Regence Blue Cross BlueShield of Utah 99+

When you choose Regence, you’re getting a health care partner. One that can help with your needs every step of the way, from quick health information to answers about claims, and from online wellness programs to one-on-one help with serious health conditions.
Our team of customer service specialists, case managers and health care professionals are devoted to helping you reach your health care goals.

Benefits they can offer:

  • Medical
  • Dental
  • Vision
  • Life

All of these will need to be quoted by Regence Blue Cross BlueShield of Utah. Please contact our staff for additional information.


Quote Request/New Business Submission Forms:

For quote and rate information for Blue Cross Blue Shield please contact our staff. Blue Cross Blue Shield for 99+ will require underwriting to review the information to determine if they will quote your group or decline to quote. Please note it can take 7 to 10 business days to go through the underwriting process. Please note our checklist which lists everything that we will need as well as optional items.

Blue Cross Blue Shield will take other carrier RFP forms in place of their forms for quote requests.


Large Group Checklist- 100+

Group Master Application 100+

Group Master Application 100+-Administrative Services Contract

Large Group Proposal Request form

Large Group Census

  • You do not have to use this census we will just need the information on the census


This needs to be completed if they do not have prior coverage to receive quotes.

Employee Application (fully-insured)

Employee Application (self-funded)


Provider Search:

Please click the below link for an up-to-date provider search.

BX- Network


Marketing/Sales Material:

Medical –

Regence 360Me flyer

BluePoint 20-40 plan highlights (51+ groups) 2015

BluePoint 30-45 plan highlights (51+ groups ) 2015

HSA Healthplan 3.0 (Standard) plan highlights (groups 51+) 2015

Engage plan highlights (groups 51+) 2015

Preferred plan highlights (groups 100+) 2015

Employee Choice-

All of Blue Cross’s small-group products can be offered through Employee Choice, an option that lets employers offer up to five different plans. Employees can pick the one that’s right for them.

2015 Employe Choice

  • A short video about employee choice and how this will benefit your employer groups.


On the road? BlueCard provides the health benefits that make members feel at home. Members have access to the largest network of doctors across the country and worldwide—without a referral.



Group dental plan highlights 2015


The forms posted on this page are for 2015. If you are interested in any forms for previous years or any pre-ACA plan forms please contact our staff.

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