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Blue Shield of California is an independent member of the Blue Shield Association MR15796SAN DIAGONAL (10/18)ImportantinformationAbout changes to your Medicare drug and health plane Shield 65 Plus
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To fill out the Annual Notice of Changes, follow these steps:
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Start by reading the instructions and understanding the purpose of the notice.
03
Review the changes that have occurred to your organization or policy during the year.
04
Update the necessary information in the notice, such as contact details, services offered, pricing, or any other relevant changes.
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Double-check all the information filled in for accuracy and completeness.
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Submit the completed Annual Notice of Changes within the designated deadline.
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Who needs annual notice of changes?

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The Annual Notice of Changes is typically required by organizations or businesses that offer services or products that may undergo significant changes throughout the year.
02
This notice is commonly used by health insurance providers, telecommunications companies, financial institutions, and other businesses regulated by specific laws or guidelines.
03
It serves as a way to inform customers, clients, or policyholders about any modifications or updates that may impact their existing contracts, policies, or agreements.
04
Individuals or organizations who have a stake or interest in the changes made by the entity would also benefit from receiving the Annual Notice of Changes.
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Annual notice of changes is a document that insurance companies are required to send to their policyholders each year to inform them of any changes to their insurance policies.
Insurance companies are required to file annual notice of changes.
Annual notice of changes can be filled out by including any changes to the policy such as premium adjustments, coverage modifications, or any other relevant updates.
The purpose of annual notice of changes is to keep policyholders informed about any modifications to their insurance policies.
Information such as changes in coverage, premium adjustments, policy terms or conditions, and any other relevant updates must be reported on annual notice of changes.
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