Downloadable Forms

For your convenience, we have developed a downloadable insurance forms section. Please feel free to check back here for frequent form updates.


  It's time for Empire BlueCross BlueShield and the Small Group market


  As you may have already heard, Empire BlueCross BlueShield is re-entering the small group market. Built on the foundation of responsible pricing, Empire has dedicated a tremendous amount of time and resources to ensure success over the long-term, with a commitment to the GA, the broker and your clients.
  With strong rate approval comes strong compensation. Empire will pay 5% of premium on EPO/PPO sales and renewals in 2017. 4% of this is a base amount which Empire envisions continuing to pay into 2018. HMO sales will pay a 2% of premium commission in 2017.
  Premiums are consistent across the NYC, Long Island, and Mid-Hudson rating areas. The Empire 2017 Small Group Product Guide includes some of the higher-level benefit and plan details. SBC and SOB documents will be available in early October.
CLICK HERE for the Downstate Q1 2017 rates
  -  CLICK HERE for the Empire 2017 Small Group Product Guide
  Benefits and rates will be available for quoting in HealthConnect by early October, with Empire accepting new business through their online SALES portal (their new Small Group quoting and enrollment system), on October 17
  With 28 new plans, 3 provider networks and an enormous investment in technology/efficiency, Empire is properly equipped to re-enter the Small Group market, and support the broker community the right way.
  Empire will also be making available a new library of materials to support your client to make selling these new products easier. It includes selling   tools, plan and network education, as well as employee on-boarding materials. 
  We look forward to working together with Empire as they re-enter the small group market.