When applicable beginning and ending dates are important in calculating waiting periods. Please complete this information on the application in order to receive appropriate credit for prior health insurance coverage. If the employee requests changes to his or her current certificate, this section must be completed by the employee. Physician Change Benefit Change Cancellation Addition of Dependents Removal of Dependents For retroactive enrollment requests Blue Cross and Blue Shield of North Carolina must be notified within 30 days of the change. Any changes received after 30 days will be made effective the first day of the next month's billing period.
Special approvals are necessary for retro-enrollments beyond the designated times.
For additional subscriber questions, please refer to the Customer Service phone numbers found on your Blue Cross and Blue Shield of North Carolina ID cards. For Dental related questions, please refer to the dental phone number found on your Blue Cross and Blue Shield of North Carolina ID card.