Illinois standard health employee 2025

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The document is a cover page for the Illinois Standard Health Employee Application for Small Employers, provided by Blue Cross and Blue Shield of Illinois (BCBSIL). It outlines the purpose of the application, which is to assist employees in enrolling for health insurance coverage through their employers. The application is standardized as per the Illinois Insurance Fairness Act and includes sections for employer information, coverage requested, waivers of coverage, individual details requesting coverage, current or prior coverage information, health statements, and additional coverage options. It emphasizes that while all insurance companies must use this standard application, specific requirements may vary by insurer.

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Click ‘Get Form’ to open the Illinois Standard Health Employee Application in our editor.
Begin with Section A, 'Employer Information.' Enter your employer's name, phone number, and address. This section allows your employer to request quotes from multiple insurance companies without needing separate applications.
Move to Section B, 'Coverage Requested.' Select the type of health coverage you wish to enroll in based on the options provided by your employer. Remember, all dependents must be enrolled in the same product.
In Section C, 'Waiver of Coverage,' indicate if you are waiving coverage for yourself or any dependents. Ensure you understand that waiving your coverage means dependents cannot enroll either.
Proceed to Section D, 'Individuals Requesting Coverage.' Fill in personal details for yourself and any eligible family members, including weight and height as required by BCBSIL.
Complete Sections E through H as applicable. Provide current or prior coverage information and additional health statements if necessary. Use our platform’s tools to easily navigate between sections.
Finally, review all entries for accuracy before signing in Section I. Your signature confirms that all information is true and complete.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What qualifies as a domestic partner in IL?

The term domestic partner(s), as referred to in Board Rules and Policies, shall mean individuals who (1) are at least 18 years of age; (2) are of the same sex; (3) are unmarried (single, divorced or widowed) and not a party to a civil union; (3) are each others sole partner; (4) are responsible for each others common

What is the Healthy Workplace Act in Illinois?

Creates the Healthy Workplace Act and amends the State Finance Act. Requires employers to provide specified paid sick days to employees. Sets forth the purposes for and manner in which the sick days may be used. Contains provisions regarding employer responsibilities, unlawful employer practices, and other matters.

What is the new health coverage disclosure requirement in Illinois?

On August 21, 2021, Illinois enacted the Consumer Coverage Disclosure Act (the CCDA) requiring that Illinois employers provide a disclosure to employees which comparing the employers group health plan compares with the essential health benefits (EHBs) under the Illinois benchmark plan.

Can I put my girlfriend on my health insurance in Illinois?

Eligible dependents of the member include: Spouse (does not include ex-spouses, common-law spouses, a new spouse of a survivor, or persons not legally married). Same-Sex Domestic Partner (enrolled prior to June 1, 2011). Civil Union Partner (Same-Sex or Opposite-Sex).

Can my girlfriend be on my health insurance if we live together?

If you are asking if two people who are not legally married but are girlfriend-boyfriend can be on the same health insurance policy, the answer is no. They would each have to buy an individual policy. Two married people cannot buy individual policies on the open market, or an Obamacare exchange policy.

illinois policies

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Can I add my girlfriend to my health insurance if we live together in Illinois?

Health insurance plans for domestic partners generally cover the partner as a dependent, similar to a spouse. Children residing in the shared residence can also be added. However, there are important tax implications to consider.

Can my partner add me to his health insurance if we are not married?

Yes. After an employee registers their domestic partnership, the employee may enroll a domestic partner in their benefits. The employee will receive the increased employer contribution for the added coverage.