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2014 PROVIDER NOTIFICATION FORM DELTA For Health Actions Completed Between 10/1/2013 and 9/30/2014 Important Information Delta Health Rewards (Powered by UnitedHealth Personal Rewards SM) program

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What is 996 page 1?

996 page 1 is a form used for reporting information related to certain employee work schedules, specifically working from 9 am to 9 pm, 6 days a week.

Who is required to file 996 page 1?

Employers who have employees working on the 996 schedule are required to file 996 page 1.

How to fill out 996 page 1?

996 page 1 is typically filled out by providing information about the employee working on the 996 schedule, including their name, position, and work hours.

What is the purpose of 996 page 1?

The purpose of 996 page 1 is to track and report the work schedules of employees on the 996 schedule to ensure compliance with labor laws.

What information must be reported on 996 page 1?

Information such as employee name, position, work hours, and details of the 996 schedule must be reported on 996 page 1.

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