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13477 Rev. 07/06 AmeriHealth Insurance Company of New Jersey FCC Insurance Company d/b/a AmeriHealth Insurance Company AmeriHealth HMO, Inc. Part 1 Cardholder/ Patient Information Part 1 must be fully

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wwwfhfagov is the official website for filing the Federal Health Insurance Marketplace Form, which is used for reporting health insurance coverage and compliance with the Affordable Care Act.

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Individuals and entities that are subject to the ACA reporting requirements, including employers providing health insurance, health coverage issuers, and anyone else mandated to report compliance with health coverage provisions.

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The purpose of wwwfhfagov is to ensure compliance with reporting requirements under the Affordable Care Act, allowing for the verification of health insurance coverage for individuals and to facilitate the administration of tax credits.

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Information that must be reported includes details about the type of health insurance coverage provided, names and Social Security numbers of covered individuals, coverage start and end dates, and the months of coverage.

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