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Get VT Form HC-2 2018-2024

Form for 3 years. DECLARATION OF HEALTH CARE COVERAGE Employer: This form is only to be completed by employees if you offer to pay a portion of a health care plan that provides hospital and physicians services to at least some of your employees. You must retain all employee declaration forms together in a file for three years and be able to produce them in the event of an audit. Employer s Legal Name (Please print).

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