Agents Forms & Resources: Illinois Small Groups

New Small Group Forms

Small Group Checklist

Employer Group Application

Domestic Partner Affidavit

Waiver of Coverage form

Existing Small Group Forms

CMS Survey

COBRA Group Continuation Notice

New Hire Application/Employee Change Form

Employer Group Application

Creditable Coverage – 2025 | Learn more

Creditable Coverage – Transitional Plans – 2025

Renewability and Rating Notice

Waiver of Coverage