Payment_of_Employee_Healthcare_Expenses_Certification.pdf

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Attached to
Three-Year Dune Maintenance Contract @ DNR Ocean City
Solicitation number
BPM046916
Issued by
Wicomico County, National CDP, Maryland

About this file

This document is a Payment of Employee Healthcare Expenses Certification required for a state and local contract opportunity in the state of Maryland. The certification requires bidders or subcontractors to certify that they either pay at least 5% of their aggregate social security wages towards employee healthcare expenses, pay at least 50% of the required premium for employee healthcare coverage, or have 30 or fewer employees and are therefore exempt from the requirement. Failure to provide accurate information on this certification may result in civil penalties of $2,500 to $25,000 per violation. The certification must be signed by an authorized representative of the bidding firm and include the firm's address information.

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Attachment O. Payment of Employee Healthcare Expenses Certification effective date: July 2024

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

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