Health Care Reform Act Information for Offline Agencies

The Division of Health Care Finance and Policy released the new Health Insurance Responsibility Disclosure (HIRD) form.  In compliance with the Health Care Reform Act, a HIRD form must be distributed to every employee in your agency who does not enroll in GIC health benefits or the Section 125 Cafeteria Plan to pay for health insurance on a pretax basis that you have implemented for non-GIC eligible employees.  We suggest that you modify this form to reflect the name of the vendor you will be using for your Section 125 Plan. 

HIRD forms must be retained at the agency for three years and be made available to the Division of Health Care Finance and Policy or the Department of Revenue upon request.

HIRD Form Instructions:
For GIC-eligible employees, the Payroll Department or GIC Coordinator must fill in the lowest available monthly employee share of GIC health insurance individual coverage premium using a July 1, 2007 GIC rate chart.  For example, currently The Commonwealth Indemnity Plan Community Choice has the lowest employee premium.  You would enter $48.66 for the 15% rate and $66.49 for the 20% rate.  The lowest cost plan and the rates will change each year.

The employee must return the form to their Payroll Department or GIC Coordinator.  Do not return the form to the GIC.  You must retain these forms for three years and make them available to the Division of Health Care Finance and Policy upon request.  We suggest that you keep all HIRD forms in a single file in alpha order for ease of look up.

If an employee refuses to return the form to you, you must document your efforts to obtain it. 
Initial Distribution:  Distribute the form to all agency employees without GIC coverage or who do not elect your agency’s Section 125 Cafeteria Plan.  According to DHCFP’s regulations, all agencies must have completed HIRD form returned to their payroll office no later than September 30 2007.

HIRD Form Distribution Ongoing:

• New Hires:  Add the HIRD form to your new hire package.  Every time you hire a new employee who is not GIC-eligible and does not elect to participate in your agency’s Section 125 Cafeteria Plan, or is eligible for GIC benefits and does not take GIC health insurance, you must have the employee complete and return to you the HIRD form within 30 days.
• Withdrawal from coverage:  If you have an employee who drops GIC health insurance or your agency’s Section 125 Cafeteria Plan coverage (e.g., obtains health insurance elsewhere, does not pay their health premiums, or goes on a military leave), you must give the employee a HIRD form to complete and return to you.
• Annual enrollment:  Employees who do not elect coverage during the GIC’s annual enrollment or your agency’s Section 125 plan’s open enrollment must complete a HIRD form within 30 days of the end of those open enrollment periods.