[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-301891-105":53,"doc-detail-301891-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","hmo-submission-checklist","HMO Submission Checklist","","HMO submission checklist detailing required components for completing an HMO enrollment and enrollment-related paperwork. Includes master application and signed enrollment application, deposit check for the first month’s premium, prior carrier’s last billing statement, and ownership documentation. Specifies additional documents for sole proprietors, partnerships, and corporations, plus broker paperwork and W-9 and E&O insurance. Covers eligibility criteria for 1099 employees, group size definitions, required DE-9c or payroll proof, and instructions for employee roster completion and waiver/decline reasons, including contact details and coverage transition notice requirements.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/hmo-submission-checklist/301891/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/hmo-submission-checklist/301891.png","ImageObject",442,249,{"name":88,"@type":89},"Hazel","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-25","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What are the core documents required for a complete HMO submission?","Question",{"text":108,"@type":109},"The submission includes the completed master application, the signed and dated enrollment application, a deposit check for the first month’s premium, the last billing statement from the previous carrier, and ownership paperwork when owner/partner names are not on the most recent DE-9c.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What documents are required for a sole proprietor, partnership, or corporation?",{"text":113,"@type":109},"Sole proprietor submissions require a business license, fictitious business name statement, and Schedule C. Partnerships require business license showing all names, fictitious business name statement showing all names, Schedule K for each partner, and a notarized partnership agreement. Corporations require corporation documents including Form 1120 with schedule E or schedule K-1, articles of incorporation, and statement of information for certain group sizes, plus broker paperwork, license, W-9, and E&O insurance.",{"name":115,"@type":106,"acceptedAnswer":116},"How do you handle 1099 employees and group coverage waivers?",{"text":117,"@type":109},"1099 employees are eligible only if they appear on the prior carrier billing statement, there was sufficient affiliation for a federal tax return, required 1040 Schedule C and 1099 Misc copies are provided, a letter requests to cover 1099 employees, they do not exceed 25% of enrolled employees, and the 1099 Contractor Verification Form is completed. For group submissions, employee rosters must include eligibility and health plan selections, and waiver/decline reasons should be indicated for employees who waive or decline coverage.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},301891,1790313567,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","# HMO Submission Checklist\n\nA complete submission includes:  \n Master application completed in its entirety.  \n Enrollment application signed and dated by employees within  \n 60eaDcedhcslthlingonequmpcoeefffectivormefdorateeacompch eliglietebledein imptls entoyeeiretydecliforning We believe thshouldatbehealteasyh carecoverage. Please note SHP requires copies of employees’ ID cards to  \nverify participation is being met.  \n  Deposit check made out to Sharp Health Plan reflectingthe appropriate amount for the first month’s premium drawnfrom the group’s account.  \n Last billing statement from the previous carrier.  \n Ownership paperwork (required if the names of the owner(s)/partnersdo not appear on the most recent DE-9c; tax extensions are not accepted) .  \nDocumentation requested may include:  \nFora sole proprietor:  \n􀂃 Business license  \n􀂃 Fictitious business name statement  \n􀂃 Schedule C tax form  \nFora partnership:  \n􀂃 Business license (showing all names)  \n􀂃 Fictitious business name statement (showing all names)  \n􀂃 Schedule K tax form (for each partner)  \n􀂃 Notarized partnership agreement  \nFora corporation:  \n􀂃 Corporation documents (Form 1120 with schedule E or schedule K-1)  \n􀂃 Articles of incorporation  \n􀂃 Statement of information (Required for groups with 4 subscribers and under)  \n Broker paperwork  \n􀂃 License  \n􀂃 Completed W-9  \n􀂃 Errors & Omission Insurance (E&O Ins.)  \n 1099 Employees are eligible if:    \n􀂃 1099 employees are on the prior carrier billing statement.  \n• over •  \n􀂃 There was an affiliation between the employer and the employee long enough for a Federal Tax returnto be filed. Copies of the Form 1040 Schedule C and Form 1099 Miscellaneous for the prior yearare required.  \n􀂃 Letter from the employer requesting to cover 1099 employees.  \n􀂃 No more than 25% of the enrolled employees may be 1099 employees.  \n􀂃 Completed 1099 Contractor Verification Form.  \nPlease include the following documents depending on the size of the group:  \nSmall groups are one to 50 benefits-eligible employees. At least one of these employees must not be an owneror spouse of an owner.  \nDE-9c is required  \n􀂃 If the group has not been in business long enoughto have a DE-9c, please submit six weeks of payroll,showing withholdings.  \n􀂃 To reconcile the DE-9c, please indicate the appropriatecode next to each employee’s name:  \nT Terminated (include date)  \nE Eligible and enrolling (indicate job titles if carveout)WG Eligible and waiving for other group coverage  \nWI Eligible and waiving for own individual coverage  \nWS Eligible and waiving spouse/domestic partner coverageIE Ineligible (part-time, seasonal, waiting period)  \nD Declining (no other coverage)  \nLarge groups are 51 or more benefits-eligible employees.Complete employee roster for each employee and include:  \n􀂃 Name  \n􀂃 Eligibility for benefits  \n􀂃 Health plan selected  \nIf employees waive or decline coverage, please indicatethe reason (has other coverage/has no other coverage, etc.) .  \nYou may send a quote request to SHP.CommercialSales@sharp.comor fax (619)228-2446 or call (619)228-2429 . You may also obtaina preliminary quote by registering to use the Sharp Health Planonline quoting tool at www.SharpHealthPlan.com.  \nUnder no circumstances shoulda prospective group  \ndiscontinue its present insurance coverage without written  \nnotice from Sharp Health Plan that new coverage has beenapproved and isin force.  \n8520 Tech Way, Ste. 200 | San Diego, CA 92123 |Tel: (858) 499-8377or 1-800-359-2002 | Fax: (858)499-8377www. SharpHealthPlan.com  \nSHPA196.12.13 © 2013 SHC","cbCaiimovdFeWw90","https://ap.wps.com/l/cbCaiimovdFeWw90","pdf",1059017,"English","# HMO Submission Requirements\n## Core Submission Documents\n## Ownership and Requested Supporting Documentation\n## 1099 Employee Eligibility and Verification\n## Group Size Rules and DE-9c / Payroll Requirements\n## Employee Roster and Coverage Waiver/Decline Notes\n## Sharp Health Plan Contact and Coverage Transition Guidance","[{\"question\":\"What are the core documents required for a complete HMO submission?\",\"answer\":\"The submission includes the completed master application, the signed and dated enrollment application, a deposit check for the first month’s premium, the last billing statement from the previous carrier, and ownership paperwork when owner/partner names are not on the most recent DE-9c.\"},{\"question\":\"What documents are required for a sole proprietor, partnership, or corporation?\",\"answer\":\"Sole proprietor submissions require a business license, fictitious business name statement, and Schedule C. Partnerships require business license showing all names, fictitious business name statement showing all names, Schedule K for each partner, and a notarized partnership agreement. Corporations require corporation documents including Form 1120 with schedule E or schedule K-1, articles of incorporation, and statement of information for certain group sizes, plus broker paperwork, license, W-9, and E\\u0026O insurance.\"},{\"question\":\"How do you handle 1099 employees and group coverage waivers?\",\"answer\":\"1099 employees are eligible only if they appear on the prior carrier billing statement, there was sufficient affiliation for a federal tax return, required 1040 Schedule C and 1099 Misc copies are provided, a letter requests to cover 1099 employees, they do not exceed 25% of enrolled employees, and the 1099 Contractor Verification Form is completed. For group submissions, employee rosters must include eligibility and health plan selections, and waiver/decline reasons should be indicated for employees who waive or decline coverage.\"}]","HMO Submission Checklist | PDF",1789786188]