Haw. Code R. § 12-11-85 - Periodic reports
(a) On March 1 of
each year, the employer's insurance carrier, self-insured employers, employers
with collective bargaining agreements, or an association of employers shall
file an annual report covering the most recently completed calendar year in a
form prescribed by the director for each employer and for each plan, furnishing
the following information:
(1) Number of
covered employees for each month of the year (number of individuals employed
during the pay period including the 12th day of the month).
(2) Amount of total wages paid in the
year.
(3) Amount of taxable wages
paid in the year.
(4) Amount of
employer contributions paid in the year, if applicable.
(5) Amount of employee contributions paid in
the year, if applicable.
(6) Amount
of benefits paid in the year.
(7)
Number of different persons paid disability benefits during the year.
(8) Number of weeks for which benefits were
paid.
(9) Number of separate
periods of disability for which benefits were paid.
(10) Number of claims denied.
(11) Amount of subrogated payments
received.
(b) On March 1
of each year, the employer's insurance carrier, self-insured employers,
employers with collective bargaining agreements, or an association of employers
shall file an annual report for each employer and for each plan the information
listed in subsection (a) and, in addition, furnish by sex, information listed
in items (1) and (6) through (10) of subsection (a) covering the most recently
completed calendar year in a form prescribed by the director.
Notes
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