We highly recommend that you enroll your clients through our Quote & Apply tool for faster service times and commission payments. If you do need paper application for your clients, we've put all the forms and applications on this page so you can easily download what you need.
|Get an enrollment application for your clients who want to enroll in Blue Shield dental plan and/or vision coverage.
English (PDF, 142KB)
Spanish (PDF, 151KB)
Chinese (PDF, 573KB)
Korean (PDF, 302KB)
Vietnamese (PDF, 145KB)
Application for Term Life Insurance Coverage (PDF, 291KB)
Life insurance infographic (PDF, 482KB)
Subscriber's Statement of Claim Form (PDF, 418KB)
Subscribers should use this form only when the provider of service does not submit a claim directly to Blue Shield.
International Claim Form (PDF, 327KB)
Download the Blue Shield Global Core International Claim Form.
Vision Claim Form (PDF, 419KB)
Download a vision claim form for members using an out-of-network provider.
Life Insurance Claim Form (PDF, 464KB)
Use this for clients with life insurance that require a Proof of Death claim form.
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Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.