Start Here: Employers and HR Professionals


Forms and Reports

Answers to Frequently Asked Questions.

Q

What is the Update Contacts Form?

A

This form is completed to report a change to the Company name or Company Address. You may also use this form to add or delete a contact’s name from the Protected Health Information user list or to make a change to the administrative contact, which is the primary point of contact on the account. All reports and correspondence from Employee Benefits Corporation will be sent to the administrative contact.

Q

What is the Unpaid Leave of Absence Form?

A

This form is completed and returned for all FMLA, Non-FMLA, and USERRA unpaid leaves of absence.

Q

What is the COBRA Initial Notice Form?

A

The Department of Labor (DOL) requires the Initial Notice for Employers with 20 or more employees. The purpose of the notice is to make employees aware of their rights under COBRA as well as clarify your responsibilities to them and their responsibilities to you. The Initial Notice must be sent to all employees, their spouses and their dependents who are enrolled in any of your group health plans. The Initial Notice should be sent out within 90 days of an employee becoming covered by your group health plan or any time an employee adds a spouse or dependent.

Q

What is the COBRA Qualifying Event Termination Form?

A

COBRA must be offered to an individual who has experienced a Qualifying Event which is an event that causes a loss of coverage under the group health plan(s). A Qualifying Event Termination form needs to be completed and submitted to Employee Benefits Corporation within 30 days of a termination, reduction in hours, death of the employee or Medicare entitlement. Events such as a divorce, legal separation or loss of dependent status must be reported within 60 days.

Q

What is the Certificate of Resolutions Form?

A

Plan design changes require the completion of a Certificate of Resolutions form. Examples of the types of change include but are not limited to: change group premium accounts, change eligibility rules, change employer contributions, modify the plan design, or modify the plan year. Contact your Client Service Consultant to request the form.

Q

Can I create customized reports?

A

Many of our reports have output options that use the special “editing bar” that appears as a control at the top of each report. The editing bar lets you perform simple functions on these reports, such as:

Scaling the final size of the working report
Performing a text search within the report
Selecting an output format
Exporting the report

Some reports allow you to choose a date range for the report along the top of the editing bar using convenient, drop-down calendars.

Log into your account at www.ebcflex.com and choose "Reports" from the menu.