Price Associates Insurance Services, Inc.
Providing Exemplary Service to Agents for Over 30 years.
Blue Cross Individual Downloads
click on the to download file
2007 Rate Increase Form # Effective
Agent Guide  SC2198  12/06
Agent Letter  SC2216  01/07
Agent Rate Guide  11134  12/06
Dental Only  SC2200-7  01/07
Important Things Member Enclosure  SC2201  12/06
Individual Life Sale  6551  03/07
Medical & Dental  SC2200-3  01/07
Medical & Dental & Age Attain  SC2200-4  01/07
Medical Age Attain  SC2200-2  01/07
Medical Only  SC2200-1  01/07
Member Plan Change Request Form  NA  12/06
Sample Client Letter for Agents  NA  01/07
Tonik  SC2200-5  01/07
Tonik Member Letter Plus Age Attainment  SC2200-6  01/07
Tonik Rate Sheet  SC2232  12/06
Tonik Vision Benefits  SC11219  12/06
Applications & Forms Form # Effective
BCC Online Application: Creating a Direct Link  NA  04/04
BCC Online Application: Updating a Direct Link  NA  04/04
Change of Coverage Application  3953  01/04
Checking Account Automatic Premium Payment  IS7134  06/05
Credit Card Authorization Form  6097  04/04
Direct Deposit  9318  07/04
Enrollment Application  IU2138  01/04
Enrollment Application (Spanish)  3963  01/04
Exceptions to Standard Enrollment  IU2071  10/04
MedicareRx Enrollment Form  S5596  01/08
Member Claim Form  IU2013  05/03
Prescription Drug Claim Form  IU2056  03/98
Request for Summary Billing  7551  06/03
Sub-Agent Application for Appointment  IS2010  03/04
Supplement to Individual Enrollment Application  3955  10/03
Benefits & Guides Form # Effective
2008 Agent Rate Guide  11134  03/08
Agent Guide  SC2198  12/06
Agent Guide  SC2198  12/06
Caring for the Whole You  7702  05/06
Caring for the Whole You (Spanish)  7702SP  05/06
Don't Get Caught Uninsured  IS7179  11/03
Don't Get Caught Uninsured (Spanish)  8680  11/03
EPO Summary of Features  IF0002  03/06
Form 8858 Instructions  NA  04/03
Generic Drug Poster  10082  07/05
Individual Underwriting Guidelines  IS8009  10/04
It's all about the coverage (Individual lead-generator)  11132  06/06
It's all about the coverage (Individual lead-generator)  11132  06/06
Life Sales Slick (Spanish)  6551SP  04/06
Life Sales Slick: Is Your Family Prepared for the Unexpected?  6551  04/06
Major Risk Medical Insurance Program Request  IS2294  10/06
Medical Report  SC1842  10/06
Mexico Consulate Flyer  11917  11/05
New Business Inquiry  3954  10/06
Short-Term Plan Sales Kit (includes application and rates)  3967  02/06
Short-Term Plan Sales Kit (includes application and rates)  3967  02/07
SmartSense  MCABR0392C  12/07
SmileNet Sales Postcard  11040  08/05
Tech Tools for Sales Success  5420  08/04
Tonik - Cover your A-Z (bill stuffer/insert)  11063  02/07
Uninsured Market Tool Kit  9819  12/03
Why Blue Cross  9627  06/04
You Choose Brochure  3952  02/06
You Choose Brochure (Spanish)  3952SP  02/06
You Protect Their Future Stuffer (Spanish)  11286  02/06
Dental Form # Effective
Dental Blue for Individuals and Families  13798  01/07
Dental Blue Individuals & Families Agent Guide  SC2189A  01/07
Dental PPO Brochure & App (Spanish)  IS7061SP  02/07
Dental PPO Brochure & Application  IS7061  03/06
Dental PPO Brochure and Application  IS7061  02/07
Dental Sales Slick  12366  04/06
Dental Sales Slick (Spanish)  12366SP  04/06
Dental SelectHMO Brochure & Application  IS7152  02/06
Dental SelectHMO Brochure & Application (Spanish)  IS7152SP  02/06
Dental SelectHMO Brochure and Application  IS7152  02/07
Dental SelectPPO Brochure & Application (Spanish)  IS7061SP  03/06
SmileNet Brochure and Application  11039  10/05
SmileNet Sales Brochure & Application  11039  10/05
Voluntary; DMO Basic Plan 53; w/ Ortho  NA  04/07
HIPPA Form # Effective
HIPAA Brochure and Application  3962  06/06
HIPAA Compliant Authorization Form - Use for Applicants (English & Spanish)  9680  11/03
HIPAA Compliant Form Blue Cross of California - Agent (Spanish)  SC8570  04/03
HIPAA/GLBA Notice of Privacy Practices  NA  04/04
Use for Members  8858  04/03
Use for Members (Spanish)  SC8917  04/03
HMO Form # Effective
HMO Plans Brochure (Spanish)  11136SP  02/06
Select HMO Flyer (Spanish)  11531  08/05
HSA Form # Effective
HSA Sales Slick (Spanish)  12424  04/06
Individual Participant HSA Enrollment Package  SC11964  11/05
Medicare Form # Effective
MedicareRx Plan Comparison Chart  C0003  01/07
PPO Form # Effective
3500 Deductible PPO (Spanish)  9974SP  02/06
Basic PPO and PPO Saver Brochure (Spanish)  11133SP  02/06
PPO 3500 (HSA- Compatible) Brochure (Spanish)  10413SP  02/06
PPO 3500 (HSA-Compatible) Plan Sales Brochure and Rates  10413  02/07
PPO Share Plans Brochure (Spanish)  11135SP  02/06
RightPlan PPO 40 Brochure (Spanish)  9608SP  02/06
RightPlan PPO 40 Flyer (Spanish)  11332  06/05
Tonik Form # Effective
Tonik - Cover your A-Z (bill stuffer/insert)  11063  02/06
Tonik - Get hooked up (trifold brochure)  11056  02/07
Friday, May 09 2008 
License: 0596691
© 2007 Price Associates Insurance Services, Inc.