Get the free Employee Predesignation of Personal Physician - Kern County Library - kerncountylibrary

EMPLOYEE REDESIGNATION OF PERSONAL PHYSICIAN Please return completed, signed form to: Department Payroll Clerk copy to: Workers Compensation Services The California Labor Code grants an employee,

How to fill out employee predesignation of personal

How to fill out employee predesignation of personal:

1. Obtain the form: The first step is to obtain the employee predesignation of personal form. This can usually be found on your employer's website or by asking your human resources department for a copy.
2. Read the instructions: Once you have the form, carefully read through the instructions provided. This will help you understand the purpose of the form and how to properly fill it out.
3. Provide personal information: Start by filling out your personal information section on the form. This typically includes your full name, contact details, and employee identification number.
4. Specify your chosen personal physician: The main purpose of the form is to predesignate your personal physician or medical group. In this section, provide the name, address, and contact information of the physician or medical group you have chosen.
5. Acknowledge understanding: Many predesignation forms include a section where you need to acknowledge that you understand the purpose and implications of predesignating a personal physician. Read through this section carefully and sign or initial it accordingly.
6. Submit the form: Once you have completed all the necessary information, make a copy of the form for your records and submit the original to your employer. Follow any additional instructions provided by your employer regarding submission.

Who needs employee predesignation of personal:

1. Employees with health insurance: Employee predesignation of personal is typically required for employees who are covered by a health insurance plan provided by their employer. This form allows employees to choose a personal physician or medical group that will act as their primary healthcare provider.
2. Employees seeking continuity of care: If you have an existing relationship with a specific physician or medical group and want to ensure continuity of care, you may choose to predesignate them using this form. It allows your designated personal physician to handle your medical care even when the insurance plan prefers a different provider.
3. Employees who want control over their healthcare: By predesignating a personal physician, you can have more control over your healthcare choices. This form allows you to establish a direct relationship with a preferred healthcare provider and avoid potential restrictions or referrals imposed by the insurance plan.

Overall, employee predesignation of personal is necessary for employees who want to have a say in their healthcare and ensure they receive care from a specific physician or medical group of their choice.

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