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This is the time to shop and buy insurance. It's an open enrollment period, a window of time annually when you can sign up for insurance or adjust your current plan. Applications can be submitted from November 1-January 15, 2023.

Attention: Only agents that are currently appointed with BCBSND are authorized to submit applications. If you are not appointed or are unsure of your appointment status with BCBSND contact marketingsupportcoordinators@bcbsnd.com prior to submitting any applications.

Coverage starting on January 1, 2023.

If your applicant qualifies for a tax credit, please visit HealthSherpa to complete an On Exchange enrollment.

Get started on your application

$1250.50

2 Adults, 2 Dependents

Monthly Premium

Nov 1, 2020

Coverage Start Date

Subscriber Information

*Required Fields

We only offer coverage to residents of North Dakota. Call 800-280-2583 if you feel you qualify.

How Can We Contact You?

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Now, we need more details about your spouse and dependents

BlueCare 70 2000

$1250.50

2 Adults, 2 Dependents

Monthly Premium

Nov 1, 2020

Coverage Start Date

Subscriber, Spouse and dependents

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Subscriber signature

Terms and Conditions

I understand that any company(s) with which I am applying for coverage reserves the right to accept or decline this application in whole or in part. I further understand that no contractual right is created by this application or advance premium payment and the same shall not be considered accepted unless or until the Benefit Plan is issued to me.

I have read this application in its entirety and understand and acknowledge that the accuracy and sufficiency of the information I provide (or fail to provide) in each and every section of this application serves as the basis in determining my eligibility (and the eligibility of my dependents) for coverage and receiving a Benefit Plan(s), and by signing this application I certify the information is accurate and complete. I understand and agree that inaccurate, incomplete, or omitted information represented in this application may constitute a fraudulent act or intentional misrepresentation of material facts voiding or retroactively cancelling any Benefit Plan(s) issued, as well as any claims for medical benefits and services paid, based on the information I submit through this application.

I further understand a person who submits an application or files a claim with intend to defraud or helps commit a fraud against an insurer is guilty of a crime.

By checking this box, I understand I am creating an electronic signature that carries the same legal obligations as a written signature and am agreeing to all of the terms and conditions set forth within this application, including the Notification and Authorization.

Agent Signature

Note: Include leading zeros in BCBSND Agent Number and BCBSND Agency Number.

By checking this box, I understand I am creating an electronic signature that carries the same legal obligations as a written signature and am agreeing to all of the terms and conditions set forth within this application, including the Notification and Authorization.

I am submitting this application on behalf of the individual signee. I have received verbal or written consent from the individual to submit the application. The application accurately reflects the information provided. I have printed a copy of the application and provided it to the individual signee.

Print this page for your records before submitting the application.