Grandfathered Plan Medical Forms
These forms are to be used if you have a "grandfathered" plan, an individual or family plan into which you enrolled before the Affordable Care Act was signed into law on March 23, 2010.
- If you are unsure of the plan you have, look on your Member ID card. You may contact Member Services by calling the telephone number on your card.
- Other Member Services contact numbers are also available.