US Legal Forms
Hawaii Health Care Coverage Questionnaire

Hawaii Health Care Coverage Questionnaire

Name: Hawaii Health Care Coverage Questionnaire
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.66 (426 reviews)

Category:

Hawaii Workers Compensation - Official

State:

Hawaii

Control #:

HI-SKU-1368

Format:

Instant download

This website is not affiliated with any governmental entity

Public form

Description

Health Care Coverage Questionnaire The Hawaii Health Care Coverage Questionnaire is a form used by the Hawaii Department of Human Services to determine a person's eligibility for health care coverage. The questionnaire is intended to collect information on an applicant’s income, assets, and family size to determine if they are eligible for Medicaid or other health care coverage programs. Depending on the applicant’s circumstances, they may be asked to complete one of two types of questionnaires: the Long Form Health Care Coverage Questionnaire or the Short Form Health Care Coverage Questionnaire. The Long Form is designed for individuals and families that are not currently receiving health care coverage benefits, while the Short Form is for those who are already receiving benefits and need to update their information. Both forms require information such as the applicant’s name, address, contact information, and income information. Once completed, the form is sent to the Hawaii Department of Human Services for review and approval.

The Hawaii Health Care Coverage Questionnaire is a form used by the Hawaii Department of Human Services to determine a person's eligibility for health care coverage. The questionnaire is intended to collect information on an applicant’s income, assets, and family size to determine if they are eligible for Medicaid or other health care coverage programs. Depending on the applicant’s circumstances, they may be asked to complete one of two types of questionnaires: the Long Form Health Care Coverage Questionnaire or the Short Form Health Care Coverage Questionnaire. The Long Form is designed for individuals and families that are not currently receiving health care coverage benefits, while the Short Form is for those who are already receiving benefits and need to update their information. Both forms require information such as the applicant’s name, address, contact information, and income information. Once completed, the form is sent to the Hawaii Department of Human Services for review and approval.

View Request To Modify Protective Order

View this form

View Respondents Request To Dismiss Protective Order

View this form

View Respondents Request To Vacate Temporary Protective Order

View this form

View Temporary Civil Stalking Injunction

View this form

View Return of Service (Of Protective Order Forms)

View this form

How to fill out Hawaii Health Care Coverage Questionnaire?

US Legal Forms is the most straightforward and cost-effective way to locate suitable legal templates. It’s the most extensive web-based library of business and individual legal paperwork drafted and checked by lawyers. Here, you can find printable and fillable blanks that comply with federal and local laws - just like your Hawaii Health Care Coverage Questionnaire.

Getting your template requires just a couple of simple steps. Users that already have an account with a valid subscription only need to log in to the website and download the document on their device. Later, they can find it in their profile in the My Forms tab.

And here’s how you can get a professionally drafted Hawaii Health Care Coverage Questionnaire if you are using US Legal Forms for the first time:

Look at the form description or preview the document to make certain you’ve found the one meeting your requirements, or locate another one using the search tab above.
Click Buy now when you’re sure of its compatibility with all the requirements, and choose the subscription plan you like most.
Register for an account with our service, log in, and pay for your subscription using PayPal or you credit card.
Select the preferred file format for your Hawaii Health Care Coverage Questionnaire and download it on your device with the appropriate button.

After you save a template, you can reaccess it at any time - simply find it in your profile, re-download it for printing and manual fill-out or upload it to an online editor to fill it out and sign more effectively.

Benefit from US Legal Forms, your reputable assistant in obtaining the required formal documentation. Try it out!

Form Rating

4.66

Satisfied(426)

Form popularity

FAQ

Waiving medical coverage If an employee wishes to waive medical coverage, they must submit an HC-5 Waiver form to their employer, The form can be found on the State of Hawaii Disability Compensation Division website. The employer is responsible for filing the document with the DLIR.

Employers must provide coverage to any employee who works in Hawaii for 20 or more hours a week for four consecutive weeks and earns a monthly wage at least 86.67 times the state's minimum hourly wage. Employers don't have to provide coverage for retirees, and public employers are exempt.

We have year-round sun, surf, and the Hawaii Prepaid Health Care Act. This 1974 state law requires private employers in the state to provide approved health insurance for their employees who work at least 20 hours per week for four weeks in a row.

Hawaii's Prepaid Health Care Act was enacted in 1974. This made the state the first in the nation to require employers to provide health coverage to workers.

Hawaii requires employers to provide employees not only health coverage but also temporary disability insurance (TDI).

Use this form if the employee works at least 20 hours per week and: ? Works for 2 or more employers or. ? Claims an exemption or waiver from health care coverage or. ? Terminates an exemption or. ? Changes principal and/or secondary employer designation

Who is required to provide health care insurance coverage? All employers with one or more employees, whether full-time or part-time, permanent or temporary, are required to provide Prepaid Health Care Act coverage to their eligible employees in Hawaii unless the employees fall into an excluded category.

Employers must provide health care coverage to employees who work at least twenty (20) hours per week and earn 86.67 times the current Hawaii minimum wage a month (see the Maximum Weekly Wage Base and Maximum Weekly Benefit Amount).

More info

Use and attach a copy of your insurance policy, membership card, or any other aid to help complete this questionnaire. Please completely fill out the HC-4 HEALTH CARE COVERAGE QUESTIONNAIRE FORM.Please refer to the back of this form for answers to the most often asked coordination of benefits questions. The CAHPS Health Plan Survey is a tool for collecting standardized information on enrollees' experiences with health plans and their services. Common coverage questions. Review basic questions and answers about individual health care information Forms 1095A, 1095B and 1095C. Through Medicaid or the Children's Health Insurance. MEPS is the most complete source of data on the cost and use of health care and health insurance coverage. Learn more about MEPS. Also, you may have to pay the total cost of care right away and then file a claim with your insurance company to get the allowable reimbursement for out-of-.

Hawaii Health Care Coverage Questionnaire

Description

Related forms

How to fill out Hawaii Health Care Coverage Questionnaire?

Show more info

Form Rating

Form popularity

FAQ

Can an employee waive health insurance in Hawaii?

How many hours do you have to work to get health insurance in Hawaii?

Does Hawaii have a health insurance mandate?

Do you have to have health insurance in Hawaii?

Do employers in Hawaii have to provide health insurance?

What is an HC 5 form in Hawaii?

Does the employer have to pay for health insurance in Hawaii?

What is the minimum hours for health insurance in Hawaii?

More info

Trusted and secure by over 3 million people of the world’s leading companies