2017 WI Anthem Employee Enrollment Application For 1-50 Employee Small Groups Preview on Page 1

2017 WI Anthem Employee Enrollment Application For 1-50 Employee Small Groups-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Section A: Employee Information. Fill in your last name, first name, middle initial, and Social Security number. Ensure all fields are completed accurately.
  3. Continue by providing your home address, contact numbers, marital status, and employment details including date of hire and hours worked per week.
  4. Move to Section B: Application Type. Select the appropriate enrollment type such as New Enrollment or Open Enrollment based on your situation.
  5. In Section C: Type of Coverage, choose your desired medical, dental, and vision coverage options. Make sure to enter any required contract codes as advised by your employer.
  6. Complete Sections D through G by providing dependent information, other group coverage details, waivers if applicable, and finally sign the application in Section G.

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The BCBSA has around 1,000 employees. 9. BCBS affiliates employ more than 150,000 people nationwide, making it one of the top 20 employers in the United States.
UnitedHealthcare serves all 50 states and has almost 50 million health insurance customers. Anthem began operating in 2004 and has the distinction of being the biggest for-profit Blue Cross Blue Shield company and the second-largest American health insurance company. Anthem serves 40 million people in 14 states.
Description. Anthem is a public company headquartered in Indiana with an estimated 104,900 employees.

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Whatever your health coverage needs, Anthem has a health plan in Wisconsin designed for you.
If you have questions, call us at 1-855-690-7800 (TTY 711).

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