MID-MARKET
RENEWAL KIT

Mid-Market Forms

Find the most current renewal forms on Blue Access for Producers

Benefit Plan Selection Form (BPS)
Change, add or renew medical, dental and life plans. A BPS isn’t needed if a group renews without changes.

Benefit Program Application (BPA)
Use a BPA to update eligibility requirements or change premium periods.

Group Enrollment Application/change Form
Enroll new members or update existing memberships and plan selections.

If you normally work with a General Agent (GA), please continue to send paperwork and inquiries to your GA, as usual.

Consumer Directed Health Accounts Set-Up Guide