📄 Extracted Text (56 words)
Self-Only Coverage Plan Smart Worksheet
A If questions 1 and 2 in the Employer Contributions Smart Worksheet are not checked "yes",
answer the following question:
1 Did the make an MSA contribution related to
a high deductible health plan with self-only coverage
which was in effect at the same time as this plan? Yes No
EFTA01220515
ℹ️ Document Details
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EFTA01220515
Dataset
DataSet-9
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document
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1
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