ATTENTIONForm 1095-B for the calendar year 2025 will be available upon request after the end of the calendar year.
With the new calendar year of 2026, a Medical Claim Statement is required for each patient. Watch your mailbox as the forms and instructions on completion have been mailed. The Medical Claim Statement form may be downloaded from the Forms tab above.
Contact Us
Address:2725 W. Monroe Street, Springfield, IL 62704