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  • Oh Anthem Life Insurance Company Ben01 2002

Get Oh Anthem Life Insurance Company Ben01 2002-2025

Anthem Life Insurance Company P.O. Box 182361 Columbus, OH 43218-2361 (800) 551-7265 (614) 433-8880 fax BENEFICIARY DESIGNATION FORM Name of Insured Social Security No Name of Policy owner (if different).

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How to fill out the OH Anthem Life Insurance Company Ben01 online

Filling out the OH Anthem Life Insurance Company Ben01 form is a crucial step in designating beneficiaries for your life insurance policy. This guide will provide clear and supportive instructions on how to complete this form online, ensuring that you can effectively communicate your wishes regarding your policy.

Follow the steps to successfully complete your beneficiary designation form.

  1. Click the ‘Get Form’ button to obtain the Ben01 form and access it online.
  2. Begin by entering the name of the insured in the designated field along with their Social Security number. If the policy owner is different from the insured, include their name and Social Security number as well.
  3. Next, provide the effective date of designation, the name of the employer or group (if applicable), and the policy or certificate number.
  4. Select the coverage types that are applicable, such as Basic Term Life or Voluntary Accidental Death and Dismemberment (AD&D). Ensure to read the instructions for identifying coverage types carefully.
  5. In the Primary Beneficiary section, list the names, relationships to the insured, Social Security numbers, dates of birth, and the percentage of benefits for each beneficiary. Ensure that the total percentage adds up to 100%. Repeat for the Contingent Beneficiary section if needed.
  6. Review your entries for accuracy and clarity, ensuring that the full names of beneficiaries are included as per the instructions.
  7. After completing all sections, save your changes. You may then choose to download, print, or share the form as needed.

Complete your beneficiary designation form online today to ensure your wishes are clearly documented.

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At Anthem Blue Cross and Blue Shield (Anthem), we combine national expertise with an experienced local staff to operate community-based healthcare plans. Anthem is dedicated to offering real solutions that improve healthcare access and quality care for our members.

The corporate rebranding — the company's second in less than a decade when the parent name changed in 2014 from Wellpoint to Anthem — is being done to reflect the company's businesses and operations, which have changed dramatically under the four-year reign of Boudreaux.

EDI payer IDs: 0002937 — Medical claims — Anthem/Ohio Department of Medicaid.

Premera Blue Cross. Regence BlueShield.

Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal.

BLUE CROSS & BLUE SHIELD OF OHIO is a not-for-profit mutual insurance company and an Independent Licensee of the Blue Cross and Blue Shield Assn.

If you're currently a member of Blue Cross and Blue Shield of Alabama, you'll have access to the same networks and doctors with Credence. This is not a change to your insurance carrier, but an enhanced experience from Blue Cross and Blue Shield.

By Phone: Call the number on the back of the member's ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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