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  • Aca Change Application - Florida Blue

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ACA Change Application Add due to newly married or eligible domestic partner and/or dependents Return to: Florida Blue P.O.Box 45074 Jacksonville, FL 32232 I hereby request the following changes(s).

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Although the Sunshine State has not embraced Obamacare from a legislative standpoint, the healthcare reform law has had some positive impacts there. Florida's federally facilitated health insurance exchange has the nation's highest enrollment numbers, all of whom have coverage for the ACA's essential health benefits.

Build Healthy, Strong Communities Eligibility Be located in Florida and serve Floridians. Possess exemption by the Internal Revenue Service under section 501(c)(3) of the tax code. Address Florida Blue community outreach goals and targets.

Please mail your completed claim form with original bills or receipts and copies of other Explanation of Benefits, if applicable to: Florida Blue P.O. Box 1798 Jacksonville, FL 32231-0014 Page 2 MEDICAL CLAIM FORM (To be completed by Member.) Complete ALL information or your form may be returned.

You must file your claim within one year from the date of service. You can submit your claim any time during the year. Use a separate claim form for each family member and each physician or supplier. All sections of the form must be filled out completely or your claim may be returned to you.

Blue Cross and Blue Shield companies (BCBS) participate extensively in the ACA marketplaces, with more members than any other insurance carrier and more extensive geographic coverage.

Attention: This website is operated by Florida Blue and is not the Health Insurance Marketplace® website at HealthCare.gov. ... To see all available Qualified Health Plan options, go to the Health Insurance Marketplace® website at HealthCare.gov.

While the brand name has changed to Florida Blue, the company's legal name remains Blue Cross and Blue Shield of Florida, Inc. Florida Blue is a leader in Florida's health industry.

Florida Blue is using the term 'Non-ACA' to include all older health plans without the essential benefits required under the Affordable Care Act so both grandfathered plans and transitional plans are Non-ACA plans. Affordable Care Act plans vary in benefits and premiums.

Complaint, Grievance and Appeal Process You may either call member services at the telephone number on the back of your membership card or go to your local Florida Blue office in person (the address is in your Member Handbook or available at FloridaBlue.com) to file your oral complaint.

While the brand name has changed to Florida Blue, the company's legal name remains Blue Cross and Blue Shield of Florida, Inc. Florida Blue is a leader in Florida's health industry.

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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
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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