Healthcare Cost Assistance Eligibility Questionnaire

<img src="https://risepartnership.jotform.com/uploads/jean.sung/form_files/HCA%20coral%20icon.66297dc3a2ed16.49949632.png" width="90px" height="90px" /><br /> Healthcare Cost Assistance Eligibility Questionnaire

This questionnaire asks about the number of eligible working hours you need to qualify for Carewell Healthcare Cost Assistance (HCA) benefits. Eligible working hours — also known as bargaining unit hours — are the work hours paid by Acumen, the State, and/or PPL on behalf of your consumer employer.