MID-MARKET
SALES KIT

Quote

Mid-Market Group Portfolio
We offer a variety of plans with a wide selection of deductibles, copayments and prescription benefits. Looking to save on premiums? Don’t forget to look at networks! It’s all inside our Mid-Market Portfolio. 2022   2023

Need a Quote Now?
Email a completed Mid-Market RFP to:
51-150: TexasRFP51100@bcbstx.com

Mid-Market RFP Checklist

Quoting Census Template

Enroll & Implement

Helpful References:

• Mid-Market Enrollment Guide
• Smart Census Import Tool Reference Guide

Technical Support - Mid-Market Enrollment Tool
Email: sgmm_techsupport@hcsc.com
Phone: 888-706-0583

For member enrollment, use:

• Smart Census, OR
• Group Enrollment Application/Change form

Mid-Market Forms

Find the most current enrollment forms on BAP.

Benefit Program Application (BPA)
Employer application for group coverage

Employer Group Information (EGI) Form
This form replaces the MSP form. Please submit it with the signed BPA.

HMO Disclosure form:
This form is part of the BPA. Only complete the disclosure when you sell new HMO plans.