HEALTH GUIDELINES

Cheektowaga Chamber of Commerce

HEALTH INSURANCE ENROLLMENT GUIDELINES

Coverage is available through BlueCross BlueShield of WNY, Independent Health and Univera Healthcare.

Ø Only business members and/or their employees who work at least 20 hours per week are eligible for coverage. If it is found that an ineligible employee is allowed to join, the entire group may be canceled.

Ø Current Chamber business members and their current employees can only obtain coverage effective January 1^st, our open enrollment. (Some exceptions exist.) Applications and premium payments for open enrollment must be received in the Chamber office by December 7^th.

Ø New employees may enroll throughout the year as long as they apply within 30 days from their date of hire.

Ø New Chamber business members and their current employees may enroll throughout the year as long as they apply within 60 days of joining the Chamber of Commerce.

Ø Sole Proprietors must be a member of the Chamber 60 days prior to the effective date if the insurance policy.

Ø Applications received by the 10^th of the month will be effective the first day of the following month. Applications received after the 10^th of the month become effective the first day of the month following 30 days of receipt.

Ø Retirees are not eligible for new enrollment in the Chamber’s health insurance program.

Ø Married couples must apply for family coverage. (Exception: two single policies may be issued if each spouse is employed by a Chamber-member business at least 20 hours per week.)

A non-refundable $25 application fee, payable to the Cheektowaga Chamber of Commerce, must accompany application. In addition, copies of the appropriate documentation (see chart below) must be submitted with application. Alternate documents may be acceptable in certain situations.

SMALL GROUP

Businesses with 2-50 eligible employees

Documentation Required:

If the business files NYS-45-ATT

· NYS-45-ATT

If the employee enrolling does not yet appear on the

NYS-45-ATT, proof of employment (pay stub) must be

provided.

If Partners/Owners/Businesses are not on NYS-45-ATT

· IRS Schedule C OR IRS Schedule E OR IRS Schedule K-1 OR Copy of Corporate Tax Return 1120C (income and expense page only)

If the new business is in its first year of operation

· Copy of a cancelled Business Check OR copy of a Business Bank Statement OR Certificate of Doing Business OR appropriate tax documents

NOTE: If the business has not yet filed a NYS-45-ATT, the form must be provided within 90 days of the effective date of coverage.

SOLE PROPRIETOR GROUP

Unincorporated Business, Partnership or Corporation

whose owner, partner or stockholder is the only active employee

· IRS Schedule C OR IRS Schedule K-1 AND

· Copy of Doing Business As (DBA) certificate OR Copy of NYS Dept. of Taxation & Finance Certificate of Authority AND

· Current Partnership Agreement if applicable

If the new business is in its first year of operation

· DBA OR Partnership Certificate OR Certificate of Incorporation AND

· Copy of a Cancelled Business Check OR copy of a Business Bank Statement OR Certificate of Doing Business OR appropriate tax documents

Additional Guidelines for Enrollment

Ø You must remain enrolled in the Dental Pay Plus plan for at least 12 months.

Revised 11/10

Please Click Here for 2012 Rate Sheet (PDF Format)