Medical Plan
- BCBS Summary of Medical Benefits (Premium Plan)
- BCBS Summary of Medical Benefits (Standard Plan)
- First Stop Health - Doctors available via phone or video, 24/7
- Annual Notices - Women's Health & Cancer Rights Act and More
- Diocese of Palm Beach BCBS Religious Plans Coverage Booklet
- Diocese of Palm Beach BCBS Laity Plans Coverage Booklet - Premium and Standard Plan
- Authorization to Share "Protected Health Information" - Use this form to authorize Blue Cross and Blue Shield of Florida to share personal information to person you designate, such as a spouse or adult child.
- Blue Cross Appeal Letter - Use this form if Blue Cross denies your claim and you wish to appeal their decision.
- Blue Cross Care Consultants
- Blue Card Program
- Blue Cross Claim Form - Use this form to file medical claims for charges you incurred when using an out-of-network provider.
- Blue Cross Out of the Country Form - Use this form to file a medical claim for charges you incurred outside the United States. All medical bills must be written in English and charges in U.S. dollars. Submit the claim to the address provided on the claim form.
- Customer Service Information
- Employee Change of Information Form for Blue Cross Medical and Delta Dental - Use the form to change your address, add or delete yourself and/or your dependents, or name change. You must provide proof of why the change is needed for all except address changed. For example: if you change your name, you must provide a copy of your new social security card; if you add a dependent because your spouse changes employment, you must submit a document that reflects that the other coverage has been cancelled. All forms must be submitted to the Diocese Benefits Office within 30 days of the date of the event causing the change.
- Florida Blue Personal Care Services
- Staying Healthy with Blue365
- How to find doctors on the provider directory
