Attachment O Payment of Employee Healthcare Expenses Certification.pdf
PDF 213 KB Posted
- Solicitation number
- BPM059586
- Issued by
- Maryland
About this file
This is a Payment of Employee Healthcare Expenses Certification form issued by the State of Maryland under State Finance & Procurement Article Title 17, Subtitle 8, applicable to solicitation bidders and subcontractors working on state and local contract opportunities, including the referenced project KE-000-210-001 (IQC) Replace Cell Door Panels at Housing Units 1-5 at the Maryland Correctional Training Facility under the Department of Public Safety and Correctional Services. The certification, effective July 2024, requires bidders and subcontractors to certify their employee healthcare expense compliance status for all employees who will work on or at the project site.
The form presents three certification options, and bidders must select only one: the firm pays aggregate employee healthcare expenses of at least 5 percent of aggregate social security wages paid; the firm pays 50 percent or more of the required premium necessary to obtain employee coverage by a credible health insurance plan as defined under Maryland law; or the firm has 30 or fewer employees and qualifies for an exemption. The certification must be signed by an authorized representative and include the representative's title, company street address, and city, state, and ZIP code. False certification carries potential civil penalties ranging from $2,500 to $25,000 per violation under Maryland Annotated Code Section 17-804.
View the file
Other files
Show all 14
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment O. Payment of Employee Healthcare Expenses Certification effective date: July 2024
Attachment O. Payment of Employee Healthcare Expenses Certification Under State Finance & Procurement Article Title 17, Subtitle 8
In connection with Solicitation Number _________I, ___________________[Name] hereby certify that ___________________ [Firm Name] is ☐ the bidder/☐ a subcontractor on this project (indicate whether the firm is the bidder or a subcontractor). I further certify that, with respect to employees who will work on or at the site of the project:
[CHOOSE ONLY ONE OPTION BELOW. Note that for purposes of this Certification, “Credible Health Insurance Plan” means any group policy, contract, or program that is written or administered by a disability insurer, health care service plan, fraternal benefits society, self-insured employer plan, or any other entity, in the state of Maryland or elsewhere, that arranges or provides medical, hospital, and surgical coverage not designated to supplement other private or governmental plans.]
1. ☐ The firm pays aggregate employee healthcare expenses of at least 5% of the aggregate social security wages paid.
OR
2. ☐ The firm pays 50% or more of the required premium necessary to obtain employee coverage by a credible health care insurance plan (as defined above).
OR
3. ☐ The firm has 30 or fewer employees and is therefore exempt.
Further, I acknowledge that under §17-804 of the State Finance and Procurement Article, Maryland Annotated Code, a person or entity providing false information regarding this requirement may be subject to a civil penalty of not less than $2,500 and not exceeding $25,000 for each violation.
Signature of Authorized Representative Date
Title of Authorized Representative
Company Street Address
City, State, ZIP Code
BPM059586
File details come from the government source that posted it. Updated .