Enrollment Basics

Enrollment Opportunities

Employees may enroll in your group's plan during the following times:

  • Initial opportunity - the first opportunity in which employee is eligible to enroll following completion of company's waiting period if applicable.

If employee refuses initial opportunity they cannot join until:


Enrollment Process

Determine Eligibility and Membership Type

Before enrolling each employee, you must determine

  • His or her eligibility (eligible employees)
  • His or her dependent's eligibility (eligible dependents)
  • Type of membership employee will need

 

Membership TypeDescription
SingleEmployee with no dependents
Two-PersonEmployee plus one dependent (child, spouse, party to civil union, or eligible domestic partner)
FamilyEmployee with more than one eligible dependent.

Note:  Employees must enroll all eligible dependents with the exception of spouse, party to a civil union or eligible domestic partner; they may refuse coverage.

 

Complete a Group Enrollment Form

Enrolling employees: submit a completed Group Enrollment Form

Employees declining group coverage:  submit a signed Group Enrollment Fom indicating refusal of coverage to keep refusal application on file at group.

Note:  Employees who refuse coverage cannot join the group until one of the two occurs:  open enrollment or special enrollment
 

Primary Care Provider Choice (if Managed Care)

If a managed care plan is selected, a primary care provider (PCP) must be selected for the subscriber and all eligible dependents in order for membership to become effective.

Find a PCP (link to online provider directory)