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Enrollment Kit - Anthem Blue Cross (Dental and Vision)

This checklist is provided as a guide. The carrier may require additional items and documentation. Please refer to the carrier's underwriting guidelines for a complete list of requirements. Please use the latest version of forms.
 
Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval.  The following list outlines Anthem Blue Cross’s case submission requirements​​.
 
††DE-9C not required on Specialty only sales, including standalone new sales and up sells on existing Medical cases
 
*See Section 3, California Underwriting Business Requirements for the Sole Pro​prietor, Partner, or Corporate Officer Statement not appearing on the DE-9C​​. See section 3, California Underwriting Business Requirements for the

 
After approval, prior carrier termination letter must be submitted by the employer or broker.
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For other useful or older documents, please refer to the Forms database.