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Submitted URL: https://r20.rs6.net/tn.jsp?f=001HgTlDHZc72u9Ndqqs5PbYjafrGB6fzzicyAzO-ELo77eBXKyoPGkmBBePL6cVa06o3h3izsdxOA9PZrIMDFA...
Effective URL: https://www.fepblue.org/email-sign-up
Submission: On November 08 via api from US — Scanned from DE
Effective URL: https://www.fepblue.org/email-sign-up
Submission: On November 08 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<h2 class="m-comp-header__title">Join Our Email List</h2>
<p class="m-comp-header__description u-margin-bottom">Sign up to receive our monthly newsletter, tips for healthy living and important updates.</p>
<p class="u-margin-bottom"><i>*Indicates required fields</i></p>
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<p>Please review and re-submit the form.</p>
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<h3 class="display-h5 u-margin-top u-margin-bottom-small">Tell us a little more about you so we can personalize the information you receive.</h3>
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<legend class="u-margin-bottom-small">Are you a member of the Blue Cross and Blue Shield Service Benefit Plan? <small>Please select one.</small></legend>
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<legend class="u-margin-bottom-small">What would you like to hear about? <small>Select all that apply.</small></legend>
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<p class="u-margin-bottom-small u-margin-top-small"> By clicking submit, you agree to receive emails from the Blue Cross and Blue Shield Federal Employee Program. <br>You may unsubscribe at any time. Read our
<a href="/privacy-policy">Privacy Policy</a> for more details. </p>
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First Name*
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TELL US A LITTLE MORE ABOUT YOU SO WE CAN PERSONALIZE THE INFORMATION YOU
RECEIVE.
If you are a dependent, please answer these questions as though you are the
primary contract holder.
Are you a member of the Blue Cross and Blue Shield Service Benefit Plan? Please
select one.
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Are you a federal employee or uniformed service member?* Please select one.
* Federal Employee
* Uniformed Service Member
What would you like to hear about? Select all that apply.
* Healthy Eating
* Exercise
* Health Tips
* Benefits & Tools
* Plan Updates & News
What plan are you most interested in learning about?* Please select one.
* FEP Blue Focus
Quality coverage with budget-friendly benefits.
* Basic Option
Great in-network benefits with no deductible.
* Standard Option
Flexibility to get care in and out-of-network.
* I'm not sure
Are you interested in learning about dental and vision coverage? Select all that
apply.
* Blue Cross Blue Shield FEP DentalSM
* Blue Cross Blue Shield FEP VisionSM
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Shield Federal Employee Program.
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