Blue Care Network Service Company Self Funded Group Exception Form

Who is this for?

The Blue Care Network Service Company Self Funded Group Exception Form is for businesses that provide self-funded health insurance to their employees.

If you offer self-funded health insurance for your employees, you can use this form to ask for payment for services your plan doesn’t usually cover.

The Blue Care Network Service Company Self Funded Group Exception Form (PDF) is for companies or businesses that provide self-funded health insurance to employees administered by Blue Care Network Service Company. Both self-funded ERISA and non-ERISA groups can use it.

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