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SISC Flex Change Form 2024 Plan Year Employer Code: SISEMPLOYER:South Orange County Community College DistrictEmployee Information (Please print clearly) NAME:FirstMILastADDRESS:Street Address or
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Gather all necessary information about the employer.
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Who needs employer informationsisc - self-insured?

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Employers who are self-insured need to provide employer information.
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Insurance providers and regulatory agencies may also require this information.
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Employer informationisc - self-insured refers to employers who choose to assume the financial risk for providing health benefits to their employees rather than purchasing insurance.
Employers who self-insure their health benefits plans are required to file employer informationisc - self-insured forms.
Employers can fill out the employer informationisc - self-insured forms by providing details about their self-insured health benefits plans, including participant information and coverage periods.
The purpose of employer informationisc - self-insured is to report information about self-insured health benefits plans to the IRS.
Employers must report information such as participant names, social security numbers, coverage periods, and plan details on employer informationisc - self-insured.
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