Helpful Forms

Choosing Your Plan (if you’re not a BCBSRI member yet)

The easiest way to enroll in our health and dental plans is using our simple shopping tool online. But we understand that sometimes you need to use paper, so you can download these forms:

Enroll in a medical plan
Enroll in a dental plan
Enroll in medical and dental plans together
Add more dependents to your enrollment form

Making Changes

Change your health plan
Change your dental plan
Cancel your electronic payments

Health and Dental Plan Paper Application for Individuals and Families
If you are not a member, but would like to apply for one of our plans for individuals and families please choose from these forms.

Dependent Addendum for 2016 Plans for Individuals and Families
If the Health and Dental application for individuals and families does not accommodate all of your dependents, please use this 2016 form in addition to the application.