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Ann Arbor Michigan Form 4876-A: What You Should Know

U-M Form 4800-1 — Certification — Individual Health Plan Cost Information U-M Form 4800-1— Certification — Individual Health Plan Cost Information for U-M employees. Form 4800 has a second section with cost information for each individual health plan purchased. If you own two or more U-M health insurance/plan options, please use the U-M Form 4800-1 for each individual that the plan requires a separate certification for. The certification should be written with the first line being the name(s) of the employee(s) (under a pen), and the second line being the name(s) of the health benefits plan.  Form 2556, U-M Employee's Certificate of Registration for Health Benefits Plan A U-M employee's certificate of registration (Form 2556) must be completed by the employee. It was designed for individuals who will enroll in their own health benefits plan, provided they have the proper identification and paperwork ready. Form 2556 — U-M Employee's Certificate of Registration for Health Benefits Plan (Rev. April 2016) If you are paying for health insurance on your own (see question 8) when you need to find a job or get a benefit, you must use Form 2556 instead of Form 1040, U.S. Individual Income Tax Return. U-M Form 1040 contains information from three different tax return sources, and the information for Form 2556 has been updated to reflect those changes. This is the easiest and the recommended method for the U-M employee to obtain their own health insurance. If you are not paying for health insurance on your own, and are paying someone else, you will have to use Form 1040, U.S. Individual Income Tax Return. A health insurance provider must be listed on Form 1095-A (or Form 1095-B) Ann Arbor Michigan.

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