Employer's Health Insurance Return - California 2026

1. Click ‘Get Form’ to open the Employer's Health Insurance Return in our editor.
2. Begin by entering the name of the parent employee in the designated field. Ensure accuracy as this information is crucial for identification.
3. Next, provide the home address of the absent parent employee. If unknown, you can indicate that in the space provided.
4. Indicate whether the employee has any insurance policies. If none exist, check the appropriate box. If there are policies, list them under 'the following insurance policies' section, including company name, type of policy, policy number, and persons insured.
5. Complete the employer's details at the bottom of the form, including signature and contact information.
6. Finally, ensure to return this completed form to the specified district attorney within 30 days as indicated on the document.

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