Iowa online Form 1094-C 2024-2025

Iowa online Form 1094-C: What You Should Know

Notice of Intent to Acquire A4: A copy of any notice of intent to acquire you for the purpose of qualifying an item, sale, or acquisition, including an announcement of the proposed transaction. If you are a member of a grandfathered health plan, you should also consider an affidavit that states whether you received a notice of intended acquisition. Answers for the 1094-C & 1095-C Questions You should use the information on this section to answer those questions. Are you a member of a grandfathered health plan or a health plan? Yes No Is your grandfathered health plan (i.e., plan year beginning January 1, 2011, and continuing through the end of 2011) eligible for the health insurance Marketplace as described in section 1311(d) of the Patient Protection and Affordable Care Act (PACA)? Yes No Has a notice of intent to acquire been issued for the plan? Yes No Have a copy of the notice of intent to acquire been transmitted to the Federal or State agency with responsibility for investigating the plan? Yes No Have you paid the required premium and any applicable taxes and other applicable penalties? Yes No Under the conditions described in section 1311(d) of PACA, did you have to report the health insurance coverage information for the plan under section 1094-C or 1095-C? Yes No Under the conditions described in section 1311(e) (d) (i) (ii) (iii) of PACA, is there a notice of intention to acquire you for the purposes of qualifying an item or sale of property under section 1094-C or 1095-C which has been reported to the National Health Board for review and determination? Yes No The IRS has approved my health insurance coverage at this time. Yes No If you are a member of a grandfathered health plan, it is expected that the IRS will approve your grandfathered health plan and report you as a current member on an 1140 or 1095-C. For more information on your current status, visit the Forms 1040 and 1095.

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