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Request for Contract Change Blue Shield of California and Blue Shield of California Life & Health Insurance Company Customer No. No. of pages faxed Fax: (209) 367-6603 For groups with 2 to 50 enrolled
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How to fill out blue shield of california

How to fill out Blue Shield of California:
01
Start by gathering all the necessary information, such as your personal details, contact information, and any dependent information if applicable.
02
Visit the Blue Shield of California website or access their enrollment forms through your employer if you have coverage through work.
03
Begin filling out the enrollment form by entering your personal information accurately and completely. This includes your full name, date of birth, social security number, and address.
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Provide any necessary additional information, such as your employer details and employment status if applicable.
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Indicate your desired coverage options, including the type of plan (individual, family, etc.), coverage level (such as bronze, silver, gold), and any additional benefits you may need.
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If you have any dependents, provide their information as well, including their full names, dates of birth, and social security numbers.
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Carefully review all the information you have entered to ensure accuracy and completeness.
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Sign and date the enrollment form, either electronically if submitting online or by hand if mailing the form.
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Submit the completed form as per the instructions provided by Blue Shield of California, whether it be through online submission or mailing it to their designated address.
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Individuals and families residing in California who require health insurance coverage.
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