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Anthem Blue Cross Blue Shield Health Insurance  
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spacer imageGroup Product Information Request

For information on our group products, just fill in the information below, click Submit, and an Anthem Blue Cross and Blue Shield appointed producer or account executive will get back to you quickly with customized information on our plans and rates.


Company Name:

Contact Name:


Address (Street/City/Zip):

Telephone Number:

Fax Number:

E-Mail Address:

Total Employees Part-time /Full-time:

Total Employees @ 30+ hours/week:

Current Coverage and Carrier:

Anniversary Date:

Producer or Agent:

What Kind of Coverage Are You Interested In?

Health Plan
Life and/or Accidental Death & Dismemberment
Short-Term and Long-Term Disability


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ę2005 copyright of Anthem Insurance Companies, Inc.

Health insurance

for individuals, families & employers. Find Anthem Blue Cross Blue Shield health and medical insurance information for visitors, members, individuals & families, employers, brokers & producers. Learn about group health insurance plans, family & individual insurance options, health insurance savings accounts, obtain a health insurance quote.

Anthem Blue Cross and Blue Shield

is the trade name for the following: In Connecticut: Anthem Health Plans, Inc. In Colorado, Rocky Mountain Hospital and Medical Service, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky. In Maine: Anthem Health Plans of Maine, Inc. In Missouri: RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC) and HMO Missouri, Inc. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi) and Compcare Health Services Insurance Corporation (Compcare). Independent licensees of the Blue Cross and Blue Shield Association. Serving residents and businesses in Indiana, Kentucky, Missouri, Ohio, Wisconsin, Colorado, Nevada, Connecticut, Maine, New Hampshire and Virginia (excluding the city of Fairfax, the town of Vienna and the area east of State Route 123). Use of the Anthem Web sites constitutes your agreement with our Terms of Use.

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