Anthem Blue Cross Forms

Anthem Blue Cross health insurance forms and applications. Choose appropriate form below. If you cannot find appropriate form use contact page to contact us regarding a specific form. To apply for individual/family Anthem Blue Cross using paper application please see application below. Please follow instructions on the form on how to submit it. If you are filling out paper application for individual/family plan and would like to get a quote first click here. Only completed Individual/Family applications can be faxed to 800-569-1156.

 

Individual and Family Plans
Get a Quote and Apply Online
Individual and Family Application
TONIK Individual Enrollment Application
Authorization for Use of Protected Health Info (English/Spanish)
Supplement to Individual Enrollment Application
Change of  Coverage Application
Credit Card Authorization Form
Member Claim Form
Prescription Drug Claim Form
HIPPA Brochure and Application
 
Small Group Health Plans
Get a Quote and Apply Online
Small Group Quote Request Form
Change of Coverage Application
Small Group Enrollment Application
Employee Addition Application (Existing Group)
Information Change Form
 

 

 

Tonik Health Insurance
Have you seen Tonik? Three simple, affordable health insurance plans to cover your A-Z. Body, eyes, teeth. You know, the important stuff. Click the Tonik link for details.