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Form H13: Benefit Election and Section 125 Pretax Agreements form should be used by employees to elect or decline medical and dental coverage through the agencies plans for the 20192020
plan year.
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What is this form should be?
This form should be a financial disclosure form.
Who is required to file this form should be?
This form should be required to be filed by all employees of the organization.
How to fill out this form should be?
This form should be filled out by providing accurate and detailed financial information.
What is the purpose of this form should be?
The purpose of this form should be to disclose any potential conflicts of interest.
What information must be reported on this form should be?
This form should require the reporting of all assets, income, and liabilities.
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