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PAGE 1 OF 3 Small Group Enrollment Form HOURLY Section A: EMPLOYEE INFORMATION Employee Name (Last, First, M.I.) SALARIED 90DAY CONTINUATION Social Security Number County (state) Work Phone Home Phone
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What is age of small group?
The age of small group refers to the average age of individuals within a specific small group.
Who is required to file age of small group?
Employers or organizations that offer health insurance plans to small groups are required to file the age of small group.
How to fill out age of small group?
The age of small group can be filled out by providing the dates of birth for each individual in the small group and calculating the average age.
What is the purpose of age of small group?
The purpose of age of small group is to determine the overall age profile of a specific small group, which can impact insurance premiums and coverage options.
What information must be reported on age of small group?
The age of each individual in the small group must be reported in order to calculate the average age.
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