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CERTIFICATION OF HEALTH CARE PROVIDER SHARED LEAVE PROGRAM FOR EMPLOYEES SERIOUS HEALTH CONDITION NOTE: IF APPLYING FOR FMLA OR MEDICAL LEAVE, ADDITIONAL FORMS ARE REQUIRED SECTION I: FOR COMPLETION

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What is employee health provider form?

Employee health provider form is a document that employers use to report information about the health coverage they offer to their employees.

Who is required to file employee health provider form?

Employers who provide health coverage to their employees are required to file the employee health provider form.

How to fill out employee health provider form?

Employers can fill out the employee health provider form by providing information about the type of health coverage offered, the number of employees covered, and other relevant details.

What is the purpose of employee health provider form?

The purpose of the employee health provider form is to provide the IRS with information about the health coverage offered by employers to their employees.

What information must be reported on employee health provider form?

Information such as the employer's name, employer identification number (EIN), the number of full-time employees, and the type of health coverage offered must be reported on the employee health provider form.

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