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How to Enroll a New Small Group (2-50 employees) - Starter Packet

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Thank you for selecting Blue Cross and Blue Shield of Georgia. In an effort to make the enrollment process easier and more efficient, Blue Cross Blue Shield of Georgia has now made the Agent Starter Packets available online. The packet contains a checklist of our requirements for enrolling a new group as well as all of the forms you will need for the enrollment process. Please use the checklist as your guideline to ensure accurate and timely group submission. Please contact your sales representative if you have any questions.  
BCBSGa Group Enrollment Checklist  
Member Enrollment Application Tips  
 
Applications:
Group Commission Agreement - Single Case
The “Group Master Application” Form
(Use this form for Group Applications for HMO, POS, PPO, CMM, Dental and/or Vision coverage)
Term Life Group Master Application
Statement of Chamber Membership
Eligibility Status Verification Form
(use only if the group has been in business for less than 6 months and has not yet filed a tax form)
Small Group Member Application
 
Small Group Medical Questionnaires:
Cancer Questionnaire
Cardiac/Hypertension Questionnaire
Diabetic Questionnaire
Prescription Questionnaire
 
Employer Access:
Employer Access Demo
Employer Access Manual
Enrollment Eligibility Checklist
Username Policy and Usage Agreement
Third Party Agreement
Internet Eligibility Agreement
Employer Access Web Enrollment Acknowledgement Form
 
COBRA:
Refer to the COBRA Implementation Paperwork Guide for instructions and forms
Additional COBRA Materials
 
Miscellaneous:
Glossary
Frequently Used Contacts
Employer Reference Guide (ERG)
Employer’s Reference Guide Order Form
GGL Group Insurance Application
 
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Blue Cross Blue Shield of Georgia and Blue Cross Blue Shield Healthcare Plan of Georgia are Independent licensees of the
Blue Cross Blue Shield Association.