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  • Enrollment Application/change Form - Blue Cross And Blue Shield ...

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Enrollment Application/Change Form Please read the instructions on the inside thoroughly before completing this enrollment application/change form. A Division of Health Care Service Corporation, a.

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About Florida Blue Florida Blue is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit .FloridaBlue.com.

You must call Customer Service, (855) 836-9705, to have them cancel your current medical plan because, legally, Blue Shield cannot cancel your plan without your authorization. Failure to cancel your plan will result in you having two active plans and two sets of bills.

Speak with a Customer Service Advisor by calling 1-800-495-2583, 8 a.m.-8 p.m., Monday-Friday.

Call the Federal Marketplace at 1-800-318-2596 to cancel a policy. If you set up a bank draft, call the number on the back of your BCBSLA ID card.

Call 1-800-810-2583 (select international option) or collect at 1-804-673-1177....The written request must include: Name. Policy number. A statement asking to cancel along with requested cancellation date and subscriber's signature.

To update your contact information, click here and then click on the Network Participation tab and follow the directions under Update Your Contact Information. This process allows you to electronically submit a change to your name, office or payee address, email address, telephone number, tax ID, or other information.

About Florida Blue Florida Blue, Florida's Blue Cross and Blue Shield company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than 5 million health care members across the state.

How to cancel Blue Shield of California Call this number: (888) 256-3650. Ask to speak with an agent. Provide them with your membership information. Request termination of your contract. Ask for a confirmation email.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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