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Products & Services / Group Health / Group Health Enrollment
 Group Health Insurance
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Step-by-Step Enrollment Instructions
1.) Complete a Membership Application
- For each employee (including owner) applying for coverage. A waiver must be completed for each full time employee (17.5 hours or more per week)
not applying for coverage.
2.) Deposit for first month's premium payable to:
- Blue Cross / Blue Shield of Rhode Island
3.) Complete a Sales Agreement
- Sales Agreement must be completed in full
- Sales Agreement must be dated and signed by employer and broker
Mail all items to:
BrokerNetUSA
100 Metro Center Blvd.
Warwick, RI 02886
Enrollment paperwork must be received by the 23rd of the month prior to the requested effective date. Groups enrolling in the BlueCHiP for Healthy Options
or a HealthMate HDHP plan must submit paperwork by the 13th of the month prior to the requested effective date.
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