- 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 the Hamburg Chamber of Commerce or an 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.
- 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. The Hamburg Chamber of Commerce will notify you of this opportunity
through regular mailings and emails. 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 spouse’s 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 analysis? – 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.
- How do I terminate coverage? – Written request to terminate coverage is required. You may fax your request to (716) 649-6362 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
- 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.
- Can I pay my bill by credit card? – No. Credit Card payments are not accepted at EBS RMSCO or at the Chamber offices.
- Fees – Published rates do not include the following and are subject to change Quarterly Administration Fee – $21 per person or Monthly – $11 per person ($7.00 administration fee plus $4.00 FBA monthly billing fee).
- Membership Benefit – Access to health and dental insurance is a benefit of membership. A business MUST be a member in good standing and renew their dues on a timely basis to continue eligibility. Payments must be made by the due date
to avoid late fees and/or cancellation.
- Eligibility – All full-time employees in New York State (working 20+ hours per week) are eligible to enroll. Seasonal employees are NOT eligible. *Please call the Chamber office for complete details.
- Application Process – To apply for health/dental insurance applicants must do so within TWO WEEKS of hire or Chamber membership or a qualifying event. Effective dates vary by date of employment and membership. A $25 non-refundable
processing fee must accompany all applications. Submission of an application is not a guarantee of coverage, please contact the Chamber for questions regarding eligibility.
- Switching Plans – You can only change your plan once a year during an open enrollment period. For our annual open enrollment, applications must be received by November 10th and will be effective January 1st. Again, submission of an
application is NOT a guarantee of coverage.
- Enrollment Guidelines – Please review the following enrollment guidelines for businesses that have an employer/employee relationship and businesses, which are not sole proprietors. These guidelines are set by the carriers and must
be followed. Again, submission of an application is NOT a guarantee of coverage.
Employer checklist for health insurance applications – As the employer there are certain items that you are responsible for before a health insurance application may be processed for you or your employees.
Please note the following:
- Please read over the Enrollment Guidelines from the Carrier that are included in the health insurance comparison package supplied by the Chamber*. There are separate guidelines for companies that have employees and sole proprietors. Please follow
the guideline that pertains to your company type.
- Fill out and sign the employer section on the health insurance application. This appears in a different location on each carrier’s application. Make sure that all of the information is clearly marked.
- Make sure that the date of hire is clearly marked on the application. New hires must apply for health insurance within two weeks of their hire date.
- Please sign the application in the area marked Group Administrator. You are your employees’ administrator. The Chamber has no relationship or control over your employees.
- Please complete and sign the Group Membership Information form supplied by each of the carriers. This information pertains to your company and must be completed fully in order for the application to be processed.
- Please provide any supporting documentation that is required by the carrier. These documents are listed on the Group Membership Information form. These include, but are not limited to, a DBA certificate, NYS-45 tax form or other tax forms.
- Please complete the employer section on the Policy Selection Form. If available, please include an e-mail address for yourself or the subscriber. We are compiling a database of e-mails to provide quick notification of changes or notices regarding
the health insurance plans for those subscribing to plans through the Chamber.
Hamburg Chamber of Commerce Health Insurance Carrier Enrollment Guidelines – For businesses that have an employer/employee relationship. One of the many benefits of Chamber membership is the availability of competitively priced group
health insurance. We currently offer coverage through Independent Health.
Below are enrollment guidelines required by the insurance carriers:
- Only business members and/or their employees who work in New York State at least 20 hours per week are eligible for coverage. If it is found that an ineligible employee is allowed to enroll, the entire group may be canceled.
- Current Chamber business members and their current employees may obtain coverage effective January 1st, during our annual open enrollment period. Exceptions for qualifying events, such as loss of coverage due to divorce, death or termination of employment
(of a spouse) may allow eligible employees to enroll in Chamber sponsored medical plans. Applications due to a qualifying event must be submitted within 30 days of the date of the event.
- New employees may enroll throughout the year as long as they apply within 2 weeks of their date of hire. Effective date will be first of the month following 30 days from the date of hire or pre-established employer specific probationary
period (which must be on file with the carrier).
- New Chamber business members and their current employees may enroll throughout the year as long as they apply within 2 weeks of joining the Chamber of Commerce.
- Each application must be accompanied by:
- Form NYS-45-ATT as proof of business ownership and employment. Carriers may require additional documentation. If the name of the employee enrolling in coverage does not yet appear on the NYS-45-ATT, other proof of employment (pay stub) must be provided.
- Retirees are not eligible for new enrollment in the Chamber’s health insurance program.
- 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.)