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Form 1098 for South Carolina: What You Should Know

To request a copy of your 1095-B using the mail, mail a printed copy of your Form 1090-S to: Office of the Chief Counsel U.S. Department of Health and Human Services 1200 New Jersey Ave. NW Room S6-300 Washington, DC 20220 To request a copy of your Form 1095-B using the mail, mail the original Form 1095-B along with a letter requesting a copy of the form to: U.S. Department of Health and Human Services 1200 New Jersey Ave. NW Room S6-300 Washington, DC 20220 To request a copy of your 1095-B using the mail, mail completed Form 1095-B and your IRS-generated 1095-B request form to: U.S. Department of Health and Human Services 1200 New Jersey Ave. NW Room S6-300 Washington, DC 20220 To access Form 1095-B online, go to IRS.gov/Forms1095s. You will need your IRS social security number of your individual taxpayer identification number on the left side of the form to complete and submit using the online request forms. A: You can complete any of the steps listed under “A.1” in the table below to receive your Form 1095-B. If you completed some steps under “A.1” for more than one person, you need to complete the steps for each dependent. Do not select any of the boxes. A.1. Fill in each box to identify the person with whom you file and who provided you with or would be responsible for providing health coverage for the entire year, including health coverage provided to your spouse. Include the following: Name (Surname or First Name) Address(BS) Income Category The information in box 4 may be included in boxes 1 to 6. Only the income category of “100% self- insured” or “250% self insured” is required. Other income categories may still be provided with dependent information in boxes 1 to 6. NOTE: Only one box for each person is required. Health Coverage — Self-Insured — Indicates coverage under your own name and employer sponsored individual market plans. Coverage could have been available even if you were not the primary insured.

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