Hannah Biddix

Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level office assistant position. Ready to help team achieve company goals.

• DEPARTMENT OF HEALTH & HUMAN SERVICES
• 465 INDUSTRIAL BOULEVARD
• LONDON, KENTUCKY 40750-0001
• Hannah Biddix
• 235 Buff Creek Rd
• Sylva, NC 28779-8037
• Jan 03, 2025
• Application ID: 5319762655
• Plan Name: Silver S: Aetna network of doctors hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7
• You must file a tax return if your IRS Form 1095-A shows that you got advance payments of the premium tax credit. See Part III, Column C on your form.
• Use Form 1095-A to complete IRS Form 8962 “Premium Tax Credit (PTC)” and include it with your federal income tax return when you file. If you don't, you may have to pay back some or all of the tax credit you got last year.
• Hannah Biddix:
• Enclosed is your tax Form 1095-A about your Health Insurance Marketplace coverage. You’re getting this form because you and/or members of your household had Marketplace coverage for all or some part of 2024.
• This form has important information you’ll need to fill out your federal income tax return. We also shared this information with the Internal Revenue Service (IRS). Keep this form for your records.
• You must file a tax return
• You must file a federal income tax return if you or another member of your household got advance payments of the premium tax credit in 2024 to lower premium costs, even if you don’t normally file a return. If you don’t file a tax return:
• You may have to pay back all or some of the advance payments of the premium tax credit you got.
• You won’t qualify for advance payments of the premium tax credit or cost-sharing reductions to help pay for your Marketplace coverage in future years.
• Complete IRS Form 8962 and include it when you file your taxes. You’ll use the information on Form 1095-A to complete Form 8962. The Form 1095-A also states which months of 2024 you and other household members had coverage. You’ll need that information to complete IRS Form 8962. Get more details on the back of the enclosed form. If you need IRS Form 8962, visit IRS.gov/aca.
• Why Form 1095-A is important
• Form 1095-A includes information about:
• You and any other members of your household who were enrolled in a Marketplace plan in 2024.
• Your Marketplace plan premium and other information you may need to fill out your federal income tax return and claim the premium tax credit.
• The amount of any advance payments of the premium tax credit we paid in 2024 to a health plan for your household.
• To learn more about using your form, visit HealthCare.gov/tax-form-1095.
• You may need more information to complete your tax return
• When you file your 2024 taxes, you’ll need more information about your premium tax credit if:
• You had changes in your household that you didn't report to the Marketplace - like having a baby, moving, getting married or divorced, or losing a dependent.
• Your Form 1095-A has zeroes printed in Part III, Column B for the months you had coverage.
• Visit HealthCare.gov/tax-tool to get the information you need if either of these apply to you.
• Changes to your Form 1095-A information
• If you think information on the enclosed Form 1095-A is wrong, call the Marketplace Call Center at 1-800-318-2596 to find out how to get a corrected Form 1095-A. TTY users should call 1-855-889-4325.
• You may get more than one Form 1095-A
• You may get more than one Form 1095-A. This can happen if different members of your household had different health plans, you updated your coverage information during 2024, or you switched plans during 2024. Be sure to keep all 1095-A forms with your important tax documents.
• You also may get IRS Form 1095-B or IRS Form 1095-C
• If you or members of your household had coverage in 2024 through other programs or plans outside the Marketplace, you may also get a “Form 1095-B, Health Coverage” or “Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.” Follow the instructions on these forms when you fill out your tax return.
• NOTE: If you’re enrolled in another type of health coverage that qualifies as minimum essential coverage (for example, Medicare Part A) and got a Form 1095-B, you may no longer be eligible to get financial assistance for your Marketplace plan. It’s important to contact the Marketplace and report any changes in your coverage as soon as possible. For more information, visit HealthCare.gov/taxes/other-health-coverage.
• How to get help with your taxes
• Many people can get free help to fill out their taxes. Visit IRS.gov/VITA to learn more. You can also visit IRS.gov/FreeFile for electronic filing options.
• If you need more information, visit HealthCare.gov/taxes.
• For more help
• Visit IRS.gov if you have questions about your taxes.
• For questions about Marketplace coverage, visit HealthCare.gov, or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.
• Make an appointment with someone in your area who can help you. Information is available at LocalHelp.HealthCare.gov.
• Get help in a language other than English. Information about how to access these services is included with this notice and available through the Marketplace Call Center.
• Call the Marketplace Call Center to get this information in an accessible format, like large print, braille, or audio, at no cost to you.
• Sincerely
• Health Insurance Marketplace
• Department of Health and Human Services
• 465 Industrial Boulevard
• London, Kentucky 40750-0001
• Privacy Disclosure: The Health Insurance Marketplace protects the privacy and security of the personally identifiable information (PII) that you have provided (see HealthCare.gov/privacy). This notice was generated by the Marketplace based on 45 CFR 155.230 and other provisions of 45 CFR part 155, subpart D. The PII used to create this notice was collected from information you provided to the Health Insurance Marketplace. The Marketplace may have used data from other federal or state agencies or a consumer reporting agency to determine eligibility for the individuals on your application. If you have questions about this data, contact the Marketplace at 1-800-318-2596 (TTY: 1-855-889-4325).
• According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1207.
• Nondiscrimination: The Health Insurance Marketplace doesn’t exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, disability, sex (including sexual orientation and gender identity), or age. If you think you’ve been discriminated against or treated unfairly for any of these reasons, you can file a complaint with the Department of Health and Human Services, Office for Civil Rights by calling 1-800-368-1019 (TTY: 1-800-537-7697), visiting hhs.gov/ocr/civilrights/complaints, or writing to the Office for Civil Rights/ U.S. Department of Health and Human Services/ 200 Independence Avenue, SW/ Room 509F, HHH Building/ Washington, D.C. 20201.
• Health Insurance Marketplace is a registered service mark of the U.S. Department of Health and Human Services.
• Form 1095-A
• Health Insurance Marketplace Statement
• Department of the Treasury
• Internal Revenue Service
• Do not attach to your tax return. Keep for your records.
• Go to www.irs.gov/Form1095A for instructions and the latest information.
• Part I Recipient Information
• 1 Marketplace identifier NC
• 2 Marketplace-assigned policy number 153598784
• 3 Policy issuer’s name Aetna CVS Health
• 4 Recipient’s name Hannah Biddix
• 5 Recipient’s SSN xxx-xx-2355
• 6 Recipient’s date of birth
• 7 Recipient’s spouse’s name
• 8 Recipient’s spouse’s SSN
• 9 Recipient’s spouse’s date of birth
• 10 Policy start date 01/01/2024
• 11 Policy termination date 01/31/2024
• 12 Street address (including apartment no.) 235 Buff Creek Rd
• 13 City or town Sylva
• 14 State or province NC
• 15 Country and ZIP or foreign postal code US 28779
• Part II Covered Individuals
• A. Covered individual name
• B. Covered individual SSN
• C. Covered individual date of birth
• D. Coverage start date
• E. Coverage termination date
• 16 Hannah Biddix xxx-xx-2355 01/01/2024 01/31/2024
• Part III Coverage Information
• Month
• A. Monthly enrollment premiums
• B. Monthly second lowest cost silver plan (SLCSP) premium
• C. Monthly advance payment of premium tax credit
• 21 January 452.67 420.71 421.00
• 22 February 0.00 0.00 0.00
• 23 March 0.00 0.00 0.00
• 24 April 0.00 0.00 0.00
• 25 May 0.00 0.00 0.00
• 26 June 0.00 0.00 0.00
• 27 July 0.00 0.00 0.00
• 28 August 0.00 0.00 0.00
• 29 September 0.00 0.00 0.00
• 30 October 0.00 0.00 0.00
• 31 November 0.00 0.00 0.00
• 32 December 0.00 0.00 0.00
• 33 Annual Totals 452.67 420.71 421.00
• For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
• Form 1095-A (2024)
• Instructions for Recipient
• You received this Form 1095-A because you or a family member enrolled in health insurance coverage through the Health Insurance Marketplace. This Form 1095-A provides information you need to complete Form 8962, Premium Tax Credit (PTC). You must complete Form 8962 and file it with your tax return (Form 1040, Form 1040-SR, or Form 1040-NR) if any amount other than zero is shown in Part III, column C, of this Form 1095-A (meaning that you received premium assistance through advance payments of the premium tax credit (also called advance credit payments) or if you want to take the premium tax credit. The filing requirement applies whether or not you’re otherwise required to file a tax return. If you are filing Form 8962, you cannot file Form 1040-NR-EZ, Form 1040-SS, or Form 1040-PR. The Marketplace has also reported the information on this form to the IRS. If you or your family members enrolled at the Marketplace in more than one qualified health plan policy, you will receive a Form 1095-A for each policy. Check the information on this form carefully. If you think the information is incorrect, or if you think you should not have received a Form 1095-A because neither you nor anyone else in your family was enrolled in Marketplace health insurance, please contact your Marketplace Call Center. If you purchased insurance through the Federally-facilitated Marketplace, you can find your Marketplace Call Center information at www.HealthCare.gov/contact-us/. If you purchased insurance through a State-based Marketplace, you can find your Call Center information at your State-based Marketplace website. You can find a list of State-based Marketplace websites at www.healthcare.gov/marketplace-in-your-state/. If you or your family members were enrolled in a qualified dental plan with pediatric benefits, this column includes the portion of the dental plan premiums for the pediatric benefits. If your plan covered benefits that aren’t essential benefits, such as adult dental or vision benefits, the amount in this column will be reduced by the premiums for the nonessential benefits. If the policy was terminated by your insurance company due to nonpayment of premiums for 1 or more months, then a -0- may appear in this column for these months regardless of whether advance credit payments were made for these months. See the instructions for Form 8962, Part II, on how to complete Form 8962 if -0- is reported for 1 or more months.
• Column B. This column is the monthly premium for the second lowest cost silver plan (SLCSP) that the Marketplace has determined applies to members of your family enrolled in the coverage. The applicable SLCSP premiums is used to compute your monthly advance credit payments and the premium tax credit you take on your return. See the instructions for Form 8962, Part II, on how to use the information in this column or how to complete Form 8962 if there is no information entered, the information is incorrect, or the information is reported as -0-. If the policy was terminated by your insurance company due to nonpayment of premiums for 1 or more months, then a -0- may appear in this column for the months, regardless of whether advance credit payments were made for those months.
• Column C. This column is the monthly amount of advance credit payments that were made to your insurance company on your behalf to pay all or part of the premiums for your coverage. If this is the only column in Part III that is filled in with an amount other than zero for a month, it means your policy was terminated by your insurance company due to nonpayment of premiums and you aren’t entitled to take the premium tax credit for that month when you file your tax return. You must still reconcile the entire advance payment that was paid on your behalf for that month using Form 8962. No information will be entered in this column if no advance credit payments were made.
• Lines 21–33. The Marketplace will report the amounts in columns A, B, and C of lines 21–32 for each month and enter the totals on line 33. Use this information to complete Form 8962, line 11 or lines 12–23.
• This Notice Has Important Information. This notice has important information about your application or coverage through the Health Insurance Marketplace. Look for key dates in this notice. You may need to take action by certain deadlines to keep your health coverage or help with costs. You have the right to get this information and help in your language at no cost. Call 1-800-318-2596 and wait through the opening. When an agent answers, state the language you need and you’ll be connected with an interpreter.
• العربية (Arabic) يحتوي هذا الإشعار على معلومات هامة تتعلق بطلبك أو تغطيتك من خلال سوق التأمين الصحي. ابحث عن تواريخ رئيسية في الإشعار. قد تحتاج إلى اتخاذ إجراء ما قبل مواعيد نهائية معينة للحفاظ على تغطيتك الصحية أو الحصول على المساعدة في التكاليف. لديك الحق في الحصول على هذه المعلومات والمساعدة بلغتك دون أي تكلفة. اتصل بالرقم 1-800-318-2596 وانتظر حتى يتم الرد على المكالمة. عندما يجيب أحد الموظفين، أذكر اللغة التي تحتاجها وسيتم ربطك بمترجم.
• 中文 (Chinese) 本通知包含有关您通过健康保险市场的申请或保险的关键信息。查找本通知中列出的重要日期。您可能需要在某些截止日期前采取措施以保持您的健康保险或帮助降低费用。您有权免费获得以您的语言提供的信息和帮助。拨打 1-800-318-2596，等待开场白结束后接通电话。请说明您所需的语言种类，工作人员将为您安排翻译。
• Français (French) Cet avis contient des informations importantes concernant votre demande ou votre couverture à travers le Marché d’assurance maladie. Recherchez les dates clés dans le présent avis. Vous pourrez avoir besoin de prendre des mesures avant certaines dates limites afin de garder votre couverture santé ou de vous aider avec les coûts. Vous avez le droit d’obtenir ces informations et de l’aide dans votre langue sans frais. Appelez le 1-800-318-2596 et appuyez sur « 0 » à deux reprises attendues à travers l’ouverture. Quand l’agent répond indiquez la langue dont vous avez besoin et vous serez mis en relation avec un interprète.
• Kreyòl Ayisyen (Haitian Creole) Avi sa a gen enfòmasyon enpòtan sou aplikasyon w lan oswa pwoteksyon atravè Health Insurance Marketplace la. Gade pou dat kle nan avi sa a. Ou ka bezwen pran kèk aksyon nan yon sèten dat limit pou ou kenbe asirans sante ou oswa ede ak depans yo. Ou gen dwa pou ou jwenn enfòmasyon sa a ak èd nan lang ou san pa koute ou anyen. Rele 1-800-318-2596 epi rete tann. Lè yon ajan reponn, di lang ou bezwen an epi yo pral konekte ak yon entèprèt.
• Deutsch (German) Diese Benachrichtigung enthält wichtige Informationen zu Ihrem Antrag oder der Versicherung durch den Health Insurance Marketplace. Suchen Sie nach wichtigen Terminen in dieser Benachrichtigung. Möglicherweise müssen Sie Maßnahmen vor bestimmten Stichtagen handeln, um Ihre Krankenversicherung aufrechtzuerhalten oder Hilfe mit Kosten zu erhalten. Sie haben das Recht, diese Informationen und Hilfe in Ihrer Sprache kostenlos zu erhalten. Rufen Sie 1-800-318-2596 an und warten Sie die Ansage ab. Wenn sich ein Mitarbeiter meldet, wählen Sie die Sprache aus, die Sie benötigen und Sie werden mit einem Dolmetscher verbunden.
• ગુજરાતી (Gujarati) આ સૂચનામાં તમારા આરોગ્ય વીમા માર્કેટપ્લેસ દ્વારા તમારા અરજી અથવા કવરેજ વિશે મહત્વપૂર્ણ માહિતી છે. આ સૂચનામાં મુખ્ય તારીખો માટે જુઓ. તમારે તમારા આરોગ્ય કવરેજને જાળવવા અથવા ખર્ચમાં મદદ કરવા માટે ચોક્કસ સમયમર્યાદા દ્વારા પગલાં લેવા જરૂરી હોઈ શકે છે. તમને આ માહિતી અને મદદ તમારી ભાષામાં મફતમાં મેળવવાનો અધિકાર છે. 1-800-318-2596 પર કૉલ કરો અને ખુલ્લા થવા માટે રાહ જુઓ. જ્યારે એક એજન્ટ જવાબ આપે છે, ત્યારે તમારે જે ભાષા જોઈએ તે જણાવો અને તમને દભાષીય સાથે જોડવામાં આવશે.
• Italiano (Italian) Questo avviso contiene informazioni importanti riguardo la sua richiesta
• Copertura assicurativa tramite l’Health Insurance Marketplace. Controlli le date più importanti di questo avviso. Potrebbe avere la necessità di compiere alcune azioni al fine di conservare la sua copertura medica
• Per ridurre i costi. Hai il diritto di ricevere queste informazioni ed assistenza nella sua lingua senza costi aggiuntivi. Chiami al 1-800-318-2596 e resti in attesa del primo operatore disponibile. Quando un nostro operatore risponderà, comunichi la lingua di cui ha bisogno e sarà collegato/a con un interprete.
• 日本語 (Japanese) この通知には重要な情報が含まれています。この通知には、Health Insurance Marketplace 経由のアプリケーションまたは補償範囲に関する重要な情報が含まれます。この通知では、重要な期日に注意してください。補償範囲や費用を維持するためには、特定の期日までに実行する必要がある場合があります。これらの情報を無料で取得する権利がありお客様の言語でサポートを受ける権利があります。1-800-318-2596 にお問い合せいただき、つながるまでお待ちください。エージェントにつながりましたら、必要な言語を伝えて、通訳者とつながります。
• 한국어 (Korean) 이 통지서에는 건강 보험 시장을 통한 귀하의 신청이나 보험 커버리지에 관한 중요한 정보가 포함되어 있습니다. 이 통지서에 나타난 중요한 날짜들을 잘 찾아 보십시오. 귀하는 귀하의 보험 커버리지를 계속 유지시키거나 비용을 절감하는 도움을 얻기 위해서 일정한 마감일 까지 필요한 조치를 취해야 할 수도 있습니다. 귀하는 귀하의 언어로 이 정보와 도움을 무료로 받을 수 있는 권리가 있습니다. 1-800-318-2596 로 전화하시고 연결되기 전에 기다리십시오. 직원이 응답하면 받으면 귀하가 필요한 언어를 말씀하십시오. 그러면 귀하와 통역사와 연결될 것입니다.
• Polski (Polish) To ogłoszenie zawiera ważne informacje odnośnie Państwa wniosku
• Ubezpieczenie lub polisy zdrowotnej zakupionej przez Rynek Ubezpieczeń Zdrowotnych. Prosimy zwrócić uwagę na kluczowe daty zawarte w tym ogłoszeniu aby przy podejmowaniu ewentualnych decyzji dotyczących odnowienia polisy lub pomocy związanej z kosztami, nie przekroczyć terminów. Macie Państwo prawo do bezpłatnej informacji we własnym języku. W tym celu prosimy
• Telefon pod numer 1 800 318 2596, następnie proszę poczekać na zgłoszenie się operatora i wypowiedzenie preferowanego języka a rozmowa zostanie przełączona do tłumacza.
• Português (Portuguese) Este aviso contém informações importantes sobre sua aplicação ou cobertura ao longo do Mercado de Planos de Saúde (Health Insurance Marketplace). Observe as datas importantes nesse aviso. Você poderá precisar tomar medidas, até determinadas datas, para manter sua cobertura médica ou ajuda de custo. Você tem
• Direito de obter tais informações e auxílio em seu idioma, sem custo algum. Ligue para 1-800-318-2596 e espere através da introdução. Quando
• Agente atende, afirme
• Idioma que precisa e você será transferido para um intérprete.
• Русский (Russian) В настоящем уведомлении содержится важная информация о вашей заявке или вашей страховке через рынок медицинского страхования. Вы можете найти важные даты в данном уведомлении. Возможно, вам придется предпринять некоторые действия к конкретным срокам, с тем, чтобы сохранить вашу медицинскую страховку или финансовую помощь на медицинские расходы. Вы имеете право на получение этой информации и помощи на родном языке бесплатно. Позвоните по номеру 1-800-318-2596 и дождитесь вступительного информационного сообщения. Когда ответит агент, укажите необходимый язык, и вас соединят с переводчиком.
• Español (Spanish) Este aviso contiene información importante sobre su solicitud
• Cobertura a través del Mercado de Seguros Médicos. Consulte las fechas importantes que figuran aquí. Es probable que deba tomar medidas antes de algunas fechas clave para mantener su cobertura
• Seguir recibiendo ayuda para pagar los costos. Usted tiene derecho a recibir esta información y asistencia en su idioma en forma gratuita. Llame al 1-800-318-2596 y espere a través de la introducción. Cuando el agente atiende, indique el idioma que necesita y lo pondrán en comunicación con un intérprete.
• Tagalog (Tagalog) Ang paunawa na ito ay may nilalamang mahalagang impormasyon tungkol sa iyong aplikasyon
• Kaseguruhan sa pamamagitan ng Health Insurance Marketplace. Tingnan ang mga mahalagang petsa sa paunawang ito. Maaaring mangailangang gumawa ka ng hakbang sa loob ng mga itinakdang petsa upang mapanatili ang iyong kaseguruhan pangkalusugan
• Makatanggap ng tulong sa mga gastos. Mayroon kang karapatang makuha ang impormasyon na ito at tulong sa iyong wika ng walang gastos. Tumawag sa 1-800-318-2596 at maghintay ng pagkakataong mabuksan ang linya. Kapag sumagot ang isang ahente, sabihin ang kailangan mong wika at ikaw ay iuugnay sa isang tagapagsalin sa Tagalog.
• Tiếng Việt (Vietnamese) Thông báo này có thông tin quan trọng về đơn xin của quý vị hoặc hợp đồng bảo hiểm của chương trình Thị trường bảo hiểm sức khỏe Marketplace. Xin xem những ngày then chốt trong thông báo này. Quý vị có thể phải thực hiện theo thông báo đúng thời hạn để duy trì bảo hiểm sức khỏe hoặc được trợ giúp thêm về chi phí. Quý vị có quyền được biết thông tin này và được trợ giúp bằng ngôn ngữ của mình hoàn toàn miễn phí. Xin gọi 1-800-318-2596 và đợi nghe hết lời mở đầu. Khi nghe một nhân viên trả lời, hãy nói ngôn ngữ của mình là gì và quý vị sẽ được kết nối với một thông dịch viên.
• January 2022

• First and first aid