How do I appoint another person as my representative?

Complete the Appointment of Representative Form and mail it to:

Blue Cross & Blue Shield of Rhode Island
Attn: Customer Service
500 Exchange Street
Providence, RI 02903

Download the Appointment of Representative Form in Spanish.

Last updated: 03/21/2012

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Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.