Haw. Code R. § 12-12-61 - Employers

(a) On April 15 of each year, all employers providing coverage through a health care contractor shall file an annual report for each plan covering the most recently completed calendar year. This report shall be on a form prescribed by the director and shall provide the following information:

(1) Amount of total wages paid to covered employee;

(2) Amount of employer contributions paid in the year, and

(3) Amount of covered employee contributions paid in the year, if applicable.

(b) On April 15 of each year, employers who provide health care benefits directly to their employees shall file an annual report for each plan covering the most recently completed calendar year. This report shall be on a form prescribed by the director and shall provide the following information:

(1) Number of covered employees employed on the twelfth day of each month;

(2) Amount of total wages paid to covered employees;

(3) Amount of employer contributions paid in the year;

(4) Amount of covered employee contributions paid in the year, if applicable; and

(5) Amount returned to the employer due to experience rating credit or dividends, if applicable.

Notes

Haw. Code R. § 12-12-61

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