Green Shield

Tools

Hot Topics for Plan Administrators

Key Points to completing the Enrollment Form

BBD Online Information

Group Insurance Contribution Report

Green Shield Fact Sheet - Initial Days Supply

Health and Dental Conversion

Administration Forms

Group Insurance Enrollment (Fillable) Original signature required at BBD offices.

Employee Report Form

Change of Name

Dependent Status Change (Fillable)

Partial Waiver (Fillable)

Reinstatement of Waived Benefits (Fillable)

Claim Forms

Health and Dental Claim Form:

Green Shield General Claim Submission Form (Fillable)

Green Shield Health Care Spending Account Claim Submission Form (Fillable)

Payment Options

Pre-Authorized Payment Plan Form