Blue Cross and Blue Shield of IL
Small Group
BCBSIL Enrollment Forms for Small Group
2024 Benefit Program Application- BPA
2025 Benefit Program Application- BPA (for effective dates of 1.1.2025 and later)
2024 Benefit Plan Selection- BPS
2025 Benefit Plan Selection – BPS (for effective dates of 1.1.2025 and later)
Employer Group Information- EGI
Employee Application Enrolling
OR you can use Enrollment Spreadsheet- Please contact your Broker Service Specialist at MIBS for a copy