Small Group Quotes

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 David Solomon at (918) 594-5295 ext. 4610 if you have questions or need assistance completing the forms.

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 our employer group including tax identification number
  • Think about how you need your billing statement to reflect any different locations
  • Be prepared to provide your current hourly requirement to be eligible for coverage as well as how many employees you have on payroll, how many full-time employees and how many eligible employees will be enrolling.
  • 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: Complete the "CareWeb Employer Connection" security request.

This will allow you to enroll your employees through a secure portal. If you choose not to take advantage of this process, you can submit paper employee applications. If you take advantage of this process, once the security request has been processed, you will receive an email which will provide you with your user name and password which will allow you to login and enroll your employees.

STEP 3: 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.

If you need assistance with your enrollment, please contact your broker or feel free to call 918-594-5230 for assistance.