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Get Highmark Bcbs Form Enr-010 2009
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How to fill out the Highmark BCBS Form ENR-010 online
This guide provides clear and comprehensive instructions for filling out the Highmark BCBS Form ENR-010 online. By following these steps, users can efficiently complete the form to manage their member changes.
Follow the steps to fill out the Highmark BCBS Form ENR-010 online.
- Press the ‘Get Form’ button to access the form and open it in your editing tool.
- Enter the employer name in the designated field to identify the organization associated with the member change.
- Fill in the employer telephone number, ensuring accuracy and correctness.
- Provide the association name if applicable, or leave blank if your group does not participate in an association.
- Input the group number, which is a unique 8-digit identification number assigned to your group.
- Complete the employee's last name, first name, and middle initial in the appropriate fields.
- Include the member identification number, which is the Social Security number of the member.
- Specify the effective date of the change to indicate when it will take effect.
- Use the brief description field to clarify any specific changes being made, if necessary.
- Complete the street address, city, state, and zip code for the employee’s contact information.
- Fill in the home and work phone numbers where applicable.
- Indicate the hire date of the employee in the appropriate field.
- Select the type of change being submitted: Add, Change, or Terminate, and provide reasoning if necessary.
- For spouse/domestic partner and dependents, complete the designated fields for the respective changes being made.
- If applicable, fill out additional fields for primary care physician information for managed care groups.
- Ensure all required signatures and dates are added at the end of the form from both the employee and employer.
- Once the form is filled out, review all information for accuracy, then save the changes, download, print, or share the form as needed.
Complete your Highmark BCBS Form ENR-010 online today for efficient management of your member changes.
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Highmark does provide coverage for Wegovy, but this may depend on specific plans and circumstances. It is crucial to verify your individual plan details and any necessary eligibility criteria. If you have questions about coverage and claims related to Wegovy, refer to resources such as the Highmark BCBS Form ENR-010 to help clarify your options.
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