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Web blue cross blue shield settlement c/o jnd legal administration po box 91390. Postmarked by october 19, 2007. Web claim form for the blue cross and blue shield parties' settlement fundand election of contribution to charitable foundation or. Your business could receive cash compensation from a. Deadline for claim form submission:
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Web english authorized representative designation form use this form to select an individual or entity to act on your behalf during the disputed claims process. Download and complete the appropriate form below, then submit it by december 31 of the year following the year that you received service. Only members of the damages class are. If you recently visited a doctor outside of your network and you need to submit a claim, you.
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Web you can also download a copy of the claim form, found here, and mail it to the below address: Web in order to fully understand your rights under this settlement. Your business could receive cash compensation from a. You must sign the claim form certification in section f and mail it to the address below, postmarked by november 5, 2021, in order for your claim to be considered.