In late-April, we made some changes to our application for Individual, non-ACA business. Effective immmediately, we will no longer accept old versions of the application. Please throw out any old paper versions and start using the new one right away. You can access a copy of the most current application below. Or you can always find the most up-to-date version on the Producer Toolbox. Just click on the Sales & Training tab, then choose Tools & Resources.
Ohio - Individual Non-ACA Application
Indiana - Individual Non-ACA Application
Kentucky - Individual Non-ACA Application
Missouri - Individual Non-ACA Application
Wisconsin - Individual Non-ACA Application
How do I know if I am using the wrong application?
If you've previously downloaded a copy of the application, make sure it has a 1/15 (or later) revision date at the bottom of the application. If it doesn't, please download the new one and start using it right away.
If you have any questions, please contact your Anthem Sales Representative.