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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES NOTICE OF FORM CHANGE NO. 06-120 DATE 08/24/2006 TO: FROM: County Welfare Director Supply Clerk / Forms

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What is lic 857?

Lic 857 is a form used for reporting health and welfare plan information for multiemployer plans.

Who is required to file lic 857?

Both the plan sponsor and the plan administrator of a multiemployer plan are required to file lic 857.

How to fill out lic 857?

Lic 857 can be completed online through the official website of the Department of Labor or by mailing a printed copy of the form.

What is the purpose of lic 857?

The purpose of lic 857 is to collect data and information about multiemployer health and welfare plans to ensure compliance with relevant laws and regulations.

What information must be reported on lic 857?

Lic 857 requires reporting of various details such as plan identification, funding status, benefits provided, participant count, and financial information.

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