Attachment O - Payment of Employee Healthcare Expenses Certification.pdf
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- Solicitation number
- BPM058791
- Issued by
- Maryland
About this file
This is a certification document for employee healthcare expenses required under Maryland State Finance & Procurement Article Title 17, Subtitle 8, applicable to bidders and subcontractors on state contracts with the State of Maryland. The certification must be completed by an authorized representative of the bidding firm or subcontractor and submitted in connection with solicitation opportunities. Contractors must demonstrate compliance with one of three employee healthcare expense options: paying aggregate healthcare expenses of at least 5% of aggregate social security wages paid to employees working on the project; paying 50% or more of the required premium for credible health insurance plan coverage; or qualifying for an exemption if the firm has 30 or fewer employees.
Failure to provide accurate information on this certification exposes the contractor to civil penalties ranging from $2,500 to $25,000 per violation under Maryland Annotated Code Section 17-804. The certification requires the authorized representative's signature, title, date, company address, and identification of whether the certifying firm is the prime bidder or a subcontractor on the project. This document is mandatory for participation in Maryland state procurement activities and serves as a compliance mechanism to ensure contractors meet state-mandated employee healthcare benefit standards.
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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
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