D25 · Health insurance premium statement 2025 - Erik Lindqvist (individual plan)
Golden Poppy Health Plan · insurance_statement · belongs to spouse · tax year 2025 · received 2026-02-11 22:12 from client · GoldenPoppy_2025.pdf · 1 page
landed on the return
Golden Poppy Health PlanD25 · page 1 / 1
Premium statement 2025. Subscriber Erik Lindqvist, individual PPO plan (not marketplace). Premiums paid January-December 2025: 1,200.00 per month, total 14,400.00. Paid from the Lindqvist Studio account.
Where this document landed
1 return line: Sch1.17
Evidence for checks: SEHI-ELIGIBILITY
Extraction: extracted · 1 values
Used by engine: v1 ✓ · v2 ✓ · v3 ✓
1 extracted value
ev-0484 · p1 · premiums
Total premiums paid 2025
Sch1.17
14,400
99%
Verify ev-0484