Haw. Code R. § 12-12-60 - Health care contractors

(a) Health care contractors shall submit a monthly report, in a form designated by the department, showing the following information:

(1) Name of newly enrolled or terminated employer;

(2) State department of labor and industrial relations account number as assigned by the unemployment insurance division;

(3) Plan number;

(4) Group number;

(5) Effective date of coverage; and

(6) Effective date and reason for cancellation.

(b) On April 15 of each year, health care contractors shall file an annual report for each employer and for each plan covering the most recently completed calendar year. This report shall be on a form prescribed by the director and shall contain the following information:

(1) Number of covered employees employed on the twelfth day of the month for each month of the year.

(2) Number of covered employees providing coverage for their dependents for each month of the year; and

(3) Amount returned to the employer due to experience rating credit or dividend during the year.

(c) On April 15 of each year, the following consolidated information shall be furnished by health care contractors for all employers covered by such contractor:

(1) Number of claims filed by covered employees;

(2) Number of claims paid to covered employees; and

(3) Amount of claims paid to covered employees.

(d) If coverage is provided through an association of employers or to employers through a collectively bargained health and welfare type trust fund or similar arrangement, and it is not feasible to obtain information for each employer in the association or trust fund, the health care contractor may file a consolidated report in a form prescribed by the director.

Notes

Haw. Code R. § 12-12-60

[Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS § 393-32)