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2010 Orleans County Chamber of Commerce Enrollment Letter
This letter was sent to all members outlining the plan options and changes for the 2009 Open Enrollment.
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BCBS of WNY Application and Change form
Used for all new enrollments as well as existing member changes. This should be submitted along with the appropriate underwriting documentation. Please call our office for details.
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BCBS of WNY Enrollment Form
Please complete this application when enrolling in a BCBS of WNY plan option.
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BCBS of WNY Health Plans for Orleans County Chamber
New 2010 plans and rates for BCBS POS 7100, Community Blue 206, and HMO 104 Frozen Plans in the Orleans County Chamber. Please note these plans require special underwriting and participation requirements. Please call for details.
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BCBS of WNY Underwriting for Groups
Please use this underwriting for all groups in the Orleans Chamber when enrolling in a plan through BCBS.
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BCBS of WNY Underwriting for Sole Proprietors
Please use this underwriting for all sole proprietors in the Orleans Chamber when enrolling in a plan through BCBS.
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Independent Health Chamber Enrollment form
Please use this enrollment form for all enrollments or changes in a chamber plan.
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Independent Health FlexFit Pans for Orleans County Chamber
Independent Health FlexFit Select plan comaprison for the Orleans County Chamber of Commerce. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP Enrollment Form
Please use this enrollment application when enrolling an employee in an MVP product.
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MVP Underwriting for Employer Groups
These documents must be submitted with all new employer groups applying for MVP Plans.
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MVP Underwriting for Sole Proprietors
All Sole Proprietors enrolling in a MVP Health Care product must complete this underwriting.
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Independent Health Underwriting for Groups
Please use this underwriting for all groups in the Orleans Chamber when enrolling in a plan through Independent Health.
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Independent Health Underwriting for Sole Proprietors
Please use this underwriting for all sole proprietors in the Orleans Chamber when enrolling in a plan through Independent Health.
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MVP Trivantage EPO Plans for Orleans County Chamber
New 2010 plans and rates for MVP Trivantage T01S, E0041S, and E0046S for the Orleans County Chamber. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP Trivantage EPO and Hybrid Plans for Orlenas County
New 2010 plans and rates for MVP Trivantage T03S, E0016S, and E0050S for the Orleans County Chamber. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP Underwriting for Groups
Please use this underwriting for all groups in the Orleans Chamber when enrolling in a plan through MVP.
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MVP Underwriting for Sole Proprietors
Please use this underwriting for all sole proprietors in the Orleans Chamber when enrolling in a plan through MVP.
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Univera 2010 AU 13 Plan Comparison
New 2010 plan and rates for Active Univera AU 13 Plan through Univera. Please note these plans require special underwriting and participation requirements. Please call for details.
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Univera Chamber Enrollment Form
Please use this Univera Application for all enrollments and changes through a Chamber plan.
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Univera Underwriting for Groups
Please use this underwriting for all groups in the Orleans Chamber when enrolling in a plan through Univera.
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Univera Underwriting for Sole Proprietors
Please use this underwriting for all groups in the Orleans Chamber when enrolling in a plan through Univera.
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Bene-Care Cancellation Form
Please use this form for all cancellation requests.
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