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Blue Cross California
Home Benefit Description Provider Directory Forms FREE QUOTE


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HMO - English

Employer Forms
Employer Application form
Termination Request
Sole Proprietor, Partner, or Corporate Officer Statement form
Partnership Agreement
Authorization for use of protected health information

Employee Forms
Employee Application form
Exsisting Small Group Employee Addition form
Small Group Change of Coverage Application
Patient Claim form
Cal-COBRA (section 4 must be completed )
COBRA (section 4 must be completed )

Benefit Descriptions

HMO 100%
HMO Saver

HMO - Dental

Small Group Dental Plans at a Glance
Group dental enrollment form
Select HMO Enrollment form

Individual Dental Forms


Individual Dental Plans
Individual HMO Dental Enrollment Form
HMO Dental Brochure

PPO Dental Application
Individual PPO Dental Brochure

Individual Health Forms

Individual PPO Benefits
 Short Term PPO - Application
Short Term PPO - Brochure
Individual Change of Coverage
Individual New Business Inquiry
Credit Card Payment Authorization
Exceptions to Standard Enrollment
*Cal-Cobra 2-19 employees
**Cobra 20+ employees
HIPAA - After Cal-Cobra / Cobra has exhausted benefit period

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More about blue cross of california

We are the Blue Cross and Blue Shield Association, the trade association for the independent, locally operated blue cross of california and Blue Shield Plans. We are the proven consumer health advocates, always with the public's best interests at heart. When families are seeking quality health insurance, they think of our member Blue Plans. Both blue cross of california and blue shield of california.

The 43 local member companies of the blue cross of california and Blue Shield Association have provided millions of families like yours with top-quality, affordable health insurance for more than 70 years. For the one in four Americans who carry Blue Cross and Blue Shield cards, the Blue Plans symbolize health security. Our member Plans provide the kind of health care coverage you and your loved ones will want and need in the 21st century: high quality, customer-focused, innovative, affordable.

As we move forward in the new millennium, there are many exciting medical breakthroughs likely just around the corner. With those discoveries comes change. The blue cross of california and Blue Shield Association and its member Plans will be there every step of the way for American families, like always. Use this site to find your local blue cross of california and Blue Shield independent company now and join the best, most-recognized group of health insurance providers in the world.

Los Angeles Insurance Agency handles all matters related to blue cross of california health insurance.