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This document is an application for small businesses in Illinois to submit to UnitedHealthcare, detailing the information and documentation required for health insurance coverage for groups with 2-50
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How to fill out Illinois Small Business Employer Application

01
Obtain the Illinois Small Business Employer Application form from the Illinois Department of Employment Security website or the local office.
02
Fill out the business name and address in the designated fields.
03
Provide the owner's name and personal details, including Social Security Number and contact information.
04
Enter the type of business structure (e.g., sole proprietorship, partnership, corporation).
05
Indicate the number of employees you plan to hire.
06
Specify the nature of your business activities.
07
Include any applicable federal employer identification numbers (EIN).
08
Review the form for accuracy and completeness.
09
Submit the application either online or via mail, as directed on the form.

Who needs Illinois Small Business Employer Application?

01
Any individual or entity planning to hire employees in Illinois and operate a small business.
02
Business owners who need to comply with state employment registration requirements.
03
Entrepreneurs starting a new venture in Illinois that will involve hiring staff.
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Employers can register electronically through the MyTax Illinois​ website. Submit a completed and signed REG-UI-1 form, "Report to Determine Liability Under the Unemployment Insurance Act".
How to Apply? Method 1: Apply Online. Online is preferred as it is the fastest method to receive your EIN. Method 2: Apply by Fax. Taxpayers can also complete Form SS-4 and send it to the IRS fax number listed below for Illinois businesses. Method 3: Apply by Mail. Method 4: Apply by telephone- International Applicants.
Information Needed to File Online Your Social Security Number and name as it appears on your Social Security card; Your Driver License / State ID (this will provide your weight, which is required); If claiming your spouse or child as a dependent​, the Social Security Number, date of birth and name(s) of dependent(s);
Employers can register electronically through the MyTax Illinois​ website. Submit a completed and signed REG-UI-1 form, "Report to Determine Liability Under the Unemployment Insurance Act".
How to Apply? Method 1: Apply Online. Online is preferred as it is the fastest method to receive your EIN. Method 2: Apply by Fax. Taxpayers can also complete Form SS-4 and send it to the IRS fax number listed below for Illinois businesses. Method 3: Apply by Mail. Method 4: Apply by telephone- International Applicants.

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The Illinois Small Business Employer Application is a form used by small businesses in Illinois to register for various employer-related tax accounts and compliance purposes.
Any individual or entity operating a small business in Illinois that intends to hire employees or is required to register for state tax purposes must file the Illinois Small Business Employer Application.
To fill out the Illinois Small Business Employer Application, you need to provide basic business information, including the business name, address, type of business structure, estimated payroll, and the number of employees to be hired.
The purpose of the Illinois Small Business Employer Application is to ensure that businesses comply with state regulations and to facilitate the registration process for tax and other employer obligations.
Information that must be reported includes the business name, address, owner details, type of business, estimated number of employees, and federal Employer Identification Number (EIN).
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