Downloadable Forms

You can download and print any of the following forms.

Please note: You will need to have Adobe Acrobat installed in order to access and print the forms.

Blue Cross

• Blue Cross Existing Small Group-Employee Addition Application

• Blue Cross Individual and Small Group Drug Claim Form

• Blue Cross Individual Chase HSA Enrollment Package

• Blue Cross Individual Application

• Blue Cross Individual Application - Spanish

• Blue Cross Individual Change of Coverage Form

• Blue Cross Individual Claim Form

• Blue Cross Small Group Change Form

Blue Shield

• Blue Shield Individual Application

• Blue Shield Individual Application in Spanish

• Blue Shield Individual Application - PDF Fill in Version

• Blue Shield Individual Bank Draft Payment Form

• Blue Shield Individual Claim Form

• Blue Shield Individual Plan Change Form

• Blue Shield Option One Short Term Application

• Blue Shield Option Twelve Short Term Application

• Blue Shield RX Mail Order Form

• Blue Shield Small Group Employee Application

Kaiser

• Kaiser Enrollment Application 50 to 150

• Kaiser Small Group Employee Application

• Kaiser Application Group

• Kaiser Large Group - Transfer Worksheet

Pacificare

• Pacificare Change Form

• Pacificare Small Group Application

• Pacificare Small Group Change Request Form

• Pacificare Small Group Enrollment Application-Spanish

• Pacificare Small Group Enrollment Application

• Pacificare Small Group Reporting Form

Premier Access

• Premier Access Employee Application and Change From

Western Health Advantage

• Western Health Advantage Enrollment-Change Form