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STERLING HEALTH SERVICES (3)
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STERLING HEALTH SERVICES (3)
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Last modified
8/20/2024 1:14:25 PM
Creation date
1/23/2024 4:16:12 PM
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Template:
Contracts
Company Name
STERLING HEALTH SERVICES
Contract #
N-2019-252-02
Agency
Human Resources
Expiration Date
10/31/2024
Insurance Exp Date
5/14/2024
Notes
SEE NOTICE OF COMPLIANCE FOR INSURANCE INFO.
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VARIABLE HOUR TRACKING <br />Do you have variable hour employees? ❑ Yes E No (skip to control Groups) <br />An employee is a variable hour employee if, based on the facts and circumstances at the date the employee begins providing <br />services to the employer (the start date), it cannot be determined that the employee is reasonably expected to work an <br />average of at least 30 hours per week. <br />NEW EMPLOYEES <br />Standard Measurement Period End Date <br />Standard Measurement Period End Date <br />Standard Measurement Period End Date <br />ONGOING EMPLOYEES <br />Standard Measurement Period Start Date <br />Standard Measurement Period End Date <br />Admin Period Start Date <br />Admin Period End Date <br />Stability Period Start Date <br />Stability Period End Date <br />Would you like to receive the variable hour employee tracking report? ❑Yes ONo <br />CONTROLGROUPS <br />Are you a controlled group? If you are unsure, check with your CPA. [:]Yes 0 No (skip to Invoicing) <br />List the legal name and Tax ID/EIN of entity under the controlled group below. If any information for an entity is different from <br />the parent company (including but not limited to medical plan information, a separate renewal form is required. <br />COMPANY NAME <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />TAX ID/EIN <br />
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