New Illinois Large Group Employee Application

Starting September 1, 2019, we’re using a new large group employee application. We’ll accept the old application through November 30. After that, we’ll no longer be able to process the old one. The old application has “LGAPP-18” in the bottom-left corner.

If an outdated form is submitted on or after December 1, 2019, we’ll ask you to resubmit it using the new form.

Please bookmark the new application for easy access, and destroy any copies you have of the old version.

If you have questions, contact Client Support at 217-902-8151 or ClientSupport@healthalliance.org.

Please note: If you are enrolling new employees or making changes through the online enrollment tool, you are required to keep a hard copy of their signed application on hand for the life of the policy plus 10 years.