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IMPORTANT HEALTH COVERAGE TAX DOCUMENTS
NOTICE
OF RIGHT TO REQUEST TAX NOTIFICATION FORM 1095-B
You do not need to file a 1095 form with your federal tax
return, but some members may need the form to comply with state reporting
requirements. Members and beneficiaries may request a copy of their Form 1095-B
by:
Email to: 1095Bhelp@benesys.com
Calling: (248) 641-4950 between
7:00 AM and 4:30 PM EST
Mail to:
BeneSys, Inc.
700 Tower Drive,
Suite 300
Troy, MI 48098-2808
ATTN: 1095-B Requests
Your request MUST include: (1) your Plan’s name, (2) the
member’s name, (3) your name if you are not the primary member, (4) the address
you would like the form sent to and (5) the phone number we can call if we have
any questions.
Please call (800) 572-2525 or (248) 641-4950 with any questions about
Form 1095-B.