What coverage is offered?

Preferred Care TriVantage	Blue Choice Value	Preferred Blue Million
Preferred Care Opportunity	Blue Choice 25	20/20 Vision
Preferred Care Basix	Blue Healthy Choices	Smile Saver Dental
Preferred Care EPO	Blue EPO Balance	Guardian DentalGuard
US Direct	Healthy Blue

Rochester Business Alliance Health Insurance Participation Guidelines

The Rochester Business Alliance offers a variety of health, dental and vision products from Preferred Care, Excellus Blue Cross Blue Shield and Guardian at group rates to verified employees of member firms. We can insure self-employed individuals as well as employer groups.

There are specific documents, employee participation requirements and enrollment procedures required by each carrier to enroll. Once you have decided on a plan, contact the Insurance Department for the specific plan requirements. There are also limitations on the number of products employers can offer.  In addition, in order to enroll in the Excellus Blue Cross Smile Saver dental and 20/20 vision plans, you must also have Excellus Blue Cross medical if your company has less than 10 employees. Sole proprietors are not eligible for the Smile Saver dental plan.

You must be a member in good standing in order to participate in the insurance group. If RBA membership dues are not current, insurance will be canceled. A refund will be issued if there is an overpayment of premium.

The RBA bills quarterly for all insurance plans. Monthly billing is not available. You will be billed thirty days before your due date. The insurance quarters begin January, April, July and October. Quarterly payments will be due on March, June, September and December 20th. There are no grace periods for any of the plans. Coverage will be canceled if payment is not received by the due date. A member that is canceled due to non-payment cannot be reinstated for a period of one year.

The RBA's anniversary date is January 1st. At this time, a person may switch to another health insurance plan. This is the only time you can change insurance plans.

All plans have a one-year waiting period for any pre-existing conditions. However, if you have been covered by another health insurance plan for at least one year with no more than a 63-day lapse in coverage, the waiting period will be waived.
 
Coverage begins on the 1st of any month for new businesses joining the RBA. Paperwork and payment must be received by the 20th of the previous month. To start a policy, contact the Insurance Department and indicate the desired plan along with the type of coverage needed. (Ex: single, sponsor or family; Blue Choice, Blue Million or Preferred Care). You will then be sent the appropriate forms along with payment information. Applications should be returned to the RBA, not the insurance carrier. An application will not be processed if payment is not included or if the business is not an RBA member. Paperwork and payment received after the due date will not be processed until the next available enrollment date.

When enrolling into the RBA group, you must stay on the insurance for at least one year from when you enroll unless employment is terminated. If a person is dropped during the year, they will not be reinstated for a period of one year.

To delete an individual from the insurance, it must be in writing. Blue Cross Blue Shield plans can be canceled on any date with written notice. Preferred Care and Guardian DentalGuard plans are canceled on the 1st of any month and written notice must be received by the 1st of the month the policy is to be canceled. A refund will be issued if there is an overpayment minus administration fees. Cobra coverage is available for terminated employees of an RBA member firm.

Checks should be made payable to the Rochester Business Alliance, not the insurance carrier. A company check must be submitted unless the check is from the designated RBA contact person as indicated on the RBA membership application. Personal checks will not be accepted from employees of member firms. Payments can also be made by Visa or MasterCard.

A $15 fee will be charged each time a check is returned by the bank.  A money order or bank check must be provided to cover the original check. Cancellation in coverage will result if the check is not taken care of immediately.

If you need additional information or have chosen a plan, please contact Nina Shelton at the RBA's Health Insurance Department at (585) 256-4644.  Forms are also available on the website (click here).