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New Health Insurance Marketplace Coverage Options and Your Health CoverageForm Approved OMB No. 12100149 (expires 5312020)PART A: General Information When key parts of the health care law take effect
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How to fill out affordable based on employee

01
Gather all necessary employee information, including income and household size.
02
Obtain the Affordable Care Act (ACA) application form specific to your state.
03
Fill out the personal information section with the employee's name, address, and contact details.
04
Provide details about the employee's income, ensuring it is accurate and up-to-date.
05
List any additional household members, including their income if it affects eligibility.
06
Select a health plan based on the options available through the ACA marketplace.
07
Review the application for accuracy before submission.
08
Submit the application either online, by mail, or in-person, depending on your state’s process.
09
Follow up to confirm the application has been received and processed.

Who needs affordable based on employee?

01
Employees who do not have adequate health coverage through their employer.
02
Individuals seeking to lower their healthcare costs.
03
Families with limited income who qualify for subsidies.
04
Employees looking for comprehensive health insurance options with affordability.
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Affordable based on employee refers to the cost of employer-sponsored health insurance that does not exceed a certain percentage of an employee's household income, as defined by the Affordable Care Act (ACA).
Applicable Large Employers (ALEs), typically those with 50 or more full-time equivalent employees, are required to file information regarding affordable health insurance offered to employees under the ACA.
To fill out affordable based on employee, employers must complete IRS Form 1095-C, detailing the health coverage offered, employee information, and whether the coverage is considered affordable.
The purpose of affordable based on employee is to ensure that employees have access to affordable health insurance and to comply with federal healthcare regulations under the ACA.
Employers must report information such as the employee's name, SSN, the months they were covered, the type of coverage offered, the affordability of the plan, and employee cost for the lowest cost self-only coverage.
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