Blue Shield of California Online Application
Download Blue Shield of California
Application
These
are the best Blue Shield of California rates available on the
market
There
is NO application fee and no fee for our service
A
decision is usually received in 10-14 business days
The
earliest available
effective date is 15 days from online application submittal
Online
application processing generally takes 1/2 the time of paper
apps
Credit
card will not be hit until approval and you then have 10 days
to cancel for a full refund
If downloadable application is used, information can be faxed
securely to
888/758.2122; emailed to
IFP Enrollment; or mailed to:
Download Blue Shield of California Small Group Application
The following documents can be emailed, faxed, or mailed
to us:
Master
Application (one for group)
Employee
Application for each eligible employee, owner, or officer.
Sole
Proprietor/Owner/Officer Statement for those not listed on DE6
Most
recent Quarterly Payroll report to State
Company
documentation as listed on Sole Proprietor/Owner/Officer
Statement
Check
for 1st month's premium made to Blue Shield of California
This information can be faxed to
888/758.2122; emailed to
Group Enrollment; or mailed to:
Senior
Medicare Supplement Application for Blue Shield
California:
Download Blue Shield of California Senior
Medicare Supplement Application
Please
submit prior to the 1st of the month you wish coverage to
start
Part
A and B must be already established by requested effective
date
Payment
is not required with the application
This information can be faxed to
888/758.2122; emailed to
Senior Enrollment; or mailed to:
Call us at 800-320-6269 with any questions. Our services are free to you as licensed health agents.