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Failure to fill out this application completely may result in a delay of coverage. ... Divorce Involuntary loss of creditable coverage.
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Employers who have self-funded group employee benefit plans.
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N-4313 self-funded group employee refers to a form that is used by self-funded group employees to report their health insurance coverage.
Employers who provide self-funded health insurance coverage to their employees are required to file N-4313 form.
To fill out N-4313 self-funded group employee form, employers need to provide information about the employees covered under the self-funded health insurance plan.
The purpose of N-4313 self-funded group employee form is to report information about the health insurance coverage provided by self-funded group employers.
Information such as the names and social security numbers of covered employees, the dates of coverage, and any other relevant information about the health insurance plan must be reported on N-4313 form.
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