Forms Library - Mid-size
Horizon BCBSNJ
Administrative Forms
- 1094/1095 Information Reporting Deadlines
- 51-99 Member Level Census as of 1/1/2022
- Checklist for RFP
- Claim Form for Managed Care
- Claim Form for PPO
- Deductoble Carryover Credit Form
- How to Read EOB
- Mid Size Claim Form
- Transitional Care for New Enrollees
Brochures
- 2022-Midsize-Group Brochure Dynamic-Final 9 28
- 2023 OVERVIEW Midsize Group Insurance Coverage 10 27
- Blue365 FAQ Sheet
- Blue365 Healthways Enrollment Flyer
- Blue365 Healthy Discounts
- Blue365 Member Flyer
- BlueCard Brochure
- BlueCard Worldwide
- Horizon Blue Mobile App
- Horizon Wellness Flyer
- HorizonbFit Member Flyer
- Identity Protection Services
- Level Funding Broker Brochure
- Level Funding Employer Bruchure
- Master One Pager for Mid-Size Groups (003)
- Master One Pager for Mid-Size Groups for Spansh Translation_SPA
- Midsize-Horizon-Level-Select Brochure-2.16.22-FINAL
- OMNIA Top 10 Tips
- Precious Additions Maternity Health
- Preventive Health Guidelines
- Preventive Healthcare Mandate Flyer
- Provider Counts in NJ July 2022
- Telemedicine CareOnline Overview
- Telemedicine CareOnline Regulatory Environment
- Urgent Care Options
Broker of Record Letters
Dental
- 2021 Midsize Dental Brochure
- Dental Grid & Grid Plus Information
- Dental Networks - Product Overview
- Dental Trifold
- Horizon Dental Networks v3
- Horizon Dental Search Tools
- Horizon Dental... Making Smiles Healthier
Enrollment
- Mid-Size Enrollment Change Form
- Permanent Disability Enrollment Form
- Request Enrollment for Disabled Dependent
- Transitional Benefits Coverage Application
HSA Information
Prescription
Vision