Get Group Activity Report - Blue Cross & Blue Shield Of Rhode Island

Filling out the Group Activity Report for Blue Cross & Blue Shield of Rhode Island can be straightforward with the right guidance. This document is essential for managing additions, cancellations, and changes efficiently, ensuring that all necessary information is accurately submitted.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to access the report and open it in your preferred editor.
2. Begin by entering the Group Name in the designated field, followed by the Group Number. Ensure that these details accurately reflect your organization.
3. Fill in the Prepared By section with the name of the individual responsible for completing the form. Be sure to include their Title for clarity.
4. In the Subgroup Number field, if applicable, provide the subgroup identifier. This can assist in categorizing the group activities more effectively.
5. Input the Phone Number and Email Address of the preparer for any follow-up communications.
6. List the BCBSRI Membership Number if available, and proceed to fill in the Name of Employee for whom the report pertains. Make sure to include their first name, last name, and middle initial.
7. Specify the Effective or Termination Date using the provided date fields. This date should coincide with the changes being reported.
8. Complete all sections of the form as required, referring to the instructions provided. Attach any corresponding application(s) if necessary.
9. Submit the completed form and any attachments by faxing to 401-459-2385 or mailing to the BCBSRI Membership Department at the specified address.
10. Once the form is completed, you may save your changes, download a copy, print it for your records, or share it as needed.

Get started and complete the Group Activity Report online today!