Forms Library - Individual
Horizon BCBSNJ
Administrative Forms
- Deductible Carryover Credit Form
- How to Read EOB
- IHC Off-Marketplace Health Benefits Plans Broker Manual
- International-Claim-Form-US-2024-Update-Fillable-8x11
- Privacy Notice
- Special Enrollment Check Off List
Brochures
- 2025 Horizon IHC Broker Dental-Vision Dynamic
- 2025 Horizon Medical Dental Vision Rates
- 2025 Horizon Medical, Dental & Vision Plan Guide
- 2025Horizon IHC RateCard V102524
- 2026 Horizon Dental-Broker Brochure
- 2026 Horizon Employer Choice Brochure
- 2026 Horizon IHC-Broker Brochure
- 2026 Horizon IHC-RateCard
- 2026 Horizon- ICHRA & IHC Rate Card-v2 (1)
- Blue365 FAQ Sheet
- Blue365 Flyer
- Blue365 Healthways Enrollment Flyer
- Blue365 Healthy Discounts
- GeoBlue All Product Spotlight
- Horizon Blue Mobile App ID Card Flyer
- MindCare flyer_v6_10.2023
- MindCare Introducing
- OMNIA Top 10 Tips
- Precious Additions Maternity Health
- Preventive Health Guidelines
- Preventive Healthcare Mandate Flyer
- Small Group to IHC Sales Guide
- Telemedicine CareOnline Overview
- Telemedicine CareOnline Regulatory Enviornment
- Triggering Life Events
- Urgent Care Options
Broker of Record Letters
Dental
- Centurion Dental Enrollment Form
- Dental Grid & Grid Plus Information
- Dental Networks - Product Overview
- Dental Trifold
- Horizon Dental Networks individual
- Horizon Dental Search Tools
- Horizon Individual Dental Plan Enrollment Application
- IHC Dental Plan Guide and Rates
Enrollment
- 2025 Dental & Vision Enrollment Form
- 2025 Horizon Individual Medical App V2 - Altomare
- 2026 Horizon Employer Choice Application
- 2026 Horizon IHC Enrollment Form OMNIA & EPO
- Away From Home Care Application
- Individual SAPD Enrollment Form
- Request of Enrollment for Disabled Dependent
Prescription
Vision