Blue Cross and Blue Shield of IL

Mid-Market 51+

BCBSIL Enrollment Forms for Mid-Market 51+

Mid-Market New Business Checklist

Benefit Program Application- BPA

2025 Benefit Program Application-BPA (for effective dates of 1.1.2025 and later)

Benefit Plan Selection- BPS

Employer Group Information- EGI

Employee Application Enrolling

Employee Application Waiving

OR you can use Enrollment Spreadsheet- Please contact your Broker Service Specialist at MIBS for a copy