Form 8916-A Irving Texas 2019-2025

Form 8916-A Irving Texas: What You Should Know

Molina Healthcare of Texas, Inc. 5605 MacArthur Blvd., Suite 400. Irving, TX 75038. For health insurance premium and contribution information: Email information to or telephone, Monday through Friday, 8:30 a.m. to 5:00 p.m. CST. Medical Expense Statement (for Medical and Dental Care Received) Use Form 8916-A to report expenses incurred for medical and dental care received, to the extent the amounts reported on the Schedule M-3 or Form 60520 is less than or equal to the amount of the expense on the medical expense statement. All of our expenses incurred are in the form of medical and dental care received. Use Form 8916-A to report expenses incurred for medical and dental care received, to the extent the amounts reported on the Schedule M-3 or Form 60520 is less than or equal to the amount of the expense on the actual medical expense statement, which is an itemized statement for all medical and dental expenditures incurred. Mail Form 8916-A to your taxpayer identification number: Taxpayer Identification Number (TIN): 3 46 31 0 5 0 (or see “Address or Telephone Number” at the top of the Form 8916-A for your TIN) or see the Form 8916-A instructions for additional instructions. Mail Form 8916-A to your taxpayer identification number: Taxpayer Identification Number (TIN): 3 46 31 0 5 0 (or see the 'Address or Telephone Number' at the top of the Form 8916-A for your TIN)  Molina Healthcare of Texas, Inc. 5605 MacArthur Blvd., Suite 400. Irving, TX 75038. All expenses reported are for Medical & Dental care received, including payments for medical and dental care. Use Form 8916-A to report expenses incurred for Medical & Dental care received, to the extent the amounts reported on the Schedule M-3 or Form 60520 is less than or equal to the amount of the expense on the medical expense statement. Mail Form 8916-A to your taxpayer identification number: Taxpayer Identification Number (TIN): 3 46 31 0 5 0 (or see the 'Address or Telephone Number' at the top of the Form 8916-A for your TIN)  Erin J.

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