The following forms will help you manage your BCBSRI plan:
Add Other Health Insurance
Do you or anyone else covered by your Blue Cross health plan have another health plan? If so, we can help you make the most of your benefits—and possibly save you money! Simply complete this form. You can mail it to:
Attn: OCL Department (A) - 00119
Blue Cross & Blue Shield of Rhode Island
500 Exchange Street
Providence, RI  02903-2699
Dental Direct Plan Option Change Form

Existing members may use this form to request a dental plan change.

Plans for Individuals and Families Health Plan Option 2016 Change Form

Use this form if you are a current member and would like to change your 2016 health coverage.

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.