LD 1507
pg. 10
Page 9 of 12 An Act To Clarify and Update the Laws Related to Health Insurance Page 11 of 12
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LR 1913
Item 1

 
payroll company showing wages paid to that employee
for the most recent quarter with tax withholding; or

 
(d)__If the name of the business owner or employee
does not appear on Form 941/C1-ME, a copy of one
of the following:

 
(i)__Federal income tax Form Schedule C or
Schedule F;

 
(ii)__Federal income tax Form 1120S, Schedule
K-1;

 
(iii)__Federal income tax Form 1065, Schedule
K-1;

 
(iv)__A workers' compensation insurance audit
or evidence of a waiver of benefits under
Title 39-A;

 
(v)__A description of operations in a
commercial general liability insurance policy
or equivalent insurance policy providing
coverage for the business; or

 
(vi) A signature card from a financial
institution or credit union authorizing the
employee to sign checks on a business
checking or share draft account that is at
least 6 months old; a notarized affidavit
from the employer describing the duties of
the employee and the average number of hours
worked by the employee and attesting that the
employer is not defrauding the carrier and is
aware of the consequences of committing fraud
or making a material misrepresentation to the
carrier, including a loss of coverage and
benefits; and, if the group coverage is
purchased through a producer, a notarized
affidavit from the producer affirming the
producer's belief that the employer qualifies
as an eligible group for coverage.

 
In determining if a new business or a business that adds an owner
or a new employee to payroll during the course of a year
qualifies as an eligible group for 2-person coverage under this
subparagraph, the employer must submit an affidavit stating that
all employees meet the criteria in this subparagraph and that the


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