Illinois Group Forms + Resources

Enrollment Forms

Employer Application – 2021

Employee Application for New Hire – 2021

Employee Questionnaire – 2021

Employee Census Template

CMS Survey

Additional Forms

Quartz Drug Formulary: $0 Copay List

Quartz Drug Formulary: Rx Outcomes List

Small-Group ACA Plans

Large-Group Creditable Coverage – 2021 | 2022  Learn More

Small-Group Creditable Coverage – 2021 | 2022 | Learn More

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