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 email Benefit Choices.
Enrollment/Change Application - Can be completed online and printed.
EMPIRE BLUE VISION PLAN - Enrollment Application for Vision plan
GUARDIAN DENTAL - Enrollment Application
BLUESHIELD OF NORTHEASTERN NY
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, press 2 for Ann Maria Casper, or email Ann Maria at firstname.lastname@example.org.