Illinois Health Insurance Applications

Online Application Links and Print Forms

Access health insurance applications -- online forms and paper documents (pdf format) -- for our most popular plans:

Blue Cross and Blue Shield of Illinois

BCBSIL Online Application
BCBSIL Traditional PPO Plans Application Form -- 156KB
BCBSIL HSA-Compatible Plans Application Form -- 179KB

UniCare

UniCare Illinois Online Application
UniCare Illinois Application Form -- 142KB

Humana One

Humana One Online Application
Humana One Phone-In Application Instructions -- 61KB

United HealthCare / Golden Rule

United HealthCare / Golden Rule Online Application
United HealthCare / Golden Rule Illinois Application Form -- 102KB

Aetna - Illinois

Aetna Illinois Online Application
Aetna Illinois Application Form -- 111KB

Celtic

CeltiCare II (Traditional PPO) Online Application
Celtic Basic (Lower Cost PPO) Online Application
CelticSaver (HSA-Compatible) Online Application

Assurant Health (Permanent Coverage)

Assurant Online Application

Assurant Health Short-Term

Assurant Illinois Online Application
Assurant Illinois Application Form (to 12 months) -- 67KB

Blue Cross IL Traditional PPO Blue Cross IL HSA-Compatible UniCare Traditional PPO UniCare HSA-Compatible Sound Health Plans UniCare Dental Humana One Traditional PPO Humana One HSA-Compatible Aetna PPO and HSA Assurant Health Celtic UnitedHealthcare Assurant Short-Term Medical Dental Insurance Illinois Group Health Insurance HSA Overview HSA Contributions HSA Distributions HSA Administrators Q&A - Individual Health Insurance Q&A - Group Health Insurance Health Insurance Glossary Priority Resource Websites More Websites of Interest

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