FAQ's for Hamburg Chamber of Commerce Group Health Insurance
WHO IS ELIGIBLE FOR GROUP HEALTH INSURANCE?
Current business members and their eligible employees may apply for group health coverage(s) through the Hamburg Chamber of Commerce. Member companies must maintain a current membership with the Hamburg Chamber of Commerce in order to continue to receive access to group health insurance through the Hamburg Chamber of Commerce.
WHAT PAPERWORK IS REQUIRED TO BE COMPLETED BY EMPLOYERS?
First, New York State insurance regulations require that businesses enrolling in group health coverage through a Hamburg Chamber of Commerce or Association show that they are authorized to do business in the State of New York (i.e., by providing a dba certificate, partnership or incorporation papers) AND show income from the business (by providing Schedule C information from prior tax year or NYS 45, quarterly withholding report showing employees for corporations). See checklist at the end of this FAQ.
Each insurance company requires member company’s complete an Employer Application at the time the group enrolls. Employers need only complete the Employer Application associated with the carrier employees are enrolling.
WHAT PAPERWORK IS REQUIRED TO BE COMPLETED BY EMPLOYEES?
Eligible employees are to complete (in full) an application for the appropriate coverage selected and return it to their employer for approval and submission to EBS Benefit Solutions. For new members applications for health coverage may be obtained from the Hamburg Chamber of Commerce.
WHO IS CONSIDERED AN ELIGIBLE EMPLOYEE?
Eligible employees are defined as those employees who work 20 hours or more per week, or satisfy the eligibility criteria defined by the member company. Member companies who follow different eligibility conditions must disclose this criteria in writing prior to enrolling in benefits.
HOW DO I FIND OUT ABOUT THE PLANS AVAILABLE?
Benefit summaries are available at the Hamburg Chamber of Commerce, or by clicking the link below to view a health benefits summary - click here for the 2010 Comparison Rate Sheet
WHEN CAN WE ENROLL IN GROUP HEALTH COVERAGE?
NEW member companies must enroll no later than the 1st day of the month following 30 days of hire. Sole Proprietors are eligible to enroll no later than the 1st day of the month following 60 days of Hamburg Chamber of Commerce membership.
New employees must enroll within 30 days of their date of hire, with coverage effective the first day of the month following 30 days. Of course, employees of a member company who experience a qualifying event, such as loss of coverage (through a spouse), divorce, etc. may enroll within 30 days of the date of the event.
ARE THERE OTHER TIMES DURING THE YEAR THAT WE MAY ENROLL?
Generally, Open Enrollment is the only opportunity you may enroll or change existing health coverage. Your Hamburg Chamber of Commerce will notify you of this opportunity through regular mailings. As a consumer you should take advantage of the opportunity to learn about the changes in plans, rates and enrollment requirements by attending the open enrollment sessions.
CAN I MAKE CHANGES TO MY EXISTING COVERAGE DURING THE YEAR?
Generally, changes in status or qualifying events will permit existing subscribers to make changes in response to the qualifying event. Changes in status, or qualifying events include, but are not limited to: birth of a child, QMSCO’s, marriage, divorce, legal separation, loss of coverage through another source (such as a spouse). If you lose coverage through another source, such as a spouses plan, you may enroll in coverage through the Hamburg Chamber of Commerce, as long as your employer is a current member of the Hamburg Chamber of Commerce and you enroll within 30 days of the date of the loss of coverage.
Documentation to support your qualifying event will be required to accompany your application. For example, if you become married, we will request a copy of the marriage certificate or other form of validation indicating the date the event took place.
Changes to existing health plan coverage must be made within 30 days of the date of the event by submitting a completed application to EBS Benefit Solutions.
WHEN MUST APPLICATIONS BE RETURNED TO FRINGE BENEFIT ANALYSTS?
For new hires or new member companies (and any eligible employees) applications are due at least three (3) weeks prior to the effective date of coverage. For new enrollments, premium payment MUST accompany all applications being submitted to EBS Benefit Solutions.
SOLE PROPRIETORS – applications and coverage are effective first of the month following 60 days from date of membership.
HOW DO I DETERMINE HOW MUCH TO REMIT WITH MY APPLICATION?
You must contact EBS Benefit Solutions to receive our Premium Calculator to determine how much you should remit with your applications. This form will be sent to you for completion and will be required to be returned with all items identified on the checklist (see last question in this FAQ). Applications that are not accompanied by the appropriate first months’ premium will not be processed until payment is received. You will not receive a bill for initial enrollments, the premium calculator will serve as your receipt, please retain a copy for your records.
HOW DO I TERMINATE COVERAGE?
Written request to terminate coverage is required. You may fax your request to (716) 564-2748. Termination requests must include the person's name and the last day of the month in which coverage is to terminate. Terminations must be received no later than 30 days from the date coverage is to end.
HOW DO I DISENROLL A DEPENDENT?
In the event you must disenroll a dependent due to death, divorce or a qualifying event, and enrollment form must be completed and sent to EBS Benefit Solutions within 30 days of the event. You must also submit a copy of documentation to support the qualifying event, such as the 1st and last page of the divorce decree with enrollment change form. Documentation must accompany the enrollment form in order for the change to be processed by the insurance company.
WHEN WILL I RECEIVE MY HEALTH INSURANCE INVOICE?
The Billing Schedule will generally be issued five (5) weeks prior to the calendar quarter for quarterly payees, with payment due dates clearly marked on your invoice. During open enrollment and annual rate adjustments, the billing schedule will often be delayed.
WHERE DO I MAKE MY INSURANCE PAYMENTS?
All payments are to be sent to:
EBS Benefit Solutions
25 Northpointe Parkway
Suite F
Amherst, New York 14228
You should indicate the invoice number from your monthly or quarterly bill on your check.
CAN I PAY MY BILL BY CREDIT CARD?
No. Credit Card payments are not accepted at Fringe Benefit Analysts or at the Chamber offices.
IS THERE A CHECKLIST I CAN USE TO ENSURE MY PAPERWORK IS IN ORDER?
For new member companies applying for health insurance, the following items must be submitted as a complete package, BEFORE any enrollments can be processed for insurance coverage.
- Individual Enrollment Application(s)
- DBA Certificate, Partnership Agreement or Articles of Incorporation
- NYS 45 (Quarterly Withholding) from the most current quarter.
OR
- Schedule C, from the most current period end.
- First months premium payable to Fringe Benefit Analysts, Inc.
- Application Fee of $25.00 (per each application), payable by separate check to HAMBURG CHAMBER OF COMMERCE.
TO ENSURE TIMELY PROCESSING OF YOUR APPLICATION(s), THE APPROPRIATE PREMIUM MUST ACCOMPANY YOUR APPLICATION.
Hamburg Chamber of Commerce
(716) 649-7917
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