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Every business is unique. That's why we're ready to work with you to get your employees the coverage they deserve.
Complete the form below and an Account Associate will contact you by telephone or email. Of course, you can always call us,
Monday through Friday, 8 a.m. to 5 p.m. EST, at 1-800-422-3545.

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Are you currently working with a broker? *This question is required.
Are you an existing account with Blue Cross Blue Shield of Massachusetts? *This question is required.
Employee 1 Information
Employee 1 InformationType of Coverage Date of Birth Home ZIP Code
1
Employee 2 Information
Employee 2 InformationType of Coverage Date of Birth Home ZIP Code
2
Employee 3 Information
Employee 3 InformationType of Coverage Date of Birth Home ZIP Code
3
Employee 4 Information
Employee 4 InformationType of Coverage Date of Birth Home ZIP Code
4
Employee 5 Information
Employee 5 InformationType of Coverage Date of Birth Home ZIP Code
5
Employee 6 Information
Employee 6 InformationType of Coverage Date of Birth Home ZIP Code
6
Employee 7 Information
Employee 7 InformationType of Coverage Date of Birth Home ZIP Code
7
Employee 8 Information
Employee 8 InformationType of Coverage Date of Birth Home ZIP Code
8
Employee 9 Information
Employee 9 InformationType of Coverage Date of Birth Home ZIP Code
9
Are any employees located outside of Massachusetts? *This question is required.
What plans are you interested in learning about? *This question is required.
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How would you prefer to be contacted? *This question is required.

Final rates are subject to SIC code verification, underwriting review and actual enrollment as of the plan effective date.

 

Eligible Employees—Permanent full-time employees regularly work 30 or more hours per week and permanent part-time employees working at least 20 hours, but less than 30 hours per week, at the employer's usual place of business and paid in accordance with state & federal wage requirements.

 

 

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