Hawaii Administrative Rules
Title 12 - DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
Chapter 12 - PREPAID HEALTH CARE
Subchapter 5 - REPORTS
Section 12-12-61 - Employers
Universal Citation: HI Admin Rules 12-12-61
Current through August, 2024
(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.
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