Great! You've found a plan you are interested in offering to your employees. Now it is time to enroll.

How Employers Enroll in the CommunityCare Small Group Plans.

Application & Forms

Steps for completing your application and forms:

  1. Open the file
  2. Download and Save to your Computer
  3. Fill-out the form
  4. Save it
  5. Send us the forms
Please contact an Account Executive if you have questions or need assistance in completing the forms.
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Step 1: Complete the Employer Group Application

In addition to knowing what plans you are interested in offering to your employees, you will need additional information to apply. To start your application, please have the following information ready:

  • Personal information about your Employer group including tax identification number.
  • Think about how you need your billing statement to reflect any different locations
  • What is your current hourly requirement to be eligible for benefits? How many employees are currently on your payroll? How many are full time employees? How many employees will be enrolling in coverage?
  • What is your current waiting period before an employee is able to enroll in your medical plan? You can decide how much time must pass before coverage can become effective for a new employee hired after your initial enrollment period or renewal. However you cannot select a period of more than 60 days if you are using a "first of the month following" method. For waiting periods greater than 60 days, you can use either "immediately following two months" or "immediately following 90 days". This will ensure the waiting period never goes beyond the maximum 90-day waiting period when their coverage actually starts.
  • What is your current employer contribution requirement?
  • Are you eligible for the premium tax credits available through enrolling through the SHOP? If so, please include the SHOP attestation which is a part of the employer group paperwork. Please note: To qualify for the Small Business Health Care Tax Credit, you must contribution at least 50% of the total employee premium. Visit the Small Business Health Care Tax Credit Estimator at https://www.healthcare.gov/small-businesses/provide-shop-coverage/small-business-tax-credits/ to see if you qualify tax credit and how much it may be worth to you.
  • Do you have qualified group dental coverage? Please see the dental attestation form which will need to be included.
  • Do you know about the Insure Oklahoma premium reimbursement program? You could qualify. Please visit http://www.insureoklahoma.org/ for more information. If you qualify, please make sure you are enrolling with a qualified CommunityCare plan.
  • Please be prepared to include information about your brokers

STEP 2: Enroll your employees.

See the employee application below. This is the information that will either need to be input into a secure portal or submitted to CommunityCare via paper applications. CommunityCare will need an enrollment form for each of the employee’s on your payroll that is eligible for benefits even if they are electing to waive the offered coverage.

Please contact an Account Executive if you have questions or need assistance in completing the forms.