Contracting Application Forms

Agency Contracting

If your agency (FEIN #) is not contracted with Blue Cross and Blue Shield of Illinois and would like to be, please click to submit the required information. All compensation is paid to the agency.

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Producer Contracting

If you would like to become contracted (SS#) as a producer, please click to submit the required information. All compensation is paid directly to you.

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Sub-Producer Contracting

If you work with an agency that is contracted or submitting contracting with Blue Cross and Blue Shield of Illinois and you would like to become a contracted sub-producer, please click to submit the required information. The agency must be submitting new contracting, or already contracted, in order for you to complete the sub-producer information. All compensation is paid to the agency.

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