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* Individual & Family
* LOG IN FOR ACCESS
* View all submitted applications
* Access client list
* Start enrollment
* Broker training webinars
* News & announcements
* PUBLIC LINKS
* Individual & Family Home
* Medical plans
* Dental plans
* Vision plans
* Life plans
* * Sales collateral
* Forms & applications
* Client notifications
* Tools & Resources
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* * Product Cycle updates
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* Individual & Family
* LOG IN FOR ACCESS
* View all submitted applications
* Access client list
* Start enrollment
* Broker training webinars
* News & announcements
* PUBLIC LINKS
* Individual & Family Home
* Medical plans
* Dental plans
* Vision plans
* Life plans
* * Sales collateral
* Forms & applications
* Client notifications
* Tools & Resources
* Contact sales & support offices
* Medicare
* LOG IN FOR ACCESS
* Compare plans & enroll
* View client list
* View application status
* News & FAQs
* Sales & marketing collateral
* Enrollment materials
* PUBLIC LINKS
* Medicare Eligible home
* Products
* MA-PD/PDP certification
* Policies & procedures
* Renewals
* Training & resources
* * Product Cycle updates
* Help Medicare Supplement clients
* Help MA-PD clients
* Help PDP clients
* Tools & Resources
* Contact sales & support offices
* Small Business
* LOG IN FOR ACCESS
* Shop & enroll
* New group submission status
* View client list
* Online renewal
* Administer member level changes
* Employer Connection
* Renewal and post enrollment packets
* News & announcements
* PUBLIC LINKS
* Small Business home
* Medical plans
* Dental plans
* Vision plans
* Life and AD&D plans
* Plan and network comparison tools
* * Sales collateral
* Forms & applications
* Product Cycle updates
* Tools & Resources
* Contact sales and support offices
* Resources for our Brokers
* Large Groups
* LOG IN FOR ACCESS
* Administer member level changes
* Employer Connection
* Post enrollment packets
* News & announcements
* PUBLIC LINKS
* Large Group home
* Medical plans
* Dental plans
* Vision plans
* Life and AD&D plans
* Plan and network comparison tools
* * Sales collateral
* Forms & applications
* Tools & Resources
* Contact sales and support offices
* Resources
* LOG IN FOR ACCESS
* Broker compensation
* Advertising & marketing resources
* Order materials
* Update your profile
* Direct deposit
* Manage your accounts
* * Rewards & commissions
* Mandates information
* Personalize your website
* Email Producer Services
* Broker communications
* Broker of Record Change
* PUBLIC LINKS
* Quick links for Brokers
* Tools & Resources
* Find a Doctor
* Pharmacy
* Health & wellness
* Contact us
* Be a Blue Shield of CA Broker
1. Broker
2. Small Business
3. Small Business Resources
4. Small Business library
1. Small Business
2. Small Business Resources
SMALL BUSINESS LIBRARY
Document library
Current forms and applications, January 1, 2025 to June 1, 2025
Employee application English (PDF, 1.5 MB), Spanish (PDF, 1.6 MB)
Enrollment spreadsheet with Master Group agreement
Group Change Request English (PDF, 724 KB), Spanish (PDF, 637 KB)
Master Group application English (PDF, 640 KB), Spanish (PDF, 640 KB)
Subscriber Change Request English (PDF, 1.3 MB), Spanish (PDF, 1.4 MB)
Refusal of Coverage English (PDF, 764 KB), Spanish (PDF, 881 KB)
Forms and applications from previous quarters
Pharmacy Care Reimagined
Amazon Pharmacy Set-Up guide (Commercial/IFP)
Amazon 1-page flyer
Blue Shield member ID card changes
Blue Shield Pharmacy Care Model
Health Reimagined
Member pharmacy page
Member experience video
Member letter non-open refill transfer
Member letter open refill transfer
* Broker resources
* Small Business home
* Rates
* Renewal center
* Forms and applications
* Sales resources and collateral
* Underwriting guidelines
Other useful documents from across the small business Broker Connection pages,
organized from A to Z
Accelerated Death Benefit claim
Additional Contact Designation Notice of Lapse or Term of Policy for Non-Payment
Amazon Pharmacy guide (Commercial/IFP)
American Specialty Health (ASH) – Subscriber claim
Authorization to Disclose Health Information
Away From Home Care (HMO Only)
Beneficiary affidavit
Beneficiary change request
BlueCard brochure
BlueCard Worldwide International claim
Blue Shield Member ID card changes
Book of Business transfer request
Bundled savings 2025 | 2024
COBRA and Cal-COBRA Continuation of Coverage
Cal-COBRA Employer Notification of Qualifying Events
Cal-COBRA Takeover
Changes to (2025) HMO Mirror | HMO Off-Exchange | PPO Mirror | PPO Off-Exchange
| PPO Savings Off-Exchange | Specialty
Changes to (2024) HMO Mirror | HMO Off-Exchange | PPO Mirror | PPO Off-Exchange
| PPO Savings Off-Exchange | Specialty
Changes to medical plan names 2025 | 2024
Conversion to Individual Coverage of Group Life
CVS mail order form
Declaration of Disability of Over Age-Dependent Children
Dental claim
Dental Implant benefits
Dental PPO Mapping document
Direct Elite Rewards
Dismemberment claim
EFT banking changes
Enhanced digital pharmacy experience for members
Employee Cancellation notification
EPIC Hearing Aid
Find a doctor English | Spanish
Find dental and vision providers of your choice
Identity Theft Protection Services 2025 English | Spanish 2024 English | Spanish
International claim form
Key contacts and estimated times
LifeReferrals 24/7
Mail service prescriptions
Managing your dental plan online
Member Guide to orthodontic coverage English | Spanish
New Group submission checklist
New Group Enrollment Checklist
Notice informing individual about nondiscrimination and accessibility
requirements
Notification of CMS reporting requirements
NurseHelp 24/7 English | Spanish
Online and mobile tools English | Spanish
Owner eligibility statement
Pediatric dental and vision FAQs
Pharmacy Care Model
Pharmacy reimbursement form (CVS) English | Spanish
Plan cheat sheet 2025 | 2024
Plans at a glance 2024 | 2023
Premium Only Plan (POP) by HealthEquity
Preventive health guidelines English | Spanish
Print or order ID card English | Spanish
Privacy policy
Proof of death
Quick Match Program 2025 | 2024
Recertification guidelines
Relaxed participation 2025 | 2024
Sales guide – Medical Q1 2025 | Q4 2024 | Q3 2024 | Q2 2024
Sales guide – Specialty Q1 2025 | Q42024 | Q3 2024 | Q2 2024
Shield Concierge
Small Business administrator's guide 2024 | 2023
Small Business service support
Small Business Incentive Program (New Sales) 2025 | 2024
Small Business bonus programs 2025 | 2024
Small Group initial payment form
Small Group cancellation form
Small Group Broker of record change
Sole proprietor, Partner of Corporate Office statement
Specialty drug list for Standard Drug Formulary
Standard Drug Formulary 2025 | 2024
Start-up / Spin-off Eligibility attestation
Subscriber Statement of claim
Subscriber Statement of claim - Life
Tandem PPO flyer
Trio HMO flyer
Teladoc 2024 English | Spanish
Teladoc 2023 English | Spanish
Tiered Pharmacy Network
Tivity Health Fitness Your Way English | Spanish
Trio HMO vs. Access+
Trio Network brochure
Trio Qualification tool
Total Health and Wellness English | Spanish
Underwriting guidelines 2025 | 2024
Vaccine list English | Spanish
Value-Based Benefits Plan brochure
Vision claim
Vision - EyeMed: Accessing Your Vision Network
Vision Plan info card for CA members English | Spanish
Wellvolution
Wellvolution Headspace
Wellvolution Headspace Care Flyer
Employer, what's new Q1 2025 | Q1 2024 | Q4 2023 | Q3 2023 | Q2 2023
Why Blue Shield fast facts
Why Blue Shield Small Business
CONTACT US – PHONE
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CONTACT US – MAIL
* Blue Shield of California
* PO Box 272540
* Chico, CA 95927-2540
QUICK LINKS
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© California Physicians' Service DBA Blue Shield of California 1999-2024. All
rights reserved. California Physicians’ Service DBA Blue Shield of California is
an independent member of the Blue Shield Association. Health insurance products
are offered by Blue Shield of California Life & Health Insurance Company. Health
plans are offered by Blue Shield of California.
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