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Employer Group Size Reporting

Health Alliance Plan (HAP) strives to help our clients by directing them to information that may be helpful. If you have questions or need assistance determining your employer group size, please refer to the following Medicare regulations:

These resources provide Medicare regulations that affect employers and will assist with meeting responsibilities and obligations under the Medicare Secondary Payor (MSP) laws. HAP does not provide legal or human resources advice. If you have further questions, we encourage you to consult with an attorney or human resource professional.

Please fill out the group size form, which can be found below

 

Group size form

* Asterisk indicates required field

Be sure to count total working employees for whom a W-2 form was filed

This information can be found on your HAP invoice. Your Group ID is the 8 digit number before the dash. (Your group ID starts with 1000xxxx-; 2000xxxx-.) Enter all group IDs that apply separated by a comma.

If you are completing this form on behalf of the company, please provide your full name.

Please print your above responses before submitting, as a copy for your records. There is a print button at the top of this page.