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Take a look at the sample bill below. We've labeled and defined each section for you. If you still have questions, please send us an email and we'll give you the answers you need. Sample hospital bill; Sample Sharp Rees-Stealy bill Email or Letter Template . Employer NOT Offering Insurance [Date] [Employee Name, Address, City/State, Zip] [Greeting] As you may know, new health care reform regulations mandating insurance coverage go into effect starting Jan. 1, 2014. The changes are meant to help expand access to adequate and affordable health care coverage.