Forms Library - Individual
Horizon BCBSNJ
Administrative Forms
- Deductible Carryover Credit Form
- How to Read EOB
- IHC Off-Marketplace Health Benefits Plans Broker Manual
- International-Claim-Form-US-2024-Update-Fillable-8x11
- Privacy Notice
- Special Enrollment Check Off List
Brochures
- 2026 Horizon 65 Dental Plans
- 2026 Horizon Dental-Broker Brochure
- 2026 Horizon Employer Choice Brochure
- 2026 Horizon IHC-Broker Brochure
- 2026 Horizon IHC-RateCard
- 2026 Horizon- ICHRA & IHC Rate Card-v2 (1)
- 2027 Horizon Employer Choice (ICHRA) Premiums-Rate Card-9-28-26 (2) (1)
- 2027 Horizon Employer Choice-Brochure FINAL_a11y (1)
- 2027-ICHRA Medical Plans Grid-10-28-26 FINAL (2)
- 2027-IHC Medical Plans Grid-Standard Level-v4 FINAL (1)
- 2027-IHC-Dental Vision Brochure -v2 10 29 (1)
- 2027-IHC-Dynamic Brochure -FINAL-10-28-26 (1)
- Blue365 FAQ Sheet
- Blue365 Flyer
- Blue365 Healthways Enrollment Flyer
- Blue365 Healthy Discounts
- GeoBlue All Product Spotlight
- Horizon Blue Mobile App ID Card Flyer
- MindCare flyer_v6_10.2023
- MindCare Introducing
- OMNIA Top 10 Tips
- Precious Additions Maternity Health
- Preventive Health Guidelines
- Preventive Healthcare Mandate Flyer
- Small Group to IHC Sales Guide
- Telemedicine CareOnline Overview
- Telemedicine CareOnline Regulatory Enviornment
- Triggering Life Events
- Urgent Care Options
Broker of Record Letters
Dental
- 2027 Dental and Vision Rates Placemat (1)
- Centurion Dental Enrollment Form
- Dental Grid & Grid Plus Information
- Dental Networks - Product Overview
- Dental Trifold
- Horizon Dental Networks individual
- Horizon Dental Search Tools
- Horizon Individual Dental Plan Enrollment Application
- IHC Dental Plan Guide and Rates
Enrollment
- 2026 Horizon Employer Choice Application
- 2026 Horizon IHC Enrollment Form OMNIA & EPO
- 2027 Horizon Choice Enrollment Form
- 2027 Horizon Dental Vision Enrollment Form - Request Pay Link
- 2027 Horizon IHC Omnia Enrollment Form
- 2027 Horizon Individual Dental Enrollment Form Final
- Away From Home Care Application
- Dental 65+ Application
- Individual SAPD Enrollment Form
- Request of Enrollment for Disabled Dependent
Prescription
Vision