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Eligibility Guidelines

ELIGIBLE COMPANIES  To be eligible for coverage a company must:      Be actively in business      Enroll 1-9 eligible employees (owners included)      Contribute 50% of the Individual and 33% of the Family premium      Be located in the HPHC service area      Be a member in good standing of NBT Inc. ELIGIBLE EMPLOYEES  An eligible employee is one who:      Full Time: Works at least 30 hours per week for the employer      Part Time: Works at least 20 hours per week for the employer      Was hired to work for a period not less than 5 months      Resides in the HPHC service area NEW EMPLOYEES      All future eligible employees can be enrolled within 30 days of hire or         within a time frame consistent with company new hire probation policy WAIVER OF COVERAGE  Full Time employees can be excluded who are:      Covered by a spouse’s or parent’s health plan      Covered by Masshealth, Medicare or Veteran’s Coverage      Covered by another employer group Plan      Covered by a non-group Plan      Living outside the HPHC service area PARTICIPATION REQUIREMENTS  Groups of 1 - 5      100% of eligible employees must enroll  Groups of 6 - 9      At least 75% eligible employees must enroll (minimum of 4) PLAN SELECTION      All employees must select the same plan EFFECTIVE DATES      All coverage will be effective on the 1st day of the month, contingent         upon the HMO’s enrollment requirements. Enrollment materials should be         received by the 25th of the preceding month.