Get Instructions Completing The Annual Msp Employer ...

Completing the Annual MSP Employer Acknowledgement Form is an essential task for employers to ensure correct employee counts for Medicare payment priorities. This guide provides clear, step-by-step instructions to assist users in accurately filling out the form online.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form and open it in the document editor.
2. Provide the employer name, also referred to as the legal name of the company, in the designated field.
3. Enter the Employer Identification Number (EIN) accurately in the corresponding section.
4. Fill in the physical address, including the street number and name, city, state, and ZIP code.
5. Indicate your account number(s) and group number(s) as required on the form.
6. For new BCBSOK clients, check whether the client was in business during the preceding calendar year. Select the appropriate box.
7. For current BCBSOK clients, specify if this form is being submitted at renewal, as an update, or as an error correction.
8. If applicable, answer whether there are any affiliates or subsidiaries by selecting ‘Yes’ or ‘No’ and listing their names if ‘Yes’.
9. Respond to the questions regarding filing a federal tax return and provide the necessary information on employee counts.
10. Continue answering the questions about employer size and whether you are part of a multi-employer group health plan.
11. Once all sections are adequately filled, review the information for accuracy. Save your changes, download, print, or share the form as needed.

Complete your documents online today to ensure compliance and accuracy.