Quoting Check List
A list of items needed to get a quote.
Application Guide and
A step-by-step guide for completing the
applications and census.
Anthem Employee Application
Each employee must complete this application form for the 2-50
group. All highlighted sections must be completely filled out
before Anthem can provide a quote.
Employer Group Enrollment
Application for the employer that must be completed by all
groups regardless of how many are employed. All highlighted
sections must be completely filled out in order to receive a
Employee and Dependent
The following columns must be completed to get a quote: Columns
A, B, D, F, G, H, P, Q, S, T, U, Y, Z, and AA. Please note,
there is a tab for dependents on the spreadsheet that must be
completed. Please do not print the census, as it will print
one line per page on 152 pages.