Employee Participation Requirements Sample Clauses

Employee Participation Requirements. A. Total number of employees on payroll, regardless of hours worked PLEASE NOTE: Do not include COBRA participants, include active owners, and only count each employee once. In the following sections, please account for each employee once and only once.

Employee Participation Requirements. A. Total number of employees on payroll, regardless of hours worked (Do not include COBRA participants.) Subtotal A:

Employee Participation Requirements. Medical: at least 75% of Eligible Persons* must enroll. • Dental and Vision: 100% of Eligible Persons* must enroll. • Life and Long‐Term Disability: 100% of full‐time employees must enroll. Required Forms: • Signatures cannot be dated more than 59 days prior to the requested effective date. • Enrollment and Change Form must be completed by each full‐time employee when: o Enrolling in Medical, Dental, Vision, Group Life or Long‐Term Disability. o Waiving or terminating coverage for themselves and/or dependents. • All former employees applying for COBRA/Cal‐COBRA coverage must complete the COBRA/Cal‐COBRA section of the Enrollment Form • Beneficiary Designation Forms must be completed for Life and Long‐Term Disability. • Evidence of Insurability Information is required for groups of 2‐3 employees applying for Life and/or LTD coverage. • All groups must submit a copy of their most recent DE‐9 and DE‐9c. • HSA Administration form must be completed for groups electing integrated HSA administration. Missing signatures and questions left unanswered can delay the processing of your application. If you have any questions regarding or need assistance with reviewing the Subscription Agreement, please call Banyan Administrators – Managers for the CalCPA Health Programs at 877‐480‐7923. Once all questions have been answered, please sign and submit completed forms to: Banyan Administrators 0000 Xxxxx Xxxxx, Xxxxx 000 Mechanicsburg, PA 17055 Phone: (877) 480‐7923 Fax: (877) 237‐4519 Secure Email: xxxxxxxxxxxx@xxxxxxxxxxxx.xxx Secure portal: xxx.xxxxxxxxxxxx.xxx/xxxxxx‐portal/ * As used in this Subscription Agreement, Eligible Persons includes any W‐2 employee, proprietor, shareholders or partners of the firm.

Employee Participation Requirements. A. Total number of full-time and part-time employees, not just those enrolling. (Do not include COBRA participants.)

Employee Participation Requirements. You must offer participation in the Trust to at least 85% of your eligible employees. An eligible employee is one who works the required number of hours (on average) per week and who has completed the Employer’s required probationary period (not to exceed 90 calendar days). Should the total enrollment of eligible employees fall below the required 85%, you will be subject to a surcharge or discontinuation at the next renewal date. Existing districts that do not meet this criterion must submit to the Trust office a written plan showing how and when compliance will be accomplished. Eligibility for participation in the plan may be audited at any time. Monthly Contributions The Trustees approve the annual amount of the contributions, as determined by a qualified actuary, that are payable by participating Employers. The Trustees have the right to change the contribution amounts and how the amount is determined. By entering into this Agreement, you agree to the amounts that the Trustees have established for your group. You further agree to pay all contributions for the 12-month Plan Year by the due date in each month’s invoice and to abide by the Trust’s Delinquent Contributions Policy below.

Employee Participation Requirements. A. Total number of employees on payroll, regardless of hours worked (Do not include COBRA participants.) Subtotal A: B. Employees not eligible for coverage on this plan: 1. Employees working fewer than the minimum hours as indicated in Section 2A. 2. Employees who are not eligible by class as indicated in Section 2B (e.g. union) 3. Employees who have not completed the probationary period indicated in Section 2C. (For new groups only, enter zero (0) if you selected “future” employees in Section 2G.) 4. Employees in the 30-day orientation period if selected in Section 2D 5. Employees in the measurement period indicated in Section 2D 6. Employees paid via IRS form 1099, or temporary, seasonal or substitute employees Subtotal B: C. Please indicate the number of employees waiving coverage for each of the following approved reasons: 1. Employees covered by Medicare as primary 2. Employees covered by Military coverage (TriCare/Champus). 3. Employees covered by other group coverage (e.g., spousal, parental coverage etc.). 4. Employees covered by Tribal coverage 5. Employees waiving due to religious beliefs Subtotal C: Total eligible employees (Subtotal A - Subtotal B - Subtotal C): D. Total number of enrolled employees E. Employees covered by your group under the Federal provisions of COBRA.

Employee Participation Requirements. Eligible participation shall consist of the following: Covered employees shall first complete a health risk assessment (HRA) – either an electronic version through the FiVi web portal or a paper version, to be entered in the database manually. Based on analysis of the behavioral risk factors identified in the HRA, covered employees with high-risk behaviors shall be required to engage in one of the other targeted wellness and lifestyle coaching programs identified by the Wellness Program Coordinator in conjunction with the Co-op’s Wellness Committee. If upon review of a covered employee’s HRA, the Wellness Program Coordinator determines that the covered employee does not need targeted wellness and/or lifestyle coaching programs to address behavioral risk factors, participation for such employees shall consist of engagement in one or more of the following activities on the FiVi platform during the enrollment year:  Consumption of any health educational asset (article, video, or interactive wizard) on the FiVi portal or via push email notifications;  Logging of a health goal/biometric marker (i.e. blood pressure);  Logging of an exercise or activity routine;  Participation in a coaching opportunity (either online or phone based – delivered in a group session);  Creation of a peer support network (i.e. inviting friends/family to join personal network on the FiVi platform);  Participating in a health competition, fitness challenge, or approved worksite safety program. Each covered employee will receive a confidential risk report upon completion of the HRA along with suggestions to improve their modifiable risk factors. Participation measures will be tracked by the FiVi web portal and notifications will be sent out each employee to alert them to their status in meeting the participation requirements of the Wellness Program. All aspects of the Wellness Program are available to covered dependents of employees, but participation by dependents does not contribute to meeting the annual participation requirements of either the employee or the Member.