Blue Cross and Blue Shield of IL Group Health Documents
Document Download Year
Group Health Quoting Worksheet Download
IL Group Blue Choice Options Provider Download 2019
Grandfathered Health Plan Fact Sheet Download 2013
Producer of Record Transfer Form & Instructions Download 2021
BlueCard PPO Member Flier Download 2016
Medical Claim IL Download
Guide To Pulling a SBC Download 2021
Visit Group Enrollment Section
Document Download Year
2023 BPS - Benefit Plan Selection Form Download 2023
2022 BPS - Benefit Plan Selection Form Download 2022
2021 BPS - Benefit Plan Selection Form Download 2021
Employee Enrollment and/or Waiving Application Download 2021
Enrollment Change Request Form (Must be submitted 30 days prior to renewal effective date) Download 2018
ACA Grandfathered Plan Fact Sheet Download 2013
Document Download
Sample Waiver Of Coverage Download
Statement Of Grandfathered Status Download
Medicare Part D- What Employers Need to Consider Download
Patient Product Disclosure Notice Download
Uniform Glossary SBC Download
Employee Notice Of Exchange View Link
Employee Penalties and Related Reporting View Link
COBRA Model Election Notice Download
COBRA Model General Notice Download
Compliance Checklist for Small Employers Download
Sample Illinois State Continuation Notice Download
ERISA General Requirements View Link
Employer Health Care Arrangements View Link
HIPPA Special Enrollment Notice Download
WHCRA Enrollment Notice Download
WHCRA Annual Notice Download
Group Resources
Important Documents
Commission Schedules
Customer Service Health Representatives
Your CSR corresponds with your Last Name. Office Phone: 847-427-8000
A-H | Greta Skystimaite | Ext. 6614 | health@midwestga.com |
I-R | Christina Merrell | Ext. 6631 | christinas@midwestga.com |
S-Z | Jennifer Kanarowski | Ext. 6645 | jennifer@midwestga.com |