Employer Resources for Small Group Qualified Health Plans
Find resources and forms that help you and your employees maximize plan benefits and make informed decisions about care options.
Getting Started
Plan Comparison Tool
Use our plan comparison tool to compare our QHP plans and review benefits and costs for your organization.
Enroll Your Organization
Review the steps needed to enroll your organization in our plans and get started on the process.
Integrated Financial Accounts
We offer integrated financial accounts (HRAs, HSAs, and FSAs) that provide your organization and its employees a seamless way to manage health care spending.
Benefits & Programs
Be Well Vermont
Our Qualified Health Plans offers access to Be Well Vermont – our free, wellness program that helps members with setting wellness goals, tracking progress, and fun challenges.
Personal Health Services
Our registered nurses, licensed social workers, and behavioral health counselors offer personal health services. We offer expertise in different areas of health care, including medical, mental health and substance use treatment.
Prescription Drug Coverage
Vermont Blue Rx is your one-stop solution for prescription drug coverage, and includes access to trusted local pharmacies and a nationwide network of retail pharmacies, home delivery options, and medication management programs.
Primary and Preventive Care
Our plans cover primary care and specialty provider visits (cost-share, deductibles and copays apply). Use our find a doctor tool to get locate a provider near you.
Telemedicine Care
We provide 24/7 telemedicine care with Amwell so you can access care whenever you need, from wherever you may be.
Pediatric Dental and Vision Benefits
Included as part of the Essential Health Benefits, dental and vision benefits are available for members up to age 21.
Downloadable Resources
Share the resources below with your employees to help them with managing their health plan and care.
Understanding Preventive Coverage
The foundation of a well-rounded health plan is a regular preventive health visit. Check out our tips for getting the most out of your preventive coverage.
Mental Health Telemedicine Resources
To meet the increasing need for mental health and substance use disorder providers, we’ve partnered with Sondermind®, Valera Health®, and Amwell® to increase access to mental health care providers for our members.
Register for the Member Resource Center
Our Member Resource Center provides helpful information for your employees, including eligibility, claims and approvals. They can also access forms and send secure messages.
Maximize Your Benefits
Our blog provides members with resources for understanding health insurance and maximizing their health plan, as well as other health and wellness articles. Below are a few articles to share with your employees to help them with managing their benefits.
Zero-Dollar Office Visits
We offer zero-dollar office visits in many of our qualified health plans (QHPs) for in-network primary care, mental health, or substance use disorder treatment.
Tips for Maximizing Your Benefits
From understanding your benefits to strategically planning procedures, we've got you covered with tips to help you maximize your health plan and save money on health care.
Everything to Know About HSAs
Some of our Consumer-Directed Health Plans (CDHP) are eligible to be paired with a MyMoney Health Savings Account (HSA). HSAs let you set aside money on a pre-tax basis to pay for qualified medical expenses.
Enrollment and Change Forms
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.
- Open enrollment period (OEP): usually the anniversary date of the group's original enrollment
- Special enrollment period (SEP): outside Open Enrollment, employees have the right to sign up for a health plan if they experience a qualifying life change, such as marriage, divorce, or involuntarily lose of other coverage. A qualifying event will allow a 60-day Special Enrollment Period from the date of the event to elect new coverage.
Changes to existing coverage may be made during the open enrollment or special enrollment periods. Use the table below to help understand stand when enrollment or enrollment changes can be made.
| Event | Date of Submission | Change Effective Date |
|---|---|---|
| New Hire/ Rehire* | No later than 60 days from the date of hire | Effective date based on Group's probationary period – not to exceed 90 days from date of hire |
| Marriage/Civil Union* | Within 60 days following marriage | First of the month following receipt |
| After 60 days following marriage | Void - must wait until next Open Enrollment | |
| Birth* | Newborn is automatically added for first 60 days Within 60 days following the date of birth, to continue coverage or to request other changes to your coverage | Date of birth for child and 61st day after the birth for the membership type change |
| After 60 days following birth | Void - must wait until next Open Enrollment | |
| Adoption* | Within 60 days following the date of birth, to continue coverage or to request other changes to your coverage | Date of birth for child and 61st day after the birth for the membership type change |
| After 60 days following birth | Void - must wait until next open enrollment | |
| Death | Within 6 months of the date of death | Date of death |
| Divorce | Within 60 days of divorce | First of the month following divorce |
| Qualifying Loss of Coverage* | Within 60 days of loss of coverage | Retroactive to date of coverage loss or first month following receipt |
| Voluntary Cancellation | Submit Small Group Employee Enrollment and Change Form with employee signature Outside of Open Enrollment, proof of other coverage must be provided | First of the month following receipt or mid-month date if other coverage begins mid-month |
| Left Employment | Submit Group Membership Update Form indicating key word as "LE" | Term date of employment termination or first of the month following date of receipt |
| COBRA Eligibility | If subscriber accepts COBRA within 60 days, he or she can be retroactively reinstated | Not Applicable |
| Medicare Supplement Coverage | Within 90 days of the date of Medicare coverage | Date of Medicare entitlement. If received prior to Medicare effective date, coverage will be effective to coincide with Medicare. |
| Addition of Employee who Refused Initial Enrollment | Prior to or after Open Enrollment | Void - must wait until next Open Enrollment |
| During Open Enrollment | Effective the first of the new calendar year (January 1) after Open Enrollment ends |
* Requests not received as indicated above can be processed during Open Enrollment to begin the first of the new calendar year (January 1).
Before enrolling or making changes to your employee's membership, you must determine
- Eligibility
- The employee's dependent(s) eligibility
- Type of membership the employee will need (employee only; two-person; adult and child(ren); or family)
- If the plan requires a primary care provider (PCP) be selected, the PCP must be selected for the employee and all eligible dependents in order for the membership to become effective.
Prior to completing an enrollment form, you must ensure that your employees have the Summary of Benefits Coverage (SBC) that apply to the coverage for which they may enroll.
| Employer Forms | Purpose |
|---|---|
| Used to submit a change or to enroll an employee in a small group qualified health plan | |
| Small groups who are NEW to Blue Cross and Blue Shield of Vermont should complete this packet | |
| To show your employees what plan(s) you are offering and what contribution amounts are and allow employees to provide you their plan selection. |
All group enrollment & change forms must be signed and dated by the subscriber.
All membership update forms must be signed and dated by the appropriate group representative.
| Employer Forms | Purpose |
|---|---|
| Group Contact Update Form | This form allows employer groups to add or change designated contacts to receive or change information at Blue Cross VT for your organization. |
| Broker Authorization Form | This form allows employer groups to designate a broker agency and/or individual brokers as authorized contacts to receive or change information on behalf of the group. It will be included in this year's renewal forms that CBSS and account managers review with both small and large groups. |
Members can complete this form electronically through the Member Resource Center (under "My Forms") | For new members receiving treatment for a chronic medical, mental health or substance abuse condition or pregnant and are in their 2nd or 3rd trimester. Completion of this form will ensure a seamless transition of health care and pharmacy needs. |
| Statement of Domestic Partnership | Domestic Partner Coverage |
| Adult Dependent Coverage Request | Request for coverage, and medical certification |
| MSP Step-by-Step Guide for Small Group Exception | Step-by-step guidance on how to apply for a small employer exception from Medicare coordination of benefits contractor. |
| Waiver of Group Health Insurance | Used by spouses or partners to opt-out of Blue Cross and Blue Shield of Vermont coverage. |
All group enrollment & change forms must be signed and dated by the subscriber.
All membership update forms must be signed and dated by the appropriate group representative.
| Forms | Purpose |
|---|---|
| Creditable Coverage Simplified Determination | Important notice concerning prescription drug coverage |
| Creditable Notice Template | Important notice concerning prescription drug coverage |
| Non-Creditable Notice Template | Important notice concerning prescription drug coverage |
| CMS Creditable Coverage Guidance | Important notice concerning prescription drug coverage |
| Vermont Blue 65 Group Enrollment Application and Change Form | Medicare Supplement enrollment form for group members to enroll or make changes. |
For additional information on the above forms, visit CMS.gov.
All group enrollment & change forms must be signed and dated by the subscriber.
All membership update forms must be signed and dated by the appropriate group representative.
- Where can I locate additional Blue Cross and Blue Shield of Vermont forms?
- Is it required to submit a Group Membership Update form with the Group Enrollment Form?
- No, most membership changes can be processed from the Group Enrollment Form.
- When can an employee expect to receive their ID card(s)?
- Generally, ID cards are mailed to the subscriber’s home address within 7-10 days of processing.
- Can I submit membership changes using my invoice?
- No, do not make membership changes on the invoice or send any membership changes to our payment address.
- Can I pay a lower premium than billed based on a pending change?
- It is highly recommended you pay the total amount due shown on the last page of your invoice. If you are expecting adjustments, because we bill a month in advance, these adjustments may appear on a future invoice.
- How do I obtain information regarding COBRA/VIPER coverage?
- COBRA is federally mandated. VIPER (VT Statute) is state mandated. Please contact your legal counsel for questions.
- If COBRA/VIPER has been offered to a former employee, when should I submit the cancel request?
- Blue Cross and Blue Shield of Vermont recommends you submit the cancel request once the individual has left employment. If continuation of coverage is elected, the coverage will be effective the day coverage was lost, as long as the paperwork is received on time.
- When can I make benefit changes?
- Benefit changes can only be made once a year, on the anniversary of your original enrollment or association renewal date, or due to special enrollment event.
Qualified Health Plans (QHP) Plan Documents
Vermont Preferred Plans
- 2025 Vermont Preferred Gold Plan
- 2025 Preferred Silver Reflective Plan
- 2025 Vermont Preferred Bronze Plan
Vermont Select Plans
- 2025 Vermont Select Gold CDHP Plan
- 2025 Vermont Select Silver CDHP Reflective
- 2025 Vermont Select Bronze CDHP
Standard Plans
- Platinum, Gold, Silver and Bronze Plans Certificate of Coverage (280-318)
- Vermont Preferred Gold, Silver and Bronze Plans Certificate of Coverage (280-319)
- Vermont Select Gold, Silver, and Bronze CDHP Plans Certificate of Coverage (280-320)
- Vermont Silver and Bronze CDHP Plans Certificate of Coverage (280-326)
How can we help?
We're here for you
We'll help you find the right plans for your organization and employees.
Connect with UsHours
Monday–Friday
8:00 a.m. to 4:30 p.m.