Submit form to cancel coverage or change employee name or address.
If you can't find the form you need here, you can log in to the employer portal or contact a member of your Blue Team.
Billing and payments
Complete bank information and attach a copy of a cancelled or voided check to verify account and routing/transit numbers. Payment withdrawals from your bank account will be completed on the 1st of the month. Billing schedule is subject to change due to holidays and weekends.
Eligibility and renewals
2019 Medical Loss Ratio (MLR) Form - To be completed for 2020 group
Submit the MLR form, as required by the Affordable Care Act (ACA).
Submit this form to cancel an employee's coverage, change an employee's address or update an employee's name. You may also be able to complete this change online faster and easier within the Employer Portal.
If you offer a health plan that requires the selection of a specific network, use this form to: