New Business Enrollment

Support » New Business Enrollment

Blue Cross Blue Shield of Illinois

Follow these steps to enroll a small business or receive a final rate offer.

Step 1. Complete each form listed below:

• Benefit Program Application (BPA)
• Benefit Plan Selection (BPS)
• Group Information Form
• Medicare Secondary Payer Employer Acknowledgment Form
• Small Group Employee Application for all eligible employees
  
  Click here to download the forms.

Step 2. Obtain and submit the following group information:

• Copy of the group's current renewal
• UI3/40 quarterly wage and tax
• Most recent prior carrier billing
• Check for 1st months premium (optional)

Step 3. Return all forms and group information to:

Group Marketing Services, Inc.
ATTN: New Business
P.O. Box 370
2201 Woodlawn Road
Lincoln, IL 62656

Questions?  Call us at 866-531-7800 or 217-732-4009

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