Employer Documents

EmployerAccess Demo – A great overview of our enhanced employer website that can help you save time, reduce errors and get quick, convenient access to enrollment benefits.

EmployerAccess website – See how you can pay your bills, handle employee transactions and a whole lot more! It’s a quicker, easier and more powerful way to manage benefits.

EmployerAccess Manual – A complete guide to our Employer Access website.

Health Care Reform Guide - There's a lot to know when it comes to the Health Care Reform law. We've created this guide to help you better understand what to expect and when to expect it.

Health Care Reform Benefit Comparison Guide - This guide explains important benefit changes following Health Care Reform law implementation as of 9/23/2010.

Employer Application

Employee Add On Application (Spanish Version)

Employer Statement of Understanding

Employee Information Change Form

HSA Agreement

HRA Plan Materials

Below are HRA forms and other materials for the Lumenos HRA 3000C, 3000D, 5000C and 5000D plans:

HRA Agreement

HRA Demand Debit Authorization Form

How it Works (standard)

Guide to HRA (standard)

How it Works (copay)

Guide to HRA (copay)


How to Read Your Quarterly Statement

How to Read Your Claim Recap


ACO 20/ACO 30 Plan Enrollment Guide

ACO 20/ACO 30 Plan Enrollment Guide (Spanish)


Conditions of Enrollment for Employer Groups Offering Seasonal Coverage

Eligibility Statement

Conditions of Enrollment for Start-Up Companies/PEO Spin-Off Groups

Cobra/CalCobra/Medicare Part D Survey

Rapid Quote Request Form

New Business Inquiry Form

Benefit Modification Inquiry Form

Demand Debit Authorization (fillable-field)

Speed Pay Authorization Form

Religious Employer Exemption for Affordable Care Act Contraceptive Coverage

Provider Directories

We have a number of options for our California small groups to order provider directories.

For fast, easy access to provider information, we have Provider Finder, a powerful electronic tool available online at Anthem.com/CA

You can also order provider directories from Anthem Blue Cross. To save time and paper, you can have your custom provider directories sent quickly via e-Delivery or you can order printed copies. Contact Enrollment and Billing at 800-627-8797 to place your request.


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Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association.