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Spotlight

Behavioral Health Management

Our Behaviorial Health Management Department focuses on improving the quality of life for people suffering from mental health or substance abuse issues (MHSA) and is a key aspect of a person’s overall health and wellbeing. Learn More >>>

Mental Health Parity

The Mental Health Parity Act is effective October 3, 2009. Click here to learn more about the Act and how it affects you. Learn More >>>

Forms for Small Employer Groups of 2-50 Employees

Download Instructions:

The following applications and forms are in PDF

format. Adobe Acrobat Reader software is required to view, print and search these PDF documents. Please download this free software on the Adobe Acrobat Web site. Please note that Blue Cross of Idaho does not provide Technical Support for Acrobat Reader Software. For technical support, please contact Adobe.

APPLICATIONS & ENROLLMENT FORMS	FORM NO.
Application Cover Sheet for Group Dual Option (HSA)	3-128
Application for Small Employer Coverage	3-470
Employee Census Data	3-468
Employee's Waiver of Health Care Coverage	3-467
Group Questionnaire for New Groups 2-50 Employees	3-469
Idaho Small Employer Application Cover Sheet	3-366
Managed Care Group Questionnaire for New Groups 2-50 Employees	3-242
Small Group Enrollment Application	3-607
Statewide Schools Small Group Enrollment Application	3-607SWS

Resource Center

Find a Provider	Medicare
Prescription Drugs	Medicare Formulary