Please be advised, there is inconsistency in accessing Broker Express. We are working to resolve this as soon as possible.
Apologies for any inconvenience.
BlueChoice Advantage - Small Group On-SHOP Applications - Virginia
BlueChoice Advantage (including HSA/HRA)
| Group Size | Group Subscriber Enrollment Form | Group Contract Application |
|---|---|---|
| 2-50 | SUM6126 (for plans effective 1/1/23 and 12/31/23) |
VA/GRPAPP/HCR (1/21) (HIX) (for plans effective 1/1/21 and 12/31/23) |