TASC - Laserfiche WebLink

Home Browse Search

�•.a3.�i�`.:Idla' � �. J;�i�.��"�.6:�a z�wi^�2�ry ��'�e�i sr,�` i,� . a iry -.�'a.F�� nur�vr �=r�lka'a �r�t1.x'r,. a�..e �� yhAsr.'J��r.a ❑ FMLA Administration & Compliance set -Up Fee (due now) -- - - • Admin Fee— per employee, per month Additional Services (odditiond/feesappfy): PRICING _.._. at -. _. INFO: (No Minimum) ❑ FMIA Eligibility &Entitlement Determination gree of charge within a TAS .1 I •Annual Renewal Fee select one: Q Submit eligibility file permonth ❑ Submit eligibility file Der event PLAN INFORMATION Number of Employees -_ _ - �Number of Company Loccatiations. Number of EES currently on FMLA Leave: Enter Location Name(s): (additional fees apply per takeover at imple-mentation) _ Current FMLA Administrator (enterbelow): Enter any States doing commerce: ' ❑Self ❑TPA: ._._.— Reporting per Location? ❑ No ❑ Yes (next question FMLA to run concurrent with Workers ❑ Yes _ .. Compensation and Short-term Disability Plans ❑ No If YES enter locations and contacts Method of Reporting FMLA Hours: ❑ Manual Report (via onfineform) ❑ Data Feed (via recurring f le from your timekeeping system for FMLA time used) FMLA 12 -month Tracking Type (select one): ❑ Rolling Backward ❑ Calendar Year ❑ Rolling Forward ❑ Plan Year w/Start Date of / / TASC FMLA Plan Start Date: ADMIN ONLY:TASCFMLA- SpecialInstructions: Plan Application to this startdate. 1 VR7,"t i('r rlr "_ a xr w+ •€ r-* uP+ sa wr% )t {�1(y��aip+re„ (o- a� F 7(� v �5sfi�r 1 L3:bue1� aKrPn�n�k�.x�iE:.au'c4�t.u,a:�,:r-r.^£'e�, t'ws"t`).T` ❑ ACA Employer Reporting (Z -year contract required) • Set -Up Fee (due now) • Annual Admin Fee (due naw) • Based on number of emPlove REQUIRED: Please select your Employer type and the appropriate service offering selection for your ACA Reporting needs: ❑ Single ALE or Government Entity (one EIN): ❑ Aggregated ALE (more than one EIN); Controlled Group or Government Entity C1 Non ALE (under 50 FT employees): Contact Name: ❑ Comprehensive Plan (includes Variable Hour Tracking) Q Reporting Only ❑ Comprehensive Plan (includes Variable Hour Tracking) Q Reporting Only Employee Mandate Only Email _.......- . I File Frequency: ❑ Monthly File ❑ Per Payroll File I ❑ ALE with Insured Medical Plan Applicable Large Employer (ALE) Status ❑ ALE with Self Insured Medical Plan Q Non ALE with Self-insured Medical Plan (10948 and 1095B Filing) »no Medical Planbates-jforRrevlousselectLon)_� If you are a "NON -ALE" with Self -Insured Medical Plan you DO NOT need to Provide the information below. Please Indicate whetheryou will be including the optional services below (response required forpricing): Variable dour Tracking ❑ yes ❑ No Minimum Essential Coverage offer Indicator: Q Yes Q No The TASCACA€mployer Reporting Administration Manua/will help you answer any ofthe following items that you ❑ Qualifying Offer Method have not. already determined. Select only those that apply (leave blank if unsure): ❑ 98%Offer Method Paged Employer initial 61C_`Tf15C Tca9za-010117 ______ ..-__' '011