Plan Documents and Forms

Choosing coverage

Group Brochures
You and your employees can learn more about employer-sponsored health plans through Blue Care Network by reading these brochures.
Employee Group Coverage Waiver Form
If your employees want to opt out of their Blue Cross coverage, have them fill out this form.

HMO Group Administrative Manual
This manual will help you manage your employer-sponsored health care plan through Blue Care Network.
Change of Status Form
Employers can give this form to employees who need to enroll in a health insurance plan, choose primary care physician or update their personal information.
Tools for communicating with your members
Employers will find tools here for communicating with their employees, including BluesMarketplace and letters for dependents through age 26.
Agent Fee Payment Process and Agreement
If your group has negotiated an agent fee with us, you can read about the payment process and fill out an agreement to have us process that fee.

Overview of Group Blue Cross Coverage (PDF)
Find all the important information about your group Blue Cross health insurance plan.