Supplier Registration
Please complete the form below to register your company.
Supplier Data
Corporate Headquarters-US
Contact Information
Primary Contact
Secondary Contact
Company Description
(Check if true)
(Please click here to verify if your quality as a small business as per SBA)
IMPORTANT NOTICE
Make sure to review definitions for diverse business certifications in Federal Acquisition Regulation 19.7 or 52 219-8 at https://www.acquisitior.gov/far before responding below. For questions, check the US Small Business Administration's website at https://www.sba.gov/ or contact your local SBA office.
Diversity Information
(Check if true)
(Check if true)
Diverse Classification Certified By Agency Name Other Agency Name Expiration Date
Minority Business Enterprise (MBE)
Woman Owned Business Enterprise (WBE)
Veteran owned Business Enterprise (VET)
Service Disabled Veteran Owned Business Enterprise (SDV)
Lesbian / Gay / Bisexual / Transgender Owned Business Enterprise (LGBT)
Hubzone (HUBZ)
Small Disadvantaged Business Enterprise (SDB)
Small Business Enterprise (SBE)
Disadvantaged Business Enterprise (DBE)
Disabled Person Owned Business Enterprise (DOBE)
Small Business Administration 8(a) (SBA 8(a))
Woman-Owned Small Business (WOSB)
Economically Disadvantaged Woman-Owned Small Business (EDWOSB)
Historically Black College/University or Minority Institution (HBCU)
Alaskan Native and Indian Tribe (ANIT)
Other (OTHER)
Click to confirm Supplier’s understanding
Authorized Representative

For assistance completing the form, please email SDPInfo@bcbsa.com

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.