Paperwork Needed For A New BCBS Small Group Submission

The required documents that need to be submitted are as follows:

  • The Benefit Program Application (BPA)

  • The Benefit Plan Selection Form (BPS)

  • The Employer Group Information Form (EGI)

  • The Employee Applications (Enrolling or Waiving for all eligible  Full Time Employees working 30 or more hours per week)

  • The most recent Quarterly Wage & Tax Statement (UI/340) and W-4’s for any new hires not listed on the Wage & Tax (if applicable). The UI/340 should be reconciled (Example: Full Time = FT, Part Time = PT, Termed or Seasonal)

  • If there is a 1099 Employee, a 1099-MISC will need to be provided or if a newly hired 1099 a W-9 is required.

For a Start-up Company in addition to the above required documents the information below will also be needed:

  • Articles of Organization

  • Partnership Agreement if applicable

  • State of IL Certificate of Good Standing

  • SS4 Letter

  • Payroll documents if the Group doesn’t have a Wage & Tax Statement yet. If payroll hasn’t been generated yet, then W-4s for all the new hires

  • Letter on Company Letterhead with a list of employees and their working status (example Full Time=FT, Part time=PT, Owners)

For a group with an Owner who is NOT on the Wage & Tax Statement (UI/340) the information below will also be needed:

  • Owners Certification Form (BCBS Form)

  • KT’s (S-Corp, LLC, Partnership) or Schedule C (Sole Proprietorship)

Eligibility Reminders:

  • A Husband/Wife Group must either be a true Partnership (each must have a K1-1065) or have at least one common law employee on the Wage & Tax Statement (UI/340). This employee can be Part Time or Full Time Waiving.

  • You can have an all-owners group (not husband/wife) if all the owners consider themselves employees.

  • 1099 Compensated Employees – 1099 Employees must work at least 30 hours per week and be considered a full-time employee (the 1099 employee can only work for that company) in order to be eligible for group benefits.