
Read more about "Fillable Form Spanish Accident Questionnaire"...
2022 07 01 Ohio PPO Connect 16879 index
Read more about "2022 07 01 Ohio PPO Connect 16879 index"...
HIPAA Amend Request Form AultCare
Read more about "HIPAA Amend Request Form AultCare"...

←
1
2
3
4
5
6
7
8
→

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.

Additional Resources

Interoperability

Terms & Conditions

Language Access (Schprooch Zugang en Fashtay)

COVID-19 Information

AultCaring Conversations Podcast

Sponsorship Requests

Price Transparency

Aultman Hospital

Social

Non-discrimination Notice

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

© 2025 AultCare. All rights reserved.