Get Hird Report

Filling out the Hird Report online is essential for documenting your health insurance status with your employer. This guide provides clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the Hird Report online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the employer information section. Provide your employer's legal name, their Federal Employer Identification Number (FEIN), trade name if applicable, and the business address, including city, state, and ZIP code.
3. For question 1 in the employer section, indicate whether a 'Section 125 Cafeteria Plan' was offered to the employee by selecting Yes or No.
4. For question 2 in the employer section, indicate if employer-sponsored health insurance was offered by selecting Yes or No.
5. If you indicated Yes to offering sponsored insurance, report the dollar amount of the employee’s portion for the least expensive monthly individual health plan offered.
6. Now, move to the employee information section. Enter the employee's first and last name.
7. For question 1 in the employee section, select Yes, No, or None Offered to indicate the acceptance of employer-sponsored health insurance.
8. For question 2 in the employee section, select Yes, No, or None Offered to indicate the agreement to use the employer’s 'Section 125 Cafeteria Plan' for purchasing health insurance.
9. For question 3 in the employee section, indicate whether the employee has other health insurance by selecting Yes or No.
10. In the employee affidavit section, ensure the employee affirms all provided information is true. The employee must sign and date the form appropriately.
11. After completing the form, you can save your changes, download it for your records, print a hard copy, or share the form as needed.

Start completing your Hird Report online today to ensure timely and accurate documentation.