Apply for Coverage

Small Groups

General

Small Group Enrollment Tool — to be used by agents and groups to enroll new groups
Membership Application — to be completed by individuals joining a group
Tobacco Usage Form — to be completed by individuals joining a group

Dental

Blue DentalSM Application

Metallic Groups

Business BlueEssentialsSM Master Application and Group Request for Coverage

Chamber Groups

Group Benefit Request Form, 51-99 Lives
Group Request for Coverage (legacy Chamber groups only)

Legacy Groups

Group Request for Coverage (non-Chamber groups)

Medicare Supplements

BlueCareSM Application
Blue SelectSM Application

Companion Life

Life insurance is offered by Companion Life. Because Companion Life is a separate company from BlueCross BlueShield of South Carolina, Companion Life will be responsible for all services related to life insurance.  

Companion Life Employer Participation Application
Companion Life Group Application
Companion Life RFP