• Understand who will receive Form A; who will receive Form B. • Explain the information on each form. • Understand why some people will receive more than one form. • Identify when you need to refer consumers to either NY State of Health, the health plans, LDSS/HRA, a tax professional or . A separate form will be available for each Medicaid, Child Health Plus and EP consumer, even if multiple children are on the same Child Health Plus policy. These forms are only provided upon request. Please contact NY State of Health to request a Form B. • Phone: • E-mail: B@bltadwin.ru • Mail: NY State of Health. NY State of Health sends enrollment information to QHP enrollees in January - Form – A from NY State of Health. Step 2: Consumers reconcile APTC or claim PTC on their federal tax return during tax filing season - Use Form A from NY State of Health to complete IRS Form Step 3.
Cat. No. B Form B () f Page 2 Form B () Instructions for Recipient This Form B provides information about the individuals in your tax family (yourself, spouse, and dependents) who had certain health coverage (referred to as "minimum essential coverage") for some or all months during the year. MANAGED CARE ORGANIZATION FOCUSED SURVEY CITATIONS Focused Survey Overview: The Department of Health monitors MCOs on an ongoing basis for compliance with Public Health Law Articles 44 NYCRR Part 98, the Medicaid Model Contract for those plans offering Medicaid, and other State and federal laws and regulations as applicable. Mail: NY State of Health P.O. Box , Albany, NY 2. What do I need to do with Form B from the NYS Department of Health? If you would like a copy of your Form B for your records, you can contact NY State of Health at or at the email or mailing address listed above. This document provides information to verify.
If you think we made a mistake on this Form B, call New York State Department of Health as soon as possible at If you have a question about the A or C tax forms you may have received, call the number on those forms. For more information about form B, and other health care tax documents, please visit bltadwin.ru Form B Consumers enrolled in Medicaid, Child Health Plus and Essential Plan (EP) may request a copy of Form B from the NYS Department of Health. For Medicaid, this includes individuals whose coverage is through Local Departments of Social Services (LDSS), Human Resources Administration (HRA), or NY State of Health. • Understand who will receive Form A; who will receive Form B. • Explain the information on each form. • Understand why some people will receive more than one form. • Identify when you need to refer consumers to either NY State of Health, the health plans, LDSS/HRA, a tax professional or the IRS.
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