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How to use or fill out Florida Blue Employee Enrollment Application with DocHub
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Click ‘Get Form’ to open the Florida Blue Employee Enrollment Application in our platform.
Begin with Section A: Current Information. Fill in your Group Name, Division #, Group #, Effective Date of Coverage, Date of Hire, Location #, Employee #, Package #, Job Title, and Work Status. Ensure all details are accurate for proper processing.
Move to Section B: Employee Information. Enter your Social Security Number, Last Name, First Name, Street Address, M.I., Birth Date, City, County, Phone Number, Physician Name/ID (if applicable), Sex, State and Zip Code. Select your Marital Status and provide any optional information regarding Existing Patient status and Language of Preference.
In Section C: Health Coverage Level and Plan Information, choose your desired health coverage level and plan options. If you are refusing coverage at this time, indicate that clearly.
Proceed to Section D: Vision Coverage Level and Plan Information. Similar to health coverage selection, choose your vision coverage level or refuse it if necessary.
Complete Section E: Dependent Information by listing all dependents accurately. Attach a separate sheet if needed.
Fill out Section F: Other Health Insurance Information if applicable. This is crucial for claims processing.
Finally, review and sign the application in Section G: Acceptance of Coverage to confirm your understanding of the terms before submitting.
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What are the dates for open enrollment for health insurance in Florida?
Open Enrollment Period November 1, 2024 Open Enrollment begins. December 18, 2024 This is the last day to enroll or change plans for coverage that starts on January 1. January 1, 2025 If youve enrolled by December 18, this is when your 2025 coverage starts. January 15, 2025 Open Enrollment ends for 2025 plans.
When can I enroll in a health care plan?
Check if you qualify. November 1: Open Enrollment starts first day you can enroll in, renew, or change health plans through the Marketplace for the coming year. Coverage can start as soon as January 1.
Why is open enrollment only 2 weeks?
Generally open enrollment lasts between two to six weeks. Employers must ensure that employees have enough time to review their options and ask questions, but the time period must be short enough to ensure employees take action and dont forget to enroll in benefits coverage.
When can I enroll in Florida Blue?
If you buy your own insurance for you and your family (not Medicare), you can enroll or change plans from November 1 to January 15 every year. The changes you make take effect the following January or February, depending on when you apply.
When can you enroll in Florida prepaid?
A Florida Prepaid Plan may be opened by any individual 18 years of age or older who is a U.S. citizen or legal U.S. resident with a valid Social Security number. When can I open a Florida Prepaid Plan? You may enroll any time.
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Blue Cross and Blue Shield of Florida, Inc. (BCBSF) is now Florida Blue. The new name, new logo and tagline In the pursuit of health are all part of the companys transition to a health solutions company with an overarching mission to help the people of Florida and their communities achieve better health.
How do I get my Florida Blue member ID number?
You can find your member number on your ID card, which looks just like this one. You can enter both the alpha and numeric or just the numeric part on your card. For Dental only contracts enter the ID shown on your card.
Can I add someone to my Florida Blue insurance?
If you need to add or remove someone from your plan, call your agent for guidance. Or call us at 1-855-714-8894.
Related links
Employee Enrollment Application
I hereby apply for the coverage/membership that is selected on this form. My employer has selected health and/or vision coverage through Florida Blue and/or HMO
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