If you've had a qualifying life event, such as a marriage or the birth or adoption of a child, you may qualify for a Special Enrollment Period. If you're a Blue Option member with a qualifying life event, please complete the application and mail it to this address in order to add a spouse or dependent to your current policy:
Your privacy is important to us. In accordance with state and federal laws, we don’t share protected health information (PHI) without your consent. Use this form to authorize the release of PHI to a third party. Having this form on file will allow us to discuss your coverage with the person you list, without you having to give permission each time you want that person to contact us on your behalf.
This form gives us information about any other health coverage you may have that can affect how we pay benefits. This is also known as Coordination of Benefits (COB). You can complete this form online by logging into My Health Tookit®.