Illinois Agents Forms & Resources: Large Groups

New Large Group Forms

New Group Checklist

Employer Group Application 

Employee Application
(use with claims experience)

Employee Application 
(use when no claims experience)

Employee Questionnaire 

Domestic Partner Affidavit 

Existing Large Group Forms

New Hire application/Employee change form

Employer Group Application

Large Group Creditable Coverage | Learn More

Waiver of Coverage