Required Health Plan Contribution Report

ERISA rules require that employers track, and the Unitarian Universalist Association (UUA) report, the dollar amount of Health plan premiums paid by employers as well as the dollar amount paid by employees. Our Health Plan auditors review this information and may request detailed payroll documentation from non-reporting employers in order to satisfy Department of Labor filing requirements.

Use this secure online form to enter the monthly "split" beteween employer and employee contributions.

Important Points

  • Only include amounts for UU Heath Plan insurance premiums; do not report any premiums associated with Life, Dental or Disability coverage.
  • Show only the dollar amount that the employer contributed, and the dollar amount each employee contributed for UU Heath Plan premiums.
  • All health plan participating groups must report this information each month.
  • Report only monthly premiums, not specific payroll amounts.
  • The total for employer and employee contributions must equal the billed health premium for each person.
  • You cannot save the online form and return to it later. The form must be completed and submitted in one sitting.
  • Before hitting "Submit", please print a copy for your records.
  • Complete the online form monthly.
  • The total for each employee should match the amount billed for each employee for the month for the UU Health Plan.