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How to fill out the CA MCABR2693C online
Filling out the CA MCABR2693C form is a straightforward process that allows Anthem Blue Cross members to automatically pay their premiums through a checking account. This guide provides clear instructions for users, ensuring a smooth completion of the form online.
Follow the steps to complete the CA MCABR2693C form accurately.
- Press the ‘Get Form’ button to access the CA MCABR2693C online. This allows you to review and fill out the form conveniently.
- In the first section of the form, input your name as the policyholder. This identifies the account associated with the automatic payments.
- Enter your Member's ID or Social Security Number in the provided field to verify your identity as an Anthem Blue Cross member.
- Fill in your daytime and evening contact phone numbers. This ensures that Anthem Blue Cross can reach you if any issues arise regarding your payment.
- Specify the requested debit day for withdrawal, choosing a date between the 1st and 6th of the month. If no date is chosen, the default will be the 1st of each month.
- Provide the name of your bank, along with the required routing and account numbers. This information is crucial for processing the automatic premium payments.
- Read the authorization statement carefully. By signing, you allow Anthem Blue Cross to debit your account for the premium payments agreed upon.
- Sign the form where indicated, ensuring that your signature matches the one on file with your bank. Then, include the date of signing.
- Once you have completed all sections of the form, review for accuracy. After confirmation, you can either download, print, or share the completed form as needed.
Take the opportunity to manage your premium payments more efficiently by completing the CA MCABR2693C form online.
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