West Virginia 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

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.

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.

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.

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."

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

Can I Use My Medicaid Coverage In Any State? Generally, the answer is no because each state has its own Medicaid eligibility requirements, coverage can't be transferred from one state to another, nor is coverage provided by one state available while you're temporarily visiting another state.

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.

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.

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

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West Virginia Affidavit of No Coverage by Another Group Health Plan