Get Anthem Large Group Change Form.pdf - Cornerstone Insurance ...

This guide will assist you in completing the Anthem Large Group Change Form online. Whether you are changing your coverage or updating dependent information, the following steps will provide clear instructions to ensure accuracy and compliance.

Follow the steps to complete your form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor for online completion.
2. Begin by providing employer details in the designated section, including the employer name, address, group number, and any applicable life division numbers.
3. In the 'Reason for Change' section, clearly indicate the event that necessitates the modification. Be sure to input the event date in the specified format.
4. Next, select the type of coverage or plan appropriate for your changes. Options include Health Coverage, Life Coverage, and Dental Coverage.
5. Input your employee information thoroughly. This includes your name, date of birth, address, and Primary Care Physician (PCP) information if applicable.
6. Indicate any changes pertaining to family information by listing dependents and specifying whether you are changing their coverage or canceling it.
7. Complete the Life and Disability Insurance section if necessary, providing details about beneficiaries and verifying existing plans.
8. Review the 'Other Health Coverage' section to report any additional health insurance your dependents might have.
9. Carefully read and acknowledge the Significant Terms, Conditions, and Authorizations. Ensure accuracy in your application before signing.
10. Finally, save your changes, download the completed form, and print it if required for submission. Ensure it is returned to your employer as instructed.

Complete your documents online to streamline your changes and updates.