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Printable Form 1095-C Sunnyvale California: What You Should Know

Form 1095-C, Part. I ‚ÄĒ Coverage Offer Employers and employee groups may choose to offer group health insurance coverage through their group health plan (also known as a group health insurance issuer), if qualified. Employers may also choose to offer¬† employee group health insurance coverage through their organization (also known as a group health insurance carrier), if qualified.¬† If you do elect to offer your employee group health insurance coverage through your organization, you must:¬† 1. Use the Form 1095-C, Part I, to provide each participant with the employer contribution and premium amounts. See¬†Employee Contributions¬†and Premiums in Part V. However, see¬†Part IX, Exceptions, for other ways you may elect to offer employee group health insurance coverage with the Form 1095-C, Part I. 2. Provide the participant or beneficiary with a copy of the Employer's Offer of Coverage Notice, and the Employer's Offer of¬†Coverage Notice to the participants or beneficiaries. 3. Provide the participant or beneficiary with a Form 1095-C, Part II (and attach documentation to support the claim for coverage), describing each of the following: the benefits offered; the employee contribution to the benefit (the contribution portion of the Form 1095-C), and the premium contributions (the contribution amounts, if any), and the amount of the employee contribution to the contribution (the cost-sharing section of the Form 1095-C). The employer has the option of using one version or the other for each participant or beneficiary.¬†4. Provide the participant or beneficiary with a notice describing the choices for which he or she may be eligible to make a claim for reimbursement of health insurance coverage, and a notice describing when he or she will receive a Form 1095-C, Part I or Part II. If a participant or beneficiary is determined eligible to make a claim for reimbursement through a Form 1095-C, Part II, he or she should receive the notice describing benefits available in accordance with those benefits in accordance with the rules used to determine eligibility and the rules used to determine the amount reimbursed. If the benefits are unavailable because of a failure to comply with section 502(a)(1), the participant or beneficiary will receive a Form 1095-C, Part III that describes the options available as to what is provided as a health benefits package.

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