Request your 1095-C Form

 We would like to inform you that the 1095-C forms, which provide information about the health insurance coverage offered to you, are now available upon request. If you would like to receive your 1095-C form, please send a request to the attention of Payroll/HR using one of the following contact options: • Email your request to payroll@magnoliahealthsystems.com • Mail your request in writing to the address 8455 Keystone Crossing Indianapolis, IN 46240 When making your request, please include the following information: • Facility Name • Your full Name • Either o Employee ID number or o Date of Birth Should you have any questions about the 1095-C form or its purpose, feel free to contact us at 317-818-1240, and we’ll be happy to assist. Thank you for your attention to this matter