For Employers: Plan Forms and Documents

Looking for forms and documents? Here you'll find forms to complete enrollment, make payments and much more. We also have information to help employers, employees and agents make important decisions.

Choosing coverage

Overview of Group Blue Cross Coverage (PDF)

Use this guide to find and understand important information about your group coverage with Blue Cross Blue Shield of Michigan or Blue Care Network.

Blue Elect Plus℠ POS and Blue Elect Plus HSA℠ POS decision maker brochure (PDF)

Find value, flexibility and more choices with Blue Elect Plus.

Healthy Blue Living℠ (PDF)

Healthy Blue Living is a wellness incentive plan. This plan rewards members with cost savings for learning more about their health and taking action to improve it.

Healthy Blue Living flyer for employers (PDF)

Help your employees learn how they can save on premiums and be proactive about their care.

Enrollment forms

New Enrollment and Change of Status form (PDF)

These conditions and instructions will help employees enroll in a new plan or change to a different one.

New Enrollment and Change of Status form in Spanish (PDF)

If you're enrolling a Spanish-speaking member, this is the form you'll need to enroll them in a new plan or change an existing one.

Employee Waiver form (PDF)

If an employee wants to waive coverage, they'll need to read and fill out this form.

Employee Waiver form in Spanish (PDF)

If you have a Spanish-speaking employee who wants to waive their coverage, have them return this form.

Managing my account

Blue Care Network Self Funded Group Exception Form (PDF)

This form is for Self-Funded ERISA and Self-Funded non-ERISA groups to fill out for payment exceptions.

Healthy Blue Living group administrative manual (PDF)

This reference guide provides valuable information to help you administer Healthy Blue Living and answer questions your employees may have.

PDF

Blue Cross Blue Shield of Michigan and Blue Care Network Consolidated Appropriations Act Gag Clause Prohibition Compliance Certification (PDF)

This compliance confirmation is a detailed description of the requirements for health insurance issuers. Read more to find out the importance of compliance and what is required.

Payment forms

Employer Group Authorization Agreement for Automatic Payments (PDF)

Employers can make automatic payments to Blue Cross after filling out and returning this form.

BCBSM Agent Fee Payment Process (PDF)

Find out what the requirements are for enrollment in the BCBSM Agent Fee payment process.

BCBSM Agent Fee Processing Agreement (PDF)

Read and fill out this form for BCBSM agent fee processing.

BCN Agent Fee Payment Process (PDF)

Find out what the requirements are for enrollment in the BCN agent fee payment process.

BCN Agent Fee Processing Agreement (PDF)

Read and fill out this form for BCN agent fee processing.

Medical policy updates

PDF

Medical Policy Updates Newsletter - Fourth Quarter 2023 (PDF)

Commercial PPO/HMO Medical Policy Updates

Medical Policy Updates Newsletter - Third Quarter 2023 (PDF)

View the latest treatments and procedures that have been approved since the last newsletter.

Medical Policy Updates Newsletter - Second Quarter 2023 (PDF)

Employers can view the latest treatments and procedures that have been approved.

Medical Policy Updates Newsletter - First Quarter 2023 (PDF)

Commercial PPO/HMO Medical Policy Updates

Downloadable resources

Use these toolkits to educate your employees on how to get the most out of their health plan.

View all
TOOLKIT
Marketing planner for employers
Behavioral health

Help your employees learn more about their options for mental health care.

Read about behavioral health
TOOLKIT
What to expect with your HMO
Open enrollment

Help your employees understand how to enroll in a health care plan.

Find out about open enrollment
TOOLKIT
How to use our flu shot toolkit
Flu shot

Educate your employees on the importance of getting the flu shot during flu season.

View the flu shot toolkit
TOOLKIT
Register for your Blue Cross member account from any device
Using an online account

Help your employees learn how to manage their online account at bcbsm.com.

Learn about online accounts

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