Group Health Insurance Plan

NOTE: Links to the Group Health Plan Handbook will open in a new window. Be sure to close each new window BEFORE selecting another link.

• 
• Appeals
• COBRA
• COBRA Notification Letter
• Continuation and Conversion Privileges
• Coordination of Benefits
• Covered Services
• Definitions
• Eligibility to Receive Benefits
• Enrollment Date
• Exclusions
• Managed Benefits
• Member Bill Audit
• Notification Requirements & Special Enrollment Provisions
• Preauthorization
• Prenatal Plus Program
• Prior Approval Process
• Schedule of Benefits
• Waiting Periods for Preexisting Conditions for Late Enrollees
• Wellness Services

Other Plan Information

• Dakota Plan Features
• Preventative Screening

Mail Order Rx - Provided by PrimeMail™ Pharmacy

• Tips for Ordering Prescription Drugs by Mail
• ND PrimeMail™ Member Brochure
• ND PrimeMail™ Pharmacy Order Form

Member Rebates

• Member Rebates Frequently Asked Questions

Contact Blue Cross Blue Shield of North Dakota if you require additional information.  Fargo area:  (701) 282-1400.  Toll-free:  800-223-1704.

Participating Providers

Forms

• Group Health Insurance Application
• Waiver of Health Coverage
• Continuation of Group Health for Terminating Employees (COBRA) Form (SFN 14120)
• Dependent Continuation of Group Health (COBRA) Form (SFN 53883)
• Notice of Change (For Name & Address) (SFN 10766)

Publications

• Certificate of Insurance - Dakota Plan
• Certificate of Insurance - Dakota Retiree Plan
• Guide to Your Explanation of Benefits
• Is Case Management for You?

Blue Cross/Blue Shield of ND - (Home Page) (Member Services)