Group Health Insurance

Open enrollment for the TBA exclusive BlueCross BlueShield of Tennessee group health insurance plan has come to a close. Enrollment will open again in October 2025. Are you interested in our other group health insurance options? With access to all major carriers, we can assist you in finding a plan that meets the needs of your firm.

If you have any questions or would like to obtain a quote, please complete the following form, give us a call at 800.347.1109, or email us at tba@assoc-admin.com. If you prefer a PDF of the Quote Request Form, you can access it here.

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Group Health Insurance Quote Request - Step 1 of 2

Firm Name:

Contact Name:

Physical Address:

City:

State:

Zip Code:

County:

Phone:

Email:

Number of Employees:

Number of Full-Time Employees:

Number of Employees Participating:

Next

Please complete each field for all full-time employees and their participating dependents. For any full-time employees that do not wish to participate, select "Waive".

Name:

Date of Birth:

Home Zip Code:

Gender:Select OneMaleFemale

Relation to Firm:Select OneEmployeeEmployee's SpouseEmployee's Child

Coverage Tier:Select OneEmployee OnlyEmployee + SpouseEmployee + Child(ren)FamilyWaive Coverage

Add Employee/Dependent Remove Employee/Dependent

Additional Information:

Code: Address: Employees:

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