29 ©2024 United Benefit Advisors, LLC. All rights reserved. PART B: Information About Health Coverage Offered by Your Employer This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application. ͤ ͟ ͶΞΡΝΠΪΖΣ͑ΟΒΞΖͫ͑ ́ΟΖΝΝΚΟΘΤ͑ΈΒΝΥΖΣΤ ͥ ͟ ͶΞΡΝΠΪΖΣ͑ ͅΕΖΟΥΚΗΚΔΒΥΚΠΟ ͿΦΞΓΖΣ͙͑Ͷ ͅͿ͚ ͦ ͟ ͶΞΡΝΠΪΖΣ͑ΒΕΕΣΖΤΤͫ͑ ͧ ͟ ͶΞΡΝΠΪΖΣ͑ΡΙΠΟΖ͑ΟΦΞΓΖΣ ͨ ͨ ͡ ͞ ͦ ͡ ͩ ͞ ͤ ͡ ͡ ͦ ͨ ͟ ʹΚΥΪͫ͑ͲΥΝΒΟΥΒ ͩ ͟ ́ΥΒΥΖͫ͑͸Ͳ ͪ ͟ ΋ ͅ΁͑ʹΠΕΖ ͤ ͡ ͤ 2 ͩ ͢ ͡ ͟ ΈΙΠ͑ΔΒΟ͑ΨΖ͑ΔΠΟΥΒΔΥ͑ΒΓΠΦΥ͑ΖΞΡΝΠ ΪΖΖ͑ΙΖΒΝΥΙ͑ΔΠΧΖΣΒΘΖ͑ΒΥ͑ΥΙΚΤ͑ΛΠ ΓͰ͑͑ͳΣΒΟΟΠΟ͑ͻΠΙΟΤΥΠΟ ͢ ͢ ͟ ΁ΙΠΟΖ͑ΟΦΞΓΖΣ͙͑ΚΗ͑ΕΚΗΗΖΣΖΟΥ͑ΗΣΠΞ͑ΒΓΠΧΖ͚ ͢ ͣ ͟ ͶΞΒΚΝ͑ΒΕΕΣΖΤΤͫ͑ΓΛΠΙΟΤΥΠΟͱΤΟΖΝΝΚΟΘΤΨΒΝΥΖΣΤ͟ΔΠΞ Here is some basic information about health coverage offered by this employer: As your employer, we offer a health plan to: † All employees. Eligible employees are: All Full Time Employees † Some employees. Eligible employees are: With respect to dependents: † We do offer coverage. Eligible dependents are: