financial statement

IMPORTANT HEALTH COVERAGE TAX DOCUMENTS

You have the right to receive a copy of your 2025 Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) or Form 1095-B (Health Coverage). This form provides information about the health coverage offered to you and your family for the 2025 calendar year.

How to Request a Copy:

You may request a copy of your form at any time by contacting us through any of the following methods:

• Email: aglassner@graceworkstn.org
• Physical Mail: 104 Southeast parkway, Franklin, Tennessee, 37064
• Phone: 615.795.9055

We will provide your requested form within 30 days of receiving your request.