RESOURCE CENTER

Private Exchange - Blue Solutions Choice
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2016 Renewal & Savings Forms (Blue Solutions)
IBC branded renewal form to be completed by employer for existing 2-50 eligible business. For employers making changes to the 2016 Metallic Blue Solutions products.
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2016 Employee (2-50 size) Enrollment/Change form
Employee enrollment/change form to be used by someone who wishes to enroll into an IBC metallic tier plan, beginning with 1/1/16. Application can also be used to add/delete dependents, or change benefits. Also applies to group Medigap enrollments.
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2016 Application for 2-50 Small Employer Health Benefits (released 10/2015)
IBC branded installation form to be completed by employer for new 2-50 eligible business. Includes new plan designes for 2016. Can also be used for Blue Choice products (private exchange/defined contribution)
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2015 Employee (2-50 size) Enrollment/Change form
Employee enrollment/change form to be used by someone who wishes to enroll into an IBC metallic tier plan, beginning with 1/1/15. Application can also be used to add/delete dependents, or change benefits. Also applies to group Medigap enrollments.
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2015 Application for 2-50 Small Employer Health Benefits (released 12/2014)
IBC branded installation form to be completed by employer for new 2-50 eligible business. Includes new plan designes for 2015. Can also be used for Blue Choice products (private exchange/defined contribution)
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Waiver of Coverage Form
To be completed by an eligible employee waiving coverage. Only acceptable waivers of coverage are: spousal coverage, Medicare/Medicaid, Federal coverage, and Dependent on parent plan. Exchange coverage is not valid waiver.
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Application for 2-50 Small Employer Health Benefits (released 12/2013)
IBC branded installation form to be completed by employer for new 2-50 eligible business. Includes new plan designes for 2014. Can also be used for Blue Choice products (private exchange/defined contribution)
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Application for New 51-99 Blue Choice Benefits (released 12/2013)
IBC branded installation form to be completed by employer for new 51-99 eligible business. Includes new plan designes for 2014 specific to their Blue Choice (private exchange/defined contribution) product.
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2014 Employee (51-99 size) Enrollment/Change form
Employee enrollment/change form to be used by someone who wishes to enroll into group plan for 51-99 in size, beginning with 1/1/14. Application can also be used to add/delete dependents, or change benefits. Also applies to group Medigap enrollments.
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Amerihealth PA (51-99 size) Enrollment form
Employee enrollment form to be used by someone who wishes to enroll into a Keystone group plan for groups 51-99 in size, yet resides in a non-contiguous county. Please consult with your Account Manager to discuss NCC rules and regulations.
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2014 Employee (2-50 size) Enrollment/Change form
Employee enrollment/change form to be used by someone who wishes to enroll into an IBC metallic tier plan, beginning with 1/1/14. Application can also be used to add/delete dependents, or change benefits. Also applies to group Medigap enrollments.
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04.09.2013
Renewal & Savings Forms for 2-50 (Blue Choice)
IBC branded renewal form to be completed by employer for 2-50 eligible business renewing into the new Blue Solutions Choice (Definied Contribution) products.
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03.07.2013
Blue Solutions Choice - Cost Comparison Tool
As part of IBC's Blue Solution Choice (Defined Contribution) rollout, they have created this cost comparison tool to assist with presenting to employees until the online shopping experience starts in July. *Be sure to turn on your Macros in Excel.
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