Printable Form 5558 Louisville Kentucky 2024

Printable Form 5558 Louisville Kentucky: What You Should Know

The name of a plan which is: (a) the name of a group health plan, (b) an individual health plan, (c) an HMO plan or (d) a health maintenance organization (HMO) plan. If you have a group health plan, you may enter the health plan, the name of the plan, the group, the number of employees covered and employer identification numbers (Wins) of the employees. Enter all the required information (see part II of this form) for an employee group health plan. Also, enter a check mark on Part II-A if: (1) You are an individual (2) You are the employee of a group Employee health benefit plan, or a group health plan and a health maintenance organization (HMO), (a) for which you have provided the required minimum basic coverage in a self-insured plan you control; or (b) for which an employee was eligible before October 1, 2005, or after October 1, 2005, but prior to June 1, 2018. See also Part V, page 11, “Type of Benefit Plan” if the type and amount of benefits you receive from your plan is not described in chapter 5 (which has no part in this form). (a) for which you have provided the required minimum basic coverage in a self-insured plan you control; or (b) for which an employee was eligible before October 1, 2005, or after October 1, 2005, but prior to June 1, 2018. See also Part V, page 11, “Type of Benefit Plan” if the type and amount of benefits you receive from your plan is not described in chapter 5 (which has no part in this form). (c) for which you provided the required minimum basic coverage in a self-insured plan you control on or after January 1, 2006, or for which an employee was eligible before April 1, 2014, unless you provide an exemption under section 6055. (c) for which you provided the required minimum basic coverage in a self-insured plan you control on or after January 1, 2006, or for which an employee was eligible before April 1, 2014, unless you provide an exemption under section 6055.

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