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Printed: 05/20/2021 Form Approved OMB No. 09380391Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
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Prairie Grove Health and is a form required to be filed by businesses to report their healthcare coverage offerings to the IRS.
Employers with 50 or more full-time employees or equivalents are required to file Prairie Grove Health and forms.
You can fill out Prairie Grove Health and forms electronically or manually with the required information about healthcare coverage offered to employees.
The purpose of Prairie Grove Health and is to provide the IRS with information about the healthcare coverage options offered by employers to employees.
Information such as the type of healthcare coverage offered, the number of employees covered, and the cost of coverage must be reported on Prairie Grove Health and forms.
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