BCBS of Kansas Appointment

BCBS Kansas - Agent Appointment

Name(Required)

First Last

Agency Name (if applicable)

Email(Required)

National Producer Number(Required)

Kansas License Issue Date(Required)

Please download a copy of the BCBS of Kansas appointment paperwork by clicking the link below. You will be asked to upload a completed copy in the next step.
BCBS of Kansas Appointment Paperwork

Upload completed BCBS of Kansas appointment paperwork, Kansas License, and AHIP certification(Required)

Drop files here or

Max. file size: 36 MB, Max. files: 3.

There should be 3 files, 36MB Total for all files

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Upload a copy of your Kansas license

Max. file size: 36 MB.

36MB Total for all files

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Upload a copy of your of AHIP certification(Required)

Max. file size: 36 MB.

36MB Total for all files

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