We are an Authorized Independent Agent for Anthem Blue Cross & Blue Shield. Anthem

PPO Application for BluePreferred, Lumenos HSA,Tonik, and SmartSense plans. Prescreen Application	Premier Plan Description
HSA Plan Description	SmartSense Plus (Std Rx) Plan Description
Tonik Risk Taker Plan Description	SmartSense (Upgrade Rx) Plan Description
Clear Protection Description	Core Share Plan Description
Change of Coverage Application	Employer Funded Questionnaire

Forms can be faxed to our office at (303) 721-1085. Please confirm that application was received by calling (303) 721-1145. Please call with any questions regarding eligibility or waiting periods.