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Web Enrollment

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Still enrolling on paper? Now’s a great opportunity to save time through Web Enrollment. You’ll be able to enroll new employees, add and cancel dependents, enter name and address changes, and much more. 
Web Enrollment is secure and available 24/7. Just log on, step through an application, and send it to us electronically. We update our information to reflect your changes. 
Note: Not all employer groups are eligible for Web Enrollment. If you are interested in Web Enrollment, please contact your Anthem Blue Cross and Blue Shield Sales Team to see if you qualify. 
Not sure if Web Enrollment is right for you? Select the link below for a preview: 
Take a Virtual Tour
 
If you are having trouble viewing the online demo you may not have Flash Player installed or you may need an upgrade to the latest version. Use the link below to download this free browser plug-in: 

 
 
 
Thank you for electing to use Web Enrollment. To submit a Web Enrollment application please select the link below: 
Login to Web Enrollment
 
Select the links below to view helpful reference materials: 
Quick Reference Guide
Frequently Asked Questions
Enrollment Usage Agreement (required prior to usage)
Electronic Enrollment Options
Member Registration Form
 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use