About Health Insurance - Group Health Insurance for Small Business and Independent Contractors

Bailey Court
340 Route 202
Somers, New York 10589

Phone: (914) 277-8600
Toll Free: (800) 969-5663
Fax1: (914) 277-3452
Fax2: (914) 277-3455

EMAIL US AT:

info@abouthealthinsurance.com (General email)

Your Teams Emails:

tserraro@abouthealthinsurance.com (Trevor Serraro - VP of Sales & Acting CEO)

serraro@abouthealthinsurance.com (Chris Serraro - President)

ca@abouthealthinsurance.com (Cilony Alejandro - Office Manager & Lead Administrator)

Endorsed By
NYSOTA (NYS Occupational Therapy Association)
HTA of NY (Career Solutions for the Health Professional)
Mayor's Office of Health Insurance Access
Somers Chamber of Commerce (Our Community based website)

Affordable Dental Care fromDentalPlans.com

Forms.


Company.	Form Description.
	NY Group Managed Choice Application NY Enrollment/Change Request (new employee and any changes) Proof of eligibility form...for those that do not appear on the NYS 45 New Jersey Health Plan Application (new group enrollment form) NJ Enrollment/Change Request (new employees and any changes) Proof of Eligibility - For those that do not appear on payroll Waiver form - For those employees not taking the insurance Prescription Claim Form (Reimbursement Form)

	Member Enrollment & Physician Selection 1 (For all new enrollees and change of status) New Group Application 2 Verification form 3 Dental Enrollment Form (For all new enrollees) Addition/Termination Form Waiver Form 4 Metro group application and member application Health Claim Forms Exercise Facility Reimbursement Form Attestation and new plan election ( for renewals)

	Small Employer Group Application Form (For all groups of from 1-50 eligible members) Transaction Form for Small Groups (Membership Version) - New Enrollees Certification Form for sole proprietors and independent contractors Complete application for groups of one.

	New Group Application New Group Contract Employee Application (each employee must fill one out)

	New Group Application Employee application (each employee to fill out, even those that waive) Attestation form

	Employer Application (group application) Enrollment/Change Form (each employee to fill one out) Partners, Officers or Owners Verification Form

	Employee Enrollment Form HMO

	Employee Enrollment Form IRBA forms MHL Association plans

	Entire application for the Sole Proprietor plan