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(Required)

Max. file size: 100 MB.

Upload a copy of your Kansas license(Required)

Max. file size: 100 MB.

Upload a copy of your of AHIP certification(Required)

Max. file size: 100 MB.