Blue Cross Blue Shield Settlement CLAIM FORM
https://www.bcbssettlement.com/admin/services/connectedapps.cms.extensions/1.0.0.0/asset?id=5399b96e-406f-4a1a-89ba-09c960f94107&languageId=1033&inline=true
WEBNov 5, 2021 · The Settlement Class Period for Self-Funded Accounts (and their employees) is from September 1, 2015 through October 16, 2020. Dependents, beneficiaries (including minors), and non-employees are NOT eligible to receive payment. The Easiest Way to File is Online at www.BCBSsettlement.com. INSTRUCTIONS FOR COMPLETING THIS …
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