If you are asking for initial contracting with a carrier, please complete the online form below. If you are requesting a change to your current contract, please call Jenny Smith at 847-631-6581 to discuss those changes or visit our Agent Request to Change Personal Information page.

To be a contracted agent with Blue Cross Blue Shield of Illinois, you must provide proof of Errors and Omission coverage. BCBS has teamed with BCS Insurance Company to offer product and pricing available only to BCBS producers. Visit the BCS website for more information, or download the Agency Brochure or Agent Brochure.

Agent Request For Contract

Step 1 of 2

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  • (as it appears on license)
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  • Carrier Contract Information - Part 2