2025 ACA Form 1095‑B – Request Instructions
Hutzel & Associates, Inc. sponsors a self‑insured (level‑funded) health plan. If you or a family member had coverage through our plan during any month in 2025, you may request a copy of your Form 1095‑B.
How to request your 1095‑B
- Email: chutzel@hutzel.net
- Phone: (602) 323‑0222 (Monday through Friday, 8:00 a.m.–4:00 p.m. MST)
- Mail: Hutzel & Associates, Inc., Attn: Benefits, 972 Viceroy Lane, Camp Verde, AZ 86322
Please include your full name , mailing address , last 4 digits of your SSN , and the names of any covered dependents. We will provide your Form 1095‑B within 30 days of receiving your request.
This notice will remain available on our website through October 15, 2026.
What is Form 1095‑B? It is an informational tax document that shows the months you and any covered dependents had minimum essential coverage in 2025. You do not need this form to file your federal tax return, but you may keep it with your records.
