Set Up Process

Step 1Complete the Employer Application & Adoption Agreement and send a check for $150 prior to the requested effective date. Make the check payable to:

Bancover Insurance Services, Inc.
1350 Treat Blvd, Suite 470
Walnut Creek, CA 94597

Important Note: contact your Broker to determine whether you are eligible to receive the first year free.

Step 2 Upon receiving the completed Employer Application & Adoption Agreement and check, Bancover Insurance Services will send you the Plan Documents which include:

  1. Cover letter with instructions;
  2. Original Employer Application & Adoption Agreement;
  3. Shared Benefits Plan Specimen Document;
  4. Shared Benefits Plan Summary Plan Description;
  5. Waiver of Participation Form; and
  6. Health Savings Account Enrollment Form (where applicable).

Step 3You should then follow the instructions in the Cover Letter which include:

  • Having an officer of the company sign the last page of the Shared Benefits Plan Specimen Document;
  • Distributing copies of the following to each eligible employee:
  1. Employer Application & Adoption Agreement;
  2. Summary Plan Description;
  3. Waiver of Participation Form; and
  4. Health Savings Account Enrollment Form (where applicable).
  • Returning completed copies of the following documents to Bancover Insurance Services:
  1. Shared Benefits Plan Specimen Document signature page; and
  2. Waiver of Participation Forms.
  • Keeping copies of the following documents with their permanent records:
  1. Original Employer Application & Adoption Agreement;
  2. Shared Benefits Plan Specimen Document;
  3. Summary Plan Description;
  4. Waiver of Participation Forms; and
  5. Health Savings Account Enrollment Forms (where applicable).
  • Notifying the payroll company of any pre‐tax deductions for participating employees. 

Step 4Bancover Insurance Services will provide you with:

  • Customer service; answering any questions you may have.
  • Amendments to the Shared Benefits Plan Documents as required by changes in the law.
  • Access to online savings calculators and other useful links via www.bancover.com.