New Broker Information
Appointment Procedures for Group Business
Please call or e-mail the appropriate regional office contact for appointment information for group business. Regional Office Map
Appointment application for CoverTN business
Appointment Procedures for Individual Business
In addition to the required forms below, please submit the following:
- Your first BlueCross BlueShield of Tennessee health case/application.
- A copy of your current State of Tennessee Life and Health Insurance license.
- A copy of your Error and Omissions insurance.
Required Forms for Individual Business
- Individual Products Agency Agreement
- Producer Request For Appointment
- Privacy Addendum Agency with Business Associate
- IRS W-9 Form
- Electronic Fund Transfer Authorization Agreement
For an appointment to sell individual business, please submit your information to:
BlueCross BlueShield of Tennessee
Attn: Individual Sales Department, 3G2
801 Pine Street
Chattanooga, TN 37402-2555
If you have questions please contact the Individual Agent Representative for your area: Individual Field Agency Support Map
Additional Agency Agreement and Credentialing Required for Medicare Advantage and Medicare Part D Products
In addition to the documents and forms for Individual Business appointment listed above, with the exception of your first Medicare Advantage or Medicare Part D case/application, you must submit the following additional agency agreement.
Medicare Products Broker Agreement
Before you can sell these products, you must complete an online credentialing course. Once you have submitted all of the paperwork above and received your agent ID number, please visit BlueAccess (registration required) and click on the BlueAdvantage and BlueRx Credentialing link. This training includes 7 tests and a conflict of interest policy that must be completed, signed and returned.
Please submit this information to:
BlueCross BlueShield of Tennessee
Attn: Government Sales Department, MAEG1
801 Pine Street
Chattanooga, TN 37402-2555
Fax: (423) 296-4582
