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New Health Insurance Marketplace Coverage Options and Your Health CoverageForm Approved OMB No. 12100149 (expires 6302023)PART A: General Information When key parts of the health care law take effect
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Obtain the necessary forms from your employer.
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Provide details about your previous health insurance coverage, if applicable.
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An employer-sponsored health plan is a health insurance plan provided by an employer to its employees as part of their benefits package.
Employers who provide health coverage to their employees are required to file reports regarding their employer-sponsored health plans.
To fill out an employer-sponsored health form, employers must provide information about the plan, the employees covered, and the costs associated with the coverage.
The purpose of an employer-sponsored health plan is to provide employees with affordable health insurance coverage and to comply with regulatory requirements.
Employers must report information such as employee details, coverage offered, months of coverage, and any safe harbor information related to affordability.
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