Administrative Forms - Blue Links for Employers - Blue Cross Blue Shield of Massachusetts

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Administrative Forms

We've made it easy to find the enrollment and benefits information you and your employees need. Just browse through this list and select the appropriate link to download a PDF version of the form.

You will need Adobe Acrobat^®' Reader to view these PDF documents.

Please check our Forms Library for additional forms and brochures.

Employer Forms

Account Application form
BlueLinks Guide to Enrollment Management
BlueLinks Third-Party Authorization form
New Business Submission Checklist
New EOC Process Information
Plan Sponsor Manual
Transition of Care Request for New PPO Members
Waiver of Group Coverage (English)
Waiver of Group Coverage (Spanish)
Quarterly Wage Report Form

Employee forms

Affidavit of Domestic Partnership for Benefits Eligibility
Dental Claim form
Member's Authorization for Release of Information
Member's Designation of a Personal Representative
Member Enrollment form (Editable)
Member Enrollment form (Spanish)
Retaining Coverage for Disabled Dependent Child
Student Certification Affidavit
Student Medical Leave Affidavit form
Subscriber Submit Claim form

Popular Forms

Plan Sponsor Manual
Member Enrollment Form
Student Certification Form

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
® Registered Marks of the Blue Cross and Blue Shield Association.
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