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[DOC File]Sample Letter Employers Can Give to Employees
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Title: Sample Letter Employers Can Give to Employees Author: 499420 Last modified by: 255287 Created Date: 4/27/2005 2:23:00 PM Company: Social Security Administration
health insurance not offered letter

[DOC File]COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
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Employer Name: List the name of the employer associated with the claim. Reason for Contesting Claim: Check only . ONE . reason for contesting the claim. If “Further Investigation” is checked, list the reason for the investigation. If “No Insurance Coverage” is checked, a reason can be listed. Use “Other” only if a listed option does ...
sample letter no insurance coverage

[DOCX File]ATTACHMENT 6: CONTRACT INSURANCE commitment LETTER
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Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the New York State Workers’ Compensation Board’s website (www.wcb.ny.gov); B)Form C-105.2 (9/07),
no insurance letter from employer

[DOCX File]SAMPLE LETTER: - National Women's Law Center
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SAMPLE LETTER: NO COVERAGE POLICY FOR BREAST PUMP. To Whom It May Concern: I am enrolled in a [INSURANCE COMPANY NAME] plan, policy number [POLICY NUMBER]. I recently tried to purchase a pump through my health insurance. The Patient Protection and Affordable Care Act requires that my insurance coverage of this preventive service be with no cost ...
letter of no health insurance

[DOC File]SMALL GROUP EMPLOYER APPLICATION
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BCBSTX reserves the right to: 1) restrict new business enrollment in health insurance coverage to open or special enrollment periods unless the 50% minimum Employer contribution is met and at least 75% of eligible Employees (less valid waivers) have enrolled for coverage; and 2) review participation and contribution on existing business and non ...
letter of no insurance coverage

SAMPLE ANNUAL AGE 26 LETTER - DHRMWeb
SAMPLE ANNUAL AGE 26 LETTER. FOR ACTIVE EMPLOYEES IN COVA CARE, COVA HDHP, COVA HEALTHAWARE AND KAISER PERMANENTE. MM/DD/YYYY. Dear Employee: Under the terms of the Health Benefits Program for state employees, covered dependent children are no longer eligible for health coverage at the end of the calendar year in which they turn age 26.
employer health insurance coverage letter

[DOC File]State Continuation Notice Form (OAR 836-053-0863)
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Your employer has notified us that you have lost your eligibility for their group health insurance. This notice provides important information about your options to purchase ongoing health insurance coverage. Please read this letter carefully to find out more about the options that available to you.
sample letter not offering insurance

[DOCX File]Model COBRA Continuation Coverage Election Notice
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You must make your first payment for continuation coverage no later than 45 days after the date of your election (this is the date the Election Notice is postmarked). If you don’t make your first payment in full no later than 45 days after the date of your election, you’ll lose all continuation coverage …
letter stating no insurance offered

[DOCX File]FMLA Notification Letter
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This letter is intended solely as notice that your current absence is not eligible for coverage under the Family and Medical Leave Act of 1993 (FMLA). It is not intended as a statement regarding your eligibility to be absent from the workplace. At this time, your request for FMLA coverage is denied.
health insurance not offered letter

[DOC File]Sample COBRA letter to employees on company letterhead
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If you do not elect continuation of coverage, your group health plan coverage will end. Your cost for Continuation of Coverage: You will be charged the full cost of coverage under the group plan in which you are enrolled. You may also be required to pay a 2 percent administration charge. You may pay for the continuation of coverage on a monthly ...
sample letter no insurance coverage

No insurance coverage employer letter