Sample Client Education and Enrollment Materials
Please Note: These forms cannot be accepted for enrolling patients.
These are some sample client education and enrollment materials that you may review in order to familiarize yourself with the materials that will be sent to your patients.
(To find out how a client can enroll with a PCP, please visit our Client Enrollment page.)
- ICEB Health Plan Comparison Chart for Cook County
- ICEB Health Plan Comparison Chart for IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Health Plan Copayment Chart for Cook County
- ICEB Health Plan Copayment Chart for IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Greeting Card
- ICEB Greeting Card (Spanish)
- ICEB Initial Enrollment Letter
- ICEB Initial Enrollment Letter (Spanish)
- ICEB Initial Enrollment Letter for IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Initial Enrollment Letter for IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott (Spanish)
- ICEB Enrollment Tips
- ICEB Enrollment Tips (Spanish)
- ICEB Enrollment Form
- ICEB Enrollment Form (Spanish)
- ICEB Enrollment Form IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Enrollment Form IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott (Spanish)
- ICEB Information Guide IHC and MCO for Cook County
- ICEB Information Guide IHC and MCO for Cook County (Spanish)
- ICEB Information Guide IHC and MCO for Jackson, Kane, Madison, Perry, Randolph, St. Clair, Washington, and Williamson counties (English and Spanish)
- ICEB Information Guide IHC only
- ICEB Information Guide IHC only (Spanish)
- ICEB Information Guide IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott County
- ICEB Information Guide - IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott County (Spanish)
- ICEB Reminder Notice
- ICEB Reminder Notice (Spanish)
- ICEB Reminder Notice IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Reminder Notice IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott (Spanish)
- ICEB Second Enrollment Letter
- ICEB Second Enrollment Letter (Spanish)
- ICEB Second Enrollment Letter IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott
- ICEB Second Enrollment Letter IHC and MCO for Adams, Brown, Henry, Mercer, Pike, Rock Island and Scott (Spanish)
- ICEB Brochure
- ICEB Brochure (Spanish)
Illinois Client Enrollment Broker Client Enrollment Policy
Please download and review the Client Enrollment Policy
(Downloadable file requires Adobe Acrobat Reader - Free Download)
