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Form 8965 for Orange California: What You Should Know

S. Mail to: Department of Health Care Financing and Development, Division of Health Insurance Exemptions, Medical Records Division, Attn: J.V. Williams, SAC/PhD (S/K/A), P.O. Box 114094, San Diego, CA 92 In some cases, you may be assigned a Medical Examiner (ME) or an assistant medical examiner (AME) to assist in the collection of evidence. The medical records may be collected by the Office of the Medical Examiner (OMA); see Medical Examiner Form 2881 and  The ME will assist the Medical Examiner to collect and preserve all pertinent physical evidence, including: any records that may be subject to disclosure; The ME, in collaboration with the City's Medical Examiner's Office or a hospital or doctor treating the patient who has the most extensive medical records, may be able to identify any records of the patient's death that may be pertinent to a decision regarding the status of the patient's claim for a coverage exemption. The State would need to review your claim in order to determine whether you qualified for the exemption. You should continue to pay all premiums, coinsurance, and deductibles on your health coverage during the months that you are claiming coverage exemption. See the “Coinsurance and Deductibles” section of the section on Health Coverage Exemptions for more details. Do NOT pay any out-of-pocket costs for the month when you file your statement at the end of the month 2018 Forms 990-EZ, 990-PF, 990-N, 990-PR and 995-S 2018 Form 990-EZ (Paid by Employer) 2018 Form 990-PF (Paid by Individuals) 2018 Form 990-N (Paid by Employer) 2018 Form 990-PR (Paid by Individuals) Please check the Health Insurance Marketplace if you need more information before filing your tax return. It will list all of your current plan information including annual premiums and deductibles. There is a separate marketplace page for all insurance types, including non-group plans. If you are enrolling in coverage through the Health Insurance Marketplace, you will need to complete and attach these forms: A. The Annual Statement of Coverage. An electronic copy of the annual statement of coverage (ASCOT) is due January 31.

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