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  • Enrollment/change Request Form - Horizon Blue Cross Blue Shield ...

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Attn: Large and Mid-Size Group Enrollment P.O. Box 10168 Newark, NJ 07101-3168 Fax (973) 274-2297 www.HorizonBlue.com GROUP ENROLLMENT/CHANGE REQUEST Group Information to be completed by Employer.

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Untimely Filing: Claim was filed within the required 180 days from the date of service.

Simply sign in to the Horizon Blue app and tap Claims, then Submit a Claim. When you submit out-of-network claims by mail, please include the appropriate claim form below and mail it, and the required information listed on the form, to the address on the form: Merck members: Merck Health Insurance Claim Form.

If your Horizon Blue Cross Blue Shield of New Jersey plan has the BlueCard® Program, you're covered when you need care across the United States.

Claims must be submitted within 180 calendar days from the date of service.

Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.

If you need help accessing Horizon BCBSNJ's Member Online Services, please send an email to Member_Portal@HorizonBlue.com.

If you purchased your insurance directly through Horizon: Use our Email Us tool. Under Category, choose Enrollment; Fax your information to 1-973-274-4413; or. Check the box titled Report Address Change and complete the information on your invoice when sending your premium payment by mail.

Claims must be submitted within 180 calendar days from the date of service. The claim will be denied if not received within the required time frames. Corrected claims must be submitted within 365 days from the date of service.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232