News & Announcements

Form HC-5 for 2019 Now Available

Published Tuesday, October 2, 2018 6:27 am



The Department of Labor and Industrial Relations Disability Compensation Division recently released Form HC-5 Employee Notification to Employer for Calendar Year 2019.

Employees who choose to waive their employer's health insurance coverage must sign this form annually.   Companies with employees who waived coverage in 2018 need to follow up with these employees.  If employees intend to waive coverage in 2019, they should indicate as such on the 2019 HC-5 form.  Employers should keep a copy of the signed waiver form for their records and give a copy to the employee.

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