Chapter 44 Six Month Health Benefit Effect
We are requesting this information now that all Special Enrollments should be completed.  
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Name of District
Name of Person completing the survey
Based on results from your completed special enrollment for Chapter 44 do you anticipate that you will see Savings or an Additional Cost for the period January 1, 2021 to June 30, 2021 ? *
Required
Based on results from your completed special enrollment for Chapter 44, what is the total net dollar increase or savings to the district considering both premiums and employee contributions for the period January 1, 2021-June 30, 2021?
What was your total anticipated health benefit expense (net of employee contributions) for the same Jan 1-June 30, 2021 period prior to the law implementation?
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