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DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Commissioned Corps JUNIOR COMMISSIONED OFFICER STUDENT TRAINING AND EASTERN PROGRAM (ROSTER) STATUS REPORT INSTRUCTIONS: Complete Items
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What is phs 4772 form?
The PHS 4772 form is a document used by employers to report the health coverage they offer to their employees.
Who is required to file phs 4772 form?
Any employer that provides self-funded health coverage to its employees is required to file the PHS 4772 form.
How to fill out phs 4772 form?
To fill out the PHS 4772 form, employers need to provide information about the health coverage they offer, including the number of employees covered and the type of coverage.
What is the purpose of phs 4772 form?
The purpose of the PHS 4772 form is to gather data about the health coverage offered by employers and to ensure compliance with the Affordable Care Act.
What information must be reported on phs 4772 form?
Employers must report information such as the number of employees covered, the type of coverage offered, and the premium amounts.
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