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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