Helpful forms

Choosing your plan (if you’re not a BCBSRI member yet)

Your employer offers a variety of plans for you to choose from. Speak with your human resources department for more information on which plan is right for you.

Making changes (if you already have a BCBSRI plan)

Some changes require a qualifying event before the change can be made. Speak with your Human Resources department for more information.

Add other health insurance

Do you or anyone else covered by your Blue Cross health plan have another health plan? If so, we can help you make the most of your benefits—and possibly save you money! Simply complete this form and mail to:

Attn: OCL Department (A) - 00119
Blue Cross & Blue Shield of Rhode Island
500 Exchange Street
Providence, RI 02903-2699

Coupon for expecting Blue Cross Dental members

Studies have shown that it’s important for pregnant women to receive regular dental care—that is why pregnant Blue Cross Dental members are eligible for one extra dental cleaning per year with this Dental Coupon.

Other forms you might need

BCBSRI Logo - Feedback Survey

Tell us what you really think

It only takes a moment and your feedback can help us provide better service to you in the future.

Feedback