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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
Anthem Blue Cross is the trade name of In California: Blue Cross of California, Anthem Blue Cross Partnership Plan, Anthem BC Health Insurance Company and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.
Customer Care Centers Call 888-831-2246 Option 4 and ask to speak with Dr.
Effective Date: January 1, 2024 Plan NameSingle (1)Two-Party (2) Anthem Blue Cross Del Norte EPO $1,240.19 $2,480.37 Anthem Blue Cross Select HMO $944.08 $1,888.16 Anthem Blue Cross Traditional HMO $1,221.90 $2,443.80 Blue Shield Access+ EPO $910.34 $1,820.6815 more rows •
For help, call us at the number listed on your ID card or 1-866-346-7198.
With the PPO, you can use any of the BCBS providers in all 50 states. They may not be directly contracted with the BS of CA, but as long as they participate with the BCBS in the state you see a provider in, they will file claims with that plan. Benefits would be covered at the in-network rates given that's the case.