Step One - Gather Information and Complete the Forms
Gather Information and Complete the Forms: The information and forms you will need to submit depends upon the number of enrolled, and in some cases eligible*, employees at your credit union. Review the lists below and determine which one applies to your credit union. Links to each form are included in the list.
*Your credit union can set the eligibility requirements for employee participation in the plan, however, the minimum may be set no lower than 20 hours per week and no higher than 30 hours per week.
For credit unions with less than 5 potential enrolled employees:
For credit unions with 5 or more potential enrolled employees and less than 50 eligible employees:
For Credit Unions with more than 50 eligible employees:
**Not all of the data points on this form need to be completed in order to receive a quote. Social security number, hire date, address, city, additional classes for wait period and email address for notices are optional. That information will need to be gathered if your credit union joins the plan. To simplify the process, you may choose to enter it now.
*Your credit union can set the eligibility requirements for employee participation in the plan, however, the minimum may be set no lower than 20 hours per week and no higher than 30 hours per week.
For credit unions with less than 5 potential enrolled employees:
- Complete the AHP Employer Participation Form (.pdf)
- Census Form**
- Provide health history forms for all eligible employees
- Provide current summaries of benefits and coverage (SBCs)
- Provide current rates by plan design
For credit unions with 5 or more potential enrolled employees and less than 50 eligible employees:
- Completed AHP Employer Participation Form (.pdf)
- Census Form**
- Provide current summaries of benefits and coverage (SBCs)
- Provide current rates by plan design
For Credit Unions with more than 50 eligible employees:
- Completed AHP Employer Participation Form (.pdf)
- Census Form**
- Provide current summaries of benefits and coverage (SBCs)
- Most recent 12 months of claims data. Include monthly breakout with total membership and high claimant information if available
- Current fully insured rates or self-funded claim factors by plan
**Not all of the data points on this form need to be completed in order to receive a quote. Social security number, hire date, address, city, additional classes for wait period and email address for notices are optional. That information will need to be gathered if your credit union joins the plan. To simplify the process, you may choose to enter it now.
Step Two - Submit Information and Forms to Capstone
Submit Information and Forms to Capstone: Once you have compiled all the information and completed all the forms requested, you will submit everything*** directly to Capstone via one of the two methods below:
***The AHP Employer Participation Form goes directly to Capstone, who will forward to MnCUN for signature. Please do not send this form to MnCUN.
IF YOU NEED HELP OR HAVE ANY QUESTIONS regarding the request for quote process, please contact Jessie Hunt, Sales and Marketing Coordinator for Capstone Administrators at (317) 793-2915 or
jhunt@capstonebenefits.com.
Questions may also be sent to MnCUNAHP@capstonebenefits.com.
- Credit unions with secure emails can send everything to MNCUNAHP@capstonebenefits.com via your secure email.
- If you cannot send secure emails from your own email, you can utilize Capstone’s secure portal (https://web1.zixmail.net/s/welcome.jsp?b=capstonebenefits) and direct the email to MNCUNAHP@capstonebenefits.com.
***The AHP Employer Participation Form goes directly to Capstone, who will forward to MnCUN for signature. Please do not send this form to MnCUN.
IF YOU NEED HELP OR HAVE ANY QUESTIONS regarding the request for quote process, please contact Jessie Hunt, Sales and Marketing Coordinator for Capstone Administrators at (317) 793-2915 or
jhunt@capstonebenefits.com.
Questions may also be sent to MnCUNAHP@capstonebenefits.com.
Step Three - Complete Benefits Survey
The Plan is continually looking to expand its portfolio and is evaluating additional lines of coverage to be offered to members. We are evaluating the benefits that should be added as well as the appropriate carrier partners and would appreciate your help in this evaluation of your non-medical plan offerings by providing us with detailed information for the plans your Credit Union currently offers your employees. Please take a few minutes to complete our survey using the link below to help us better understand what you are offering today. In addition to answering the survey, we are asking Credit Unions to please provide us copies of your plan documents by using the following link. (Examples of documents to share would include your Summary Plan Descriptions (SPD), Employee Benefit Guides and/or benefit summaries. Thank you in advance for the valuable information and your participation in our survey).
MnCUEBP Benefit Survey
MnCUEBP Benefit Survey
