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ACTION: Originate: 03/16/2009 11:35 Ampule Summary and Fiscal Analysis (Part A) Attorney General Agency NameConsumer Protection Doug CrewDivisionContact30 E. Broad Street, 17th floor Columbus OH 43215342861499503286146446135Agency
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Step 1: Gather all necessary information including personal information, income information, and health coverage information.
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Step 2: Fill out the taxpayer information section including name, address, and SSN.
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Step 3: Fill out the information for each dependent covered under the plan.
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Step 4: Provide information about the health coverage including the type of coverage, coverage period, and enrollment status.
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Who needs 1095-1-03 new?

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Individuals who have had minimum essential health coverage during the tax year.
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Health insurance providers who offer coverage to individuals.
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1095-1-03 new is a tax form used to report information about health insurance coverage.
Employers with 50 or more full-time employees or self-insured employers are required to file 1095-1-03 new.
You can fill out 1095-1-03 new by providing information about the individuals covered under the health insurance plan.
The purpose of 1095-1-03 new is to provide information to the IRS about health insurance coverage to ensure compliance with the Affordable Care Act.
Information such as the names of covered individuals, their Social Security numbers, and the months in which they were covered must be reported on 1095-1-03 new.
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