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Document Center

Click on a link below to access forms to help administer your benefit program. If you do not see he form you are looking for, please contact us.


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Capital Blue Cross

Independence Blue Cross

Highmark

Highmark Northern

IMPORTANT NUMBERS
  • Member Services: 888.345.2346
  • Billing: 877.292.0174

FORMS

Member Change Form

Enrollment/Waiver Form


Western Highmark

UPMC

Aetna

Health America

PVMA Dental

PVMA Highmark Vision

General Census Forms