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Get and Sign Ma Hird Form PDF 2007-2022
Insurance?
2. Were you offered a “Section 125 Cafeteria Plan” to pay for health insurance?
The S125 Plan allows you to request that the premium for your health insurance
through the Commonwealth Connector Authority be deducted from your
paycheck on a pre-tax basis.
2a. If yes, did you decline to use the section 125 Cafeteria Plan?
3. Do you have other health insurance?
No
✔
N/A
Yes
✔
No
Yes
✔
No
Yes
✔
No
4. Do you have health insurance through the GIC as an employee of another...
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