← Home
DW
Dana Whitfield
Tamarack Benefit Partners
12 active ICHRA groups

Arjun P.

Redtail Auto Body  ·  Enrolled
AP

Arjun P.

Redtail Auto Body · employee RED-102
Date of birth 12/08/1997 Gender Female Tobacco Yes State CO
Address 767 Red Cedar Lane, Grand Junction, CO Phone (719) 555-3367
1covered
Carrier Kaiser Permanente Plan Bronze HMO 7000 Metal Bronze Coverage start Jan 1, 2026 Covering Employee only
Monthly premium
$441
Bronze HMO 7000
Employer pays
$400
Lump sum — $400 a month
They pay
$41
about $19 a paycheck, 26 a year

Household

Who the allowance has to stretch across
EmployeeArjun P.
Spouse coveredNo
Dependants covered0
Reimbursement tierEmployee only

Paperwork

What this person has signed
ICHRA Notice (90 day)On file
Annual Coverage AttestationOn file
Plan WaiverNot applicable
Form 1095Due 28 Feb 2027
Back to Redtail Auto Body