Hawaii 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

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.

Definition of noncontributory : making or involving no contribution: such as. a : involving, relating to, or being an employee benefit (such as a pension plan) which is entirely funded by the employer with no contribution from the employee a noncontributory pension noncontributory life insurance plans.

A contributory pension plan requires the employees to pay into the plan from their salary (the employees' pay stub would show the money was taken out of their pay to go into the pension plan). In a non-contributory pension plan only the employer contributes.

Noncontributory - Group life insurance plans are those in which the employer pays the entire premium and the employee supplies no portion of the premium costs. Employers have the option of contributing to the employees' premium payments in part or in full.

A plan sponsor is an employer or organization that offers a group health plan to its employees or members.

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.

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.

Hawaii Dept. The basic purpose of the Workers' Compensation is to provide wage replacement benefits and medical treatment for employees who have been injured or become ill due to a work-related injury or illness. It prevents the employer from bearing the costs of injuries that occur during normal business operations.

LESSON 11: HEALTH AND ACCIDENT INSURANCEIf the employee must contribute to the premium payments, it is considered "contributory." On the reverse side, if the employer pays the entire premium payments on behalf of the employees where the employee makes no contribution, it is considered "noncontributory."

Insurance companies typically require 100 percent of eligible employees to participate in noncontributory plans.

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Hawaii Affidavit of No Coverage by Another Group Health Plan