Plan Forms and Documents

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

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.

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

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

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.

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

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

Learn about the member enrollment process and the structure of Blue Care Network's health care system.

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

Use this form to request group and member publications.

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

Fill out this form to authorize BCN automatic payments for groups.

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

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

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