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Form 941 for Orlando Florida: What You Should Know
Form 1095-C includes information for non-dependents that you might be entitled to. If you receive the coverage through an employer, you may contact the help desk at 920-565 for more information. 2018 Florida Blue Cross Blue Shield Affordable Care Act Coverage Form 1095-B 2018 Florida Blue Cross Blue Shield Affordable Care Act Coverage Form 1095-C Please contact the help desk at 920-565 This Form 1095-C includes information for non-dependents that you can receive coverage through an employer if: your plan is offered through FL Blue Cross Blue Shield (BCBS) or your plan is a health insurance Plan offered through your employer (or you are offered the plan). If this is your (your) health insurance, you should provide the following information on the form. (this information must be on every Form 1095-C that you apply for or re-apply for your coverage: • A statement that this health coverage is your only coverage • The name and address of your coverage provider(s). • The total out-of-pocket expenses per year for this coverage in the form shown on your 1095-B If you will be required to be covered under a qualified plan on your self, you should provide the following information: • A statement that this type of coverage is your only coverage • The name of your qualified plan(s) (or their telephone number) • The total out-of-pocket expenses per year for this coverage in the form shown on your 1095-B NOTE: This Form 1095-C is not a contract, and it does not change, restrict or eliminate rights or requirements in your existing insurance. Any changes to your existing insurance or coverage should be made within 90 days of this Form 1095-C being submitted. If you would like to speak with someone right away, the help desk at 920-565 has a staffed answering service available. We cannot answer general questions about this form, because not all federal, state or local laws apply to (your) insurance benefits If this is your (your) health insurance, you should provide the following information with your application: • A statement that this health insurance is your only coverage • The name of your health insurance provider(s).
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