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Blue Cross Blue Shield Individual Plans of Georgia

If you are not associated with an Employer Health Plan, and you live in GA, these are the forms you need. If you live outside of GA, complete the form on this site.

Instructions Please Print for completing the BCBS of GA Individual Application (.pdf)

Application for BCBS of GA Individual/Family Health Insurance (.pdf)

Canncellation-Termination Form for Blue Cross Blue Shield of GA - Small Groups under 50

Blue Cross Blue Shield Group Plans of Georgia

If you are applying for Blue Cross coverage from your employer, please download the Employee Application below.
Employee Application (.pdf) - For Employees, please print and complete the form answering all questions. You must sign in two places on the last page. Give the completed form to your Human Resouces Person or FAX to First Benefits at (770) 643-4870.

Employer's Application for BCBS of GA Group Health Insurance for groups of 2-50 (.pdf)

Other Forms and Documents

Request for Proposal Form - Group Plans - Used by a Client or Prospect to gather information and submit to insurance carriers for proposals on Health and/or Disability Insurance.

Disability Claim Form - For Baltimore Life Disability Insurance

Will Questioner - Used to answer questions that will be asked by an attorney who is preparing your will.

Boston Mutual Forms

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