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Employer Name Novant Health Inc. 4. Employer Identification Number EIN 56 1376950 5. Employer Address 4020 Kilpatrick Street 6. Employer Phone Number 1. 800. 890. 5420 7. City Winston Salem 8. State NC 9. Zip Code 27104 10. Health Coverage Contact Novant Health Human Resources Service Center 11. Here is the employer information you will enter when you visit HealthCare. gov to find out if you can get a tax credit to lower your monthly premiums. If you decide to shop for coverage in the...
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01
Begin by opening the affordable-care-act-dependent-ssn-collection-mandate 2017docx document.
02
Read through the form to familiarize yourself with the information required.
03
Locate the section that pertains to dependent Social Security Number (SSN) collection.
04
Enter the SSN of each qualified dependent in the designated fields.
05
Double-check the accuracy of the provided SSNs to avoid any errors.
06
If a dependent does not have an SSN, follow the instructions provided in the form to indicate the reason.
07
Once all the required information has been filled out, review the entire form for completion.
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The affordable-care-act-dependent-ssn-collection-mandate 2017docx is required for individuals who are responsible for providing healthcare coverage under the Affordable Care Act (ACA) and have dependents.
02
This form ensures that accurate Social Security Numbers (SSNs) of dependents are collected to maintain compliance with the ACA regulations.
03
Those who need to fill out this form include employers, health insurance providers, or individuals who provide self-insured healthcare coverage for themselves and eligible dependents.
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The affordable-care-act-dependent-ssn-collection-mandate docx is a document that specifies the requirement to collect Social Security Numbers (SSNs) for dependents under the Affordable Care Act.
Employers and healthcare providers are required to file the affordable-care-act-dependent-ssn-collection-mandate docx.
To fill out the affordable-care-act-dependent-ssn-collection-mandate docx, you must accurately provide the required information for each dependent including their Social Security Number.
The purpose of the affordable-care-act-dependent-ssn-collection-mandate docx is to ensure accurate reporting of dependents' SSNs for tax and healthcare coverage purposes.
The information reported on the affordable-care-act-dependent-ssn-collection-mandate docx includes the names and Social Security Numbers of each dependent.
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