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Click ‘Get Form’ to open the premium remittance form in our editor.
Begin by reviewing the preprinted information at the top of the form. Ensure it reflects your account details accurately.
Calculate your gross insurable earnings for each employee, including any applicable optional insurance. Deduct non-insurable earnings to find your total insurable earnings.
If you have multiple NAICS codes, determine direct and common earnings. Follow the outlined steps to allocate common earnings appropriately across each code.
Enter the calculated premium amounts in their respective columns on the form, ensuring accuracy before submission.
Once completed, save your document and choose to either print it for mailing or submit it electronically if applicable.
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Additionally, on an on-going basis, fiscal staff will reconcile and remit the appropriate contributions and premiums to the medical expense fund. DefineRead more
The Combo Code determines the chartstring to which payroll expenses for each employee is charged but deduction code table configurations determine the accounts.Read more
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