Home
Forms Library
Anthem change form 2011

Anthem change form 2011-2025

anthem change form 2011 Preview on Page 1

Show details

4 out of 5

55 votes

The document is a Small Group Employee Information Change Form used for notifying terminations of employees or dependents, managing COBRA/Cal-COBRA notifications, and updating address changes. It includes sections for terminating employees, active employees declining coverage, and change of address for both employees and groups. The form outlines necessary procedures and requirements for cancellations and changes in coverage.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to modify Anthem change form 2011 in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Working on documents with our extensive and intuitive PDF editor is easy. Follow the instructions below to fill out Anthem change form 2011 online quickly and easily:

Sign in to your account. Sign up with your email and password or create a free account to test the product before upgrading the subscription.
Import a document. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit Anthem change form 2011. Easily add and highlight text, insert pictures, checkmarks, and symbols, drop new fillable fields, and rearrange or remove pages from your document.
Get the Anthem change form 2011 accomplished. Download your updated document, export it to the cloud, print it from the editor, or share it with other participants using a Shareable link or as an email attachment.

Take advantage of DocHub, the most straightforward editor to rapidly manage your documentation online!

See more anthem change form 2011 versions

We've got more versions of the anthem change form 2011 form. Select the right anthem change form 2011 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2012	4.9 Satisfied (453 Votes)
2011	4 Satisfied (55 Votes)
2009	4 Satisfied (58 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Did Anthem Blue Cross Blue Shield change its name?

This joint-branded tile will remain in place throughout 2024 to help facilitate a smooth transition. branded beginning on December 9, 2023: The Empire BlueCross payer space will be branded Anthem Blue Cross. The Empire BlueCross BlueShield payer space will be branded Anthem Blue Cross and Blue Shield.

Why did Anthem change?

We will continue to do business as Anthem Blue Cross and Blue Shield. Why the change? The upcoming name change reflects the companys strategy to elevate the importance of whole health and to advance health beyond healthcare for our customers, their families, and our communities.

Did Anthem Blue Cross Blue Shield change their name?

branded beginning on December 9, 2023: The Empire BlueCross payer space will be branded Anthem Blue Cross. The Empire BlueCross BlueShield payer space will be branded Anthem Blue Cross and Blue Shield.

Does Anthem reimburse for out of network?

If your health plan has out-of-network benefits, we may reimburse you up to the maximum allowed amount for covered services if you see a non-participating provider.

Is there a difference between Anthem Blue Cross and Blue Cross?

Anthem and Blue Cross Blue Shield are related, but they are not the same company. While they are both top health insurance providers in the USA, the big difference is that Blue Cross Blue Shield is the umbrella that is made up of several independent companies, and one of these smaller companies is Anthem.