Authorized Agent

Anthem Blue Cross Blue Shield of Colorado Business Group of One

Application Forms

After you've gotten a quote from Insurance Shoppers by email and we've decided an Anthem Blue Cross Blue Shield Business Group of One plan is the best option for you, download the following forms and fax (or email) them back to us to look over. Our fax number is (866)698-4597, and our email address is . After we make sure everything is correct, we'll give you the address (or see below) to mail the application to Anthem Blue Cross along with a check for the first month's premium (payable to Anthem Blue Cross Blue Shield of Colorado), and proof of group of one eligibility. The best proof is tax returns from the previous year showing sole proprietorship - if you don't have this, please contact us and we'll discuss other options with you. For a first of the month effective date, the forms need to be submitted to Anthem Blue Cross Blue Shield by the 10'th of the previous month.

And for your reference, here are the underwriting guidelines:

Again, you can fax these to Insurance Shoppers at (866)698-4597, ATTN: Underwriting.

Where to Mail Your Completed Forms

Again, include the completed forms from above along with a check for the first month's premium (payable to Anthem Blue Cross Blue Shield of Colorado), and proof of group of one eligibility. If you have atleast a week before the deadline of the 10'th of the previous month, mail your application packet to:

Anthem Blue Cross Blue Shield
ATTN: Small Group Health Insurance New Business
P.O. Box 172466
Denver, CO 80217-2446

If you have less than a week before the 10th of the previous month, it is recommended you overnight the application packet to:

Anthem Blue Cross Blue Shield
ATTN: Small Group Health Insurance New Business
700 Broadway, Mail Stop CO-0109-0966
Denver, CO 80273

**Any descriptions of coverage on this page may not be current and should not be taken as a description of coverage. Any persons seeking to get a full description of coverage should view Colorado plan description forms and/or brochures for the plan they are interested in.

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