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.

Blue Cross VT employees working together

Resources for You and Your Employees

For over 40 years, Blue Cross VT has been dedicated to enhancing the health and wellness of Vermonters as the state's only local, non-profit health plan. We're committed to supporting you and your employees, helping you understand your Qualified Health Plan (QHP) benefits and services.

When you have a Blue Cross VT health Plan, you have:

Trusted Local Coverage: As a non-profit organization based in Vermont, we provide reliable coverage you can count on.
Award-Winning Support: Our Vermont-based staff delivers exceptional customer service recognized for excellence.
Extensive Network Access: Benefit from the largest network of doctors and hospitals in Vermont.
Global Reach: Access healthcare professionals and facilities across the U.S. and worldwide.

If you're looking to enroll an employee in your group coverage or make changes to your existing coverage, additional information and forms can be found below. You can also log in to our Employer Resource Center to access forms online for making updates. For brokers supporting employer groups, access our Broker Resource Center to help manage your group's plan.

If you need assistance with choosing plans for your employees or managing your plan throughout the year, connect with our local small business team at (800) 255-4550 (TTY/TDD: 711).

Getting Started

Open Enrollment begins November 1 each year for enrollment in our Qualified Health Plans (QHP). Access our tools and resources to help find the right plans for your organization and employees.

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.

Patient with his primary care provider during a health visit

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.

Male patient at check up with his doctor

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.

Father and daughter working together at home

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.

Blue Cross VT Blog

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.

Mother working from home while dad and daughter having fun laptop computer work family

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.

A couple reviewing their Summary Health Plan Payments document

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

Enrolling an employee in your group coverage or making changes to your existing coverage can be done electronically through our Employer Resource Center or by completing the enrollment/change form(s) below and sending to us via email, fax, or mail.

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: usually the anniversary date of the group's original enrollment
Special enrollment period: triggered by a qualifying event

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
Marriage/Civil Union*	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
Birth*	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
Adoption*	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
Addition of Employee who Refused Initial 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
2024 Small Group Employee Enrollment/Change Form	Used to submit a change or to enroll an employee in a small group qualified health plan
2024 Small Group: New Group Enrollment Packet	Small groups who are NEW to Blue Cross and Blue Shield of Vermont should complete this packet
2024 Small Group Plan Selection Form	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.

834 Submissions Companion Guide

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.
Continuity of Care 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.

Go to Member Forms

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.

Go to Member Forms

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?
1. Member Forms
2. Provider Forms
Is it required to submit a Group Membership Update form with the Group Enrollment Form?
1. No, most membership changes can be processed from the Group Enrollment Form.
When can an employee expect to receive their ID card(s)?
1. 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?
1. 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?
1. 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?
1. 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?
1. 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?
1. 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

Vermont Select Plans

Standard Plans

How can we help?

Blue Cross VT Consumer & Business Support Services Team

We're here for you

We'll help you find the right plans for your organization and employees.

Connect with Us

Want to chat with our local team? We can connect you with an agent who can answer your questions and help you choose the plans that are best for your organization and employees. Note: all form fields are required.

(800) 255-4550 (TTY/TDD: 711)

Hours

Monday–Friday
8:00 a.m. to 4:30 p.m.