Skip to main content
Horizon Blue Cross Blue Shield of New Jersey
New Jersey Transit

For Member Services call 1-877-241-8414

Sign in
Horizon Blue Cross Blue Shield of New Jersey New Jersey Transit

Desktop Navigation

Show — Desktop Navigation Hide — Desktop Navigation
  • Plans
      • Medical Plans
      • Dental Plans
      • Summaries of Benefits and Coverage
      • Summary Plan Descriptions
        • A photo of a woman kissing her son on his cheek. Horizon Behavioral Health

        We are focused on making sure our members get the right care when you need it.
  • Tools & Services
      • Horizon Blue App
      • Find a Doctor
      • Horizon CareOnline (Telemedicine)
      • 24/7 Nurse Line
      • Lab Services
      • Treatment Cost Estimator
      • My Health Manager
      • ID Protection Services
      • Additional Resources
        • A photo of a woman kissing her son on his cheek. Horizon Behavioral Health

        We are focused on making sure our members get the right care when you need it.
  • Forms
      • Medical
      • Dental
      • Manage Private Information
  • Health Programs
      • Horizon Behavioral Health
      • Tobacco Cessation Coaching
      • Horizon Transplant Programs
      • Musculoskeletal Program
      • Primary Nurse
      • Radiology/Cardiology Imaging
      • Blue365 Discounts
        • A nurse speaking with a patient. Primary Nurse

        It’s hard to be your best when you’re not feeling well—your Primary Nurse may help.
  • Your Health
      • Aging
      • Asthma & Allergies
      • Children and Teens
      • Diabetes
      • Digestive Health
      • Emotional Health
      • Flu Prevention and Care
      • Heart Health
      • Lifestyle
      • Nutrition
      • Pain Management
      • Prenatal and Newborn Care
      • Substance Abuse
      • Vision
      • Wellness Messages
      • Preventive Health
Medical
Dental
Manage Private Information
Horizon Blue App Icon

24/7 Care and Support

Text GETAPP to 422-272 to download.
Breadcrumb
  1. Home
  2. Forms
  3. Manage Private Information

Manage Private Information

Pdf Image

Request for Appointment of Limited Personal Representative

Pdf Image

Request for Appointment of Limited Personal Representative - Spanish

Pdf Image

Request for Appointment of Legal Personal Representative

Pdf Image

Request for Appointment of Legal Personal Representative - Spanish

Pdf Image

Request to Terminate Personal Representative

Pdf Image

Request to Terminate Personal Representative - Spanish

Disclaimer for Third Party Web Sites

Please be aware you have clicked on a link to a visit another site operated by a third party. Horizon Blue Cross Blue Shield provides such links for your convenience and reference only. Horizon Blue Cross Blue Shield, and its subsidiary companies do not control these sites, and are not responsible for their content or the products and services offered therein.

Please be aware when you travel from the Horizon Blue Cross Blue Shield site to another site, whether through links we provide or otherwise, you will be subject to the privacy policies (or lack thereof) of those sites. Horizon Blue Cross Blue Shield cautions you to use good judgment and to determine the privacy policy of such sites before you provide any personal information.

Click "I Agree" to continue to the third party site. If you do not wish to visit this site, click "Cancel" to close this window.

I Agree link
The Horizon Blue Cross Blue Shield Logo with JD Power#1 in Member Satisfaction among
Commercial Health Plans in NJ, 3 out of 4 Years
  • ‌
  • ‌
  • ‌
  • ‌
  • ‌
  • ‌

This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not the Health Insurance Marketplace website. This website does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross and Blue Shield Association.

For J.D. Power 2020 award information, visit jdpower.com/awards.

Information in other Languages

  • Español
  • Polski
  • عربي
  • 中文
  • Italiano
  • اردو
  • 한국어
  • Русский язык
  • Português
  • Tagalog
  • हिंदी
  • Kreyòl ayisyen
  • ગુજરાતી
  • Français
  • Tiếng Việt

Additional Links

  • About Us
  • Privacy Center
  • Careers
  • Claims Payment Policies and Other Information
  • Find a Doctor
  • Notice of Non-Discrimination
  • Contact Us
  • Horizon BCBSNJ Employees
  • FAQs
  • Horizon BCBSNJ Retirees
trusted verisign p3p privacy NCQA Accredited Health Plan CAQH