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Healthy New York Business Applications And Recertifications For Small Group

Updated versions of the Healthy New York (HNY) New Business application and the HNY Recertification form are now available online at Blue On Demand. They are also available on our website under the Broker and Employer portals where small group new business and renewal forms are located.

The new HNY recertification is now an Excellus BCBS-branded form and includes both dental and vision questions. This should provide a more streamlined renewal process for our small business groups that have multiple lines of business along with an HNY medical plan.

For the convenience of our groups, the new HNY recertification will also be included in the renewal notification letters they are sent.

The new HNY forms will be required for renewal as of September 1st, and the old forms will no longer be accepted for renewal at that time. Please contact your broker or account manager if you have questions.

Healthy NY Application - Small Group (PDF)

Healthy New York Recertification Form - Small Group (PDF)

 

 
 
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