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This version of the form is not currently in use and is provided for reference only. Download this version of
Form HC-5
for the current year.
Form HC-5 Employee Notification to Employer for Calendar Year - Hawaii
What Is Form HC-5?
This is a legal form that was released by the Hawaii Department of Labor & Industrial Relations - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HC-5?
A: Form HC-5 is an Employee Notification to Employer for Calendar Year in Hawaii.
Q: Who needs to fill out Form HC-5?
A: Employees in Hawaii who want to notify their employer about their health coverage need to fill out Form HC-5.
Q: When should Form HC-5 be filled out?
A: Form HC-5 should be filled out for each calendar year by the employee in Hawaii.
Q: What is the purpose of Form HC-5?
A: The purpose of Form HC-5 is to notify the employer about the employee's health coverage for the calendar year in Hawaii.
Q: Is Form HC-5 mandatory for employees in Hawaii?
A: Yes, employees in Hawaii are required to fill out Form HC-5 to notify their employer about their health coverage for the calendar year.
Q: What information is required on Form HC-5?
A: Form HC-5 requires the employee's name, Social Security number, and information about their health coverage for the calendar year.
Form Details:
- The latest edition provided by the Hawaii Department of Labor & Industrial Relations;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form HC-5 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Labor & Industrial Relations.
