Forms & Resources

HEALTH PLAN FORMS  

• Enrollment & Change Application - enroll new participants and make changes to existing participants
• Declination of Coverage - new employees declining coverage
• Cancellation of Coverage - employess terminating coverage on dependents and/or themselves but continuing employment
• Request/Reject Continuation of Health Coverage - terminating employees

HEALTH PLAN GENERAL INFORMATION  

• All Plans Medicare Notice
• State Continuation Information
• Health Care Reform for Employers
• Health Care Reform for Employees
• Health Savings Account Contribution Limits

PHARMACY PROGRAM INFORMATION 

• BCBS Co-Pay Tiers
• BCBS Prescription Drug Search

PHARMACY DISCOUNT PROGRAMS

• About HarrisTeeter and the Discounted Prescriptions
• About Target Rewards Program and the Generic Prescriptions
• Costco Pharmacy and the Auto Re-Fill Program
• CVS Pharmacy and the Find-A-Drug Program

 NCBA Health Benefit Trust Financials 

• 2008-2009
• 2009-2010
• 2010-2011

SMALL BUSINESS TAX CREDIT

• Plans 1, 2, 3 & 10 certification
• BCBS Tax Credit Calculator
• Tax Credit Introduction
• IRS Qualification Calculator

CHILDRENS HEALTH INSURANCE PROGRAM (CHPRA) - Employers a re required to notify employees of their rights guranteed under the federal regulations. Here are two ways to complete the requirement.

• Notice of CHIP
• Payroll Stuffer