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Thank you for your interest in applying for the Regence BlueCross BlueShield of Oregon MedAdvantage plan. These application need to be reviewed and signed by an Agent before they can be submitted to Regence BlueCross BlueShield of Oregon. You may email fax or mail it in to CDA Insurance Fax 1. 800. 884. 2343 or 1. 541. 434. 9613. Regence MedAdvantage PPO A Enrollment Request Form PO Box 12625 Salem OR 97309-0625 1-888-REGENCE 1-888-734-3623 TTY 711 B Please contact Regence MedAdvantage if you...
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