Anthem Spotlight
At Anthem Life, our mission is to provide the people we serve with financial protection and security.

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Group Coverage @ Anthem Life
Provide competitive employee benefits that fit your budget, with our group life and disability coverage.

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Voluntary Coverage @ Anthem Life
Let employees choose their own coverage with voluntary life and disability insurance from Anthem Life.

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Massachusetts

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The state you selected is Massachusetts. Now select the application you need. 
 
Anthem Life Medical Application 
Applying for any insurance coverage more than 31 days after the insured was eligible for coverage.
Applying for insurance amounts in excess of the amount guaranteed to be issued under the employer’s insurance plan.
Applying for coverage designated by Anthem Life as requiring medical information or other information within the medical section to be completed for purposes of approving or denying benefits and/or setting premium rates.
 
Anthem Life Non-Medical Application 
Applying for insurance coverage within 31 days of the insured becoming eligible for coverage.
Applying for insurance amounts within the amount guaranteed to be issued under the employer’s insurance plan.
 
Group Life Insurance Conversion Application 
Applying for individual whole life insurance due to termination of employment.
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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