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I Hired an Employee
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CBO Report on Establishing a Single Payer System
Employee Termination Form
It is your responsibility to audit your bills from your carriers. If you find discrepancies, please contact us immediately so we can work with the insurance carrier to get this rectified as soon as possible.
You must contact us immediately after a termination or billing issue. Generally, the insurance carriers will only backdate changes up to 60 days.
Employer Contact Information
*
Indicates required field
Company Name
*
Employer Contact Name
*
First
Last
Employer Contact Email
*
Terminated Employee Information
Name
*
First
Last
Reason for Termination
*
Termination Date
*
Personal Email
*
Home Address
*
Line 1
Line 2
City
State
Zip Code
Country
Special Instructions
*
Submit
Home
About
Client Testimonials
Giving Back
Careers
Contact Us
Perfect Referral
Our Services
I Hired an Employee
I Terminated an Employee
COBRA
Employee Information Change
Client Resources
FAQ's
HR Seminar Series
HR Hotline
Privacy Policy
Blog
CBO Report on Establishing a Single Payer System