Become A Licensed Agent
After reviewing the Appointment Procedures, please complete and return:
- Agency Agreement
- Addendum to Agency Agreement
- W-9 form
- Medicare Supplement Products Agency Agreement
- Addendum to Agency Agreement With Business Associate
- Broker EFT Enrollment Form
- Conflict of Interest
You will also need to provide proof of E & O coverage and a current copy of your Tennessee license. All completed materials can be sent to:
BlueCross BlueShield of Tennessee
Attn: Individual Sales- 3G2
One Cameron Hill Circle
Chattanooga TN 37402
© 1998-2012 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.
Page Modified:August 25, 2011