Payment of Employee Health Care Expenses Certification (submit with bid).pdf

PDF 183 KB Posted

Attached to
P-054-190-010 Renovate Day-Use Bathhouse at Assateague State Park
Solicitation number
BPM043040
Issued by
Worcester County, Maryland

About this file

This document is a Payment of Employee Health Care Expenses Certification that must be submitted with a bid for a state and local contract opportunity. The contract opportunity is to Renovate the Day-Use Bathhouse at Assateague State Park in Worcester County, Maryland. The certification requires the bidder or any subcontractors to certify that they meet certain requirements regarding the payment of employee health care expenses, such as paying at least 5% of aggregate social security wages towards employee health care expenses or paying at least 50% of the premium necessary to obtain employee coverage by a credible health care insurance plan. The certification also outlines penalties for providing false information.

The document does not provide any additional details about the contract opportunity itself, such as the project scope, quantities, response dates, award dates, or contract term.

View the file

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P-054-190-010 - Addendum 3.pdf PDF
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Text version

Payment of Employee Health Care 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 health care 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).

[PRIOR TO JULY 1, 2021, THE FOLLOWING OPTION IS ALSO AVAILABLE]

3. ☐ The firm pays some portion of employee health care expenses under a contract with a credible health care insurance plan (as defined above) or through a collective bargaining agreement; and we affirm that our firm will meet the requirements of Option 1 or 2 above upon renewal of the contract or collective bargaining agreement.

4. ☐ The firm has 30 or fewer employees, and 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

File details come from the government source that posted it. Updated .