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FOR BHF USELL1
2021STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2021)
I.DPH License ID Number:
Facility
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What is benefits h?
Benefits h refers to a specific form used to report certain benefits to employees.
Who is required to file benefits h?
Employers who provide specific benefits to employees are required to file benefits h.
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Benefits h can be filled out electronically or by paper. Employers must provide certain information about the benefits provided to employees.
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The purpose of benefits h is to report certain benefits provided to employees for tax purposes.
What information must be reported on benefits h?
Information such as the value of the benefits provided, the type of benefits, and the number of employees receiving the benefits must be reported on benefits h.
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