Any Employee who has had a qualifying event & would like to either Enroll or Change their current Health Insurance Coverage, must complete this BCBS Health Insurance Enrollment/Change Form & email it to Candy Granger from your FWSU email address.  Forms will be processed within 10 calendar days & only emailed forms will be accepted.

• BCBS Health Insurance Enrollment/Change Form

  • *If you are enrolling a Domestic Partner, the Additional BCBS Domestic Partner Form (below) & its required documents must also be included at the same time the BCBS Health Insurance Enrollment/Change Form is submitted.

• Additional BCBS Domestic Partner Form*

• BCBS Disclaimers

• BCBS Find a Doctor (PCP = Primary Care Physician)

• FY25 VEHI - BCBS Health Insurance Plans Comparison Grid (7/1/24-6/30/25)

• FY25 VEHI - BCBS Approved Health Insurance Rates (7/1/24-6/30/25)

• Additional VEHI Health Benefits Information

• BCBS Member Resource Center

• Understanding Your SHPP (Formerly EOB)

  • ​A Summary of Health Plan Payments (SHPP) - formerly known as an Explanation of Benefits or EOB - is a statement from BCBSVT that explains how your benefits were paid. Reviewing a SHPP is an important tool in understanding what you are required to pay for care.   

• Life of a Medical Claim​

  • Click the heading to view the path your medical claim takes on its way through the health care and payment system.

• Life of a Pharmacy Claim​

  • Prescription claims are considered “point of sale” transactions because you cannot receive your prescription until it is paid for.  Click this heading to view the path of your prescription claim through the health care and payment system.   

• Release Authorization Form

• 2021 Statewide Bargaining Agreement for Employees' Health Insurance Benefits
  

•  Platinum & Gold BDD

• Gold CDHP & Silver CDHP BDD

For 2025 Plan Selection:

• Platinum 2025 SBC

• Gold 2025 SBC

• Gold CDHP 2025 SBC

• Silver CDHP 2025 SBC