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Prospective employers seeking membership in
the cooperative must complete the steps detailed in our
guide called Steps to Coverage. Click below to down load this form.
Steps To
Coverage
PLEASE
DOWNLOAD THE FOLLOWING ITEMS BY CLICKING ON THE BOX BELOW.
1.
1. BCBS Employer Application
2.
2. BCBS Census
3. 3.
Wage & Tax Report
4. 4. Main Street Health Group
Employee Questionnaire
5.
5. Medicare Secondary Payer
6.
6. Supplemental Employee
Verification
Click on the box to download
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