City of Orange Sign Up Information

Jon,

Thank you for your request regarding a group health insurance plan.  Attached are the documents required for a quote for your company.  If you are interested in receiving a group health proposal with rates, please complete the attached documents and e-mail to PhxBids.PhxBids@azblue.com

General requirements for Small Group

1. Company must have at least 1 eligible, common law (W2) employee and
2. At least 1 common law employee must enroll.
3. For businesses wholly owned by an individual or an individual and his/her spouse, another common law employee must enroll in order for there to be group coverage (the individual and his/her spouse are not considered common law employees for these purposes).  In certain other instances, an owner may be a common law employee.

For expedited service, please return the census in its Excel format.  I.e. do not convert to another format such as PDF etc.

Thank you.

Support Operations

Blue Cross^® Blue Shield^® of Arizona

FAX: (602) 864-5800

azblue.com