Blue Cross Blue Shield of Kansas

​New Employee Application
For new employees to fill out


Change Form
Use this form to add or delete people from your plan.  You may also use this form to terminate your coverage if, for example, you are switching to a different plan offered by a different employer or group.
 

Claim Form (updated 2020)
Use this form if your provider did not send a claim to Blue Cross and Blue Shield of Kansas.


Claim Appeal Form (updated 2020)
Use this form to appeal a claim you feel has been inadequately processed.


Application for Coverage of Handicapped Dependent (updated 2020)
Use this form to provide certification of a handicapped dependent who has reached the age limit.

BCBS Waiver Form