Florida Affidavit of No Coverage by Another Group Health Plan

State:
Multi-State
Control #:
US-321EM
Format:
Word; 
Rich Text
Instant download

Description

The employee named in this affidavit attests to the fact that he or she is not covered by any other group health plan.

How to fill out Affidavit Of No Coverage By Another Group Health Plan?

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FAQ

The primary purpose of the certificate is to show the amount of creditable coverage that you had under a group health plan or other health insurance coverage, because this can reduce or eliminate the length of time that any pre-existing condition clause in a new plan otherwise might apply to you.

Compulsory insurance is insurance that must be legally owned to do an activity, such as auto insurance and driving a car. Other types of compulsory insurance include workers' compensation and professional liability insurance.

A dependent is a person who is eligible to be covered by you under these plans.

The only two required forms of insurance are personal injury protection (PIP), which pays for your own medical bills after a crash, and property damage liability, which covers damage you cause to other people's property.

Additional insurance coverage for Bodily Injury Liability (BIL) and Property Damage Liability (PDL). Florida's No-Fault Law requires owners of motor vehicles must cover the below minimum Personal Injury Liability (PIL) insurance coverage: $10,000 of Personal Injury Protection (PIP).

You may think that if you have the minimum insurance required by Florida law, you are covered after a car accident. In fact, without bodily injury liability coverage, you are very much at risk of being personally responsible for medical bills or other damages resulting from a car accident.

If a Social Security agreement assigns coverage of the employee's work to the United States, the Social Security Administration issues a U.S. Certificate of Coverage. The certificate serves as proof that the employee and employer are exempt from the payment of Social Security taxes to the foreign country.

A certificate of Creditable Coverage (COCC) is a document provided by your previous insurance carrier that proves that your insurance has ended. This includes the name of the member to whom it applies as well as the coverage effective date and cancelation date.

In Florida, drivers need two kinds of insurance, $10,000 of personal injury protection (PIP) and $10,000 of property damage liability (PDL). Florida law also requires this car coverage on any vehicle driven in the state for more than 90 days during a 365-day period.

The Florida statute says you can recover non-economic damages if the injury results in any of the following:Significant and permanent loss of an important bodily function.Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.More items...

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Florida Affidavit of No Coverage by Another Group Health Plan