Page 39 - 2017 Benefits Enrollment
P. 39
2017 New Hire Guide
PART B: Information About Health Coverage Offered by
If checked, this coverage meets
Your Employer the minimum value standard, and
This section contains information about any health coverage offered by your employer. the cost of this coverage to you is
If you decide to complete an application for coverage in the Marketplace, you will be intended to be affordable, based
asked to provide this information. This information is numbered to correspond to the on employee wages.
Marketplace application. Note Even if your employer intends
Employer Name Employer Identiication Number (EIN) your coverage to be affordable,
Intertek USA, INC. 72–0703433 you may still be eligible for a
Employer address Employer phone number premium discount through the
2 Riverway Suite 500 877.694.8543 Marketplace. The Marketplace
City State ZIP Code will use your household income,
Houston TX 77056 along with other factors, to
Who can we contact about employee health coverage at this job? determine whether you may be
Intertek Employee Beneits Center eligible for a premium discount.
Phone Number (if different Email address If, for example, your wages vary
from above) from week to week (perhaps
855.203.0911 usa.beneits@intertek.com you are an hourly employee
or you work on a commission
Here is some basic information about health coverage basis), if you are newly
offered by this employer employed mid-year, or if you
As your employer, we offer a health plan to: have other income losses, you
All employees. Eligible employees are: may still qualify for a premium
discount.
If you decide to shop for coverage in the
Marketplace, HealthCare.gov will guide
Some employees. Eligible employees are: you through the process. Here's the
employer information you'll enter when
Regular Full time employees, and Regular Part Time employees working 30 or more you visit HealthCare.gov to ind out if
hours per week on average over a 12 month period. you can get a tax credit to lower your
With respect to dependents: monthly premiums.
We do offer coverage. Eligible dependents are:
Natural, adopted or step children if they are under age 26, children for whom you
have been awarded a court-appointed guardianship, a disabled child of any age
whose disability began prior to age 26 and who has been continuously covered as
your dependent since becoming disabled, legal spouses and same-sex domestic
partners.
We do not offer coverage.
39
PART B: Information About Health Coverage Offered by
If checked, this coverage meets
Your Employer the minimum value standard, and
This section contains information about any health coverage offered by your employer. the cost of this coverage to you is
If you decide to complete an application for coverage in the Marketplace, you will be intended to be affordable, based
asked to provide this information. This information is numbered to correspond to the on employee wages.
Marketplace application. Note Even if your employer intends
Employer Name Employer Identiication Number (EIN) your coverage to be affordable,
Intertek USA, INC. 72–0703433 you may still be eligible for a
Employer address Employer phone number premium discount through the
2 Riverway Suite 500 877.694.8543 Marketplace. The Marketplace
City State ZIP Code will use your household income,
Houston TX 77056 along with other factors, to
Who can we contact about employee health coverage at this job? determine whether you may be
Intertek Employee Beneits Center eligible for a premium discount.
Phone Number (if different Email address If, for example, your wages vary
from above) from week to week (perhaps
855.203.0911 usa.beneits@intertek.com you are an hourly employee
or you work on a commission
Here is some basic information about health coverage basis), if you are newly
offered by this employer employed mid-year, or if you
As your employer, we offer a health plan to: have other income losses, you
All employees. Eligible employees are: may still qualify for a premium
discount.
If you decide to shop for coverage in the
Marketplace, HealthCare.gov will guide
Some employees. Eligible employees are: you through the process. Here's the
employer information you'll enter when
Regular Full time employees, and Regular Part Time employees working 30 or more you visit HealthCare.gov to ind out if
hours per week on average over a 12 month period. you can get a tax credit to lower your
With respect to dependents: monthly premiums.
We do offer coverage. Eligible dependents are:
Natural, adopted or step children if they are under age 26, children for whom you
have been awarded a court-appointed guardianship, a disabled child of any age
whose disability began prior to age 26 and who has been continuously covered as
your dependent since becoming disabled, legal spouses and same-sex domestic
partners.
We do not offer coverage.
39
