Authorizations
Authorization Form - Waive Health Benefits Coverage (Small Groups)
Use this form to waive/decline health benefits coverage. ID: 2465
Automatic Pay Plan Form (Groups)
Use this form to authorize Horizon BCBSNJ to debit the checking account of a group on a regular monthly basis. ID: 8977
Automatic Pay Plan Form (Individuals and Families)
Use this form to authorize Horizon BCBSNJ to debit the checking account of an individual on a regular monthly basis. ID: 2782
