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牛津/聯合團體� ��保僱主申請表 – 康州（非HMO）.pdf

CT_Small_Group_Application_NON-HMO.pdf

🔗 Source: 212-484-9888.com

📊 Size: 111 KB

👤 Author: [email protected] 952-934-8100

⬇️ Downloads: 142

Summary

This is a Connecticut Small Group Application for Oxford Health Insurance, Inc. The application requires various information, including company details, plan administrator contact, and employee information. It also asks about the nature of the business, SIC code, and tax identification number. Additionally, the application inquires about the number of employees, full-time equivalent employees, and whether the group is subject to ERISA. There are also questions about leave of absence policies, waiting periods, and eligibility for medical coverage. The application includes sections for administrative information, such as effective dates, anniversary dates, and employer contributions towards premiums.

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Description

This is a Connecticut Small Group Application for Oxford Health Insurance, Inc.

Technical Information

File Format: PDF
File Size: 111 KB
Pages: 14
Language: EN
Author: [email protected] 952-934-8100
Total Downloads: 142
Last Updated: 1 month ago

Document Overview

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