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McKinney Texas Form 1095-C: What You Should Know

You will be permitted to use the form for the following purposes, unless otherwise required by federal regulations from HHS: — To report any employer-provided health insurance coverage For tax purposes, this information must show all the details of the health insurance plan of an individual enrolled in or obtaining coverage through (e.g, individual, family, small, large union, group, or collective bargaining coverage) from the employer. This report includes all the details of the plan coverage and benefits. The information is based entirely on information in all reports, Form 1095, 1094, 1095-B, and 1095-C. This includes, but is not limited to employer-provided insurance plans, including, but not limited to group or collective bargaining health insurance plans, health maintenance organizations (HMO's), and self-insured health plans. It does not include state insurance, such as state Medicaid, for which there can be significant differences, depending on the individual state. — To report any employer-provided health insurance, including the premium and deductible information, and medical expenses of individual enrolled or receiving coverage through an employer's HealthConnector (or other similar program) or an HMO The Forms 1095-B (health insurance plan information report) and 1095-C (report of medical expenses and employer-provided insurance coverage information report) can be used to estimate how much of an individual's out-of-pocket expenses, in dollars, are paid before insurance payments. For example, you can take the dollar amount of the estimated amount of the out-of-pocket expenses of your child receiving health care through the Health Connector (HMO) and then apply that amount to the Health Connector Premium Payment rate to get an estimate for the actual amount of the out-of-pocket expenses. You can calculate your total, out-of-pocket expenses using this information, plus any credits under Part C, and add them together. This will give you the overall cost of the plan. If the average out-of-pocket cost is less than 200, you can exclude the excess. However, you cannot deduct more than 2,500 (4,500 at an income level of 100% of the Federal Poverty Level) (other than a single individual whose income is below 100% of the Federal Poverty Level) for any tax year. (see the instructions for Part 4 of Form 1040 for additional information) Your coverage should be current and accurate.

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