Open Enrollment is held annually from November 1 through 30,
for an effective date of January 1.
All new small business or individual/sole proprietor enrollment applications must include either an NYS45 payroll document, a Schedule C, or a W4 issued to a new hire proving employment by the business.
For questions related to plans, enrollment or forms, please call 518.431.1419 or email our enrollment team.
Enrollment/Change Application - Can be completed online and printed.
*New Groups* -Employer must complete these two forms: Employer Group Size Attestation Employer Group Application
*New Groups* -Employer must complete these two forms: MVP Small Business Application NY Small Group Recertification
EMPIRE BLUE VISION PLAN - Enrollment Application for Vision plan
GUARDIAN DENTAL - Enrollment/Change Application
HIGHMARK BLUESHIELD OF NENY
Billing and Payment
Premiums for health insurance are invoiced on a monthly basis through Business Services Corporation dba Benefit Choices. Bills are mailed mid-month covering the following month; payment is due on the first of the month. (i.e., February premium invoice is mailed mid-January and is due February 1.) Payments not received in a timely fashion incur a late fee of $25. Coverage may be terminated if payments are more than 30 days past due.
We offer two payment methods:
A Check can be mailed using the envelope provided with your invoice. All payments should be mailed to Benefit Choices, PO Box 10145, Albany, NY 12201.
Electronic Payment - By completing our Authorization Form, you can elect to have your monthly premium electronically deducted on the first business day of each month.
For billing or payment questions, or to obtain a copy of your invoice, please call 518.431.1419 and ask for Trish Smith, or use the
email form below.
Business Services Corporation
5 Computer Drive South
Albany NY 12205