Forms Download

Anthem Affidavit of Domestic Partnership

Anthem 2-50 Small Group Employee Information Change Form

Anthem 2-50 Existing Small Group Employee Addition Application

Anthem EmployeeElect Medical Plan Change Request — “All Plans” (2-50)

Anthem  Group Life Beneficiary/Name Change

Anthem Cal-COBRA/COBRA and Medicare Survey

Individual Health Forms:

Anthem Individual Application

Anthem Individual Change of Coverage Application

Anthem Individual Dental Plan Enrollment Application

Anthem Short-Term PPO Plans

Anthem Summary of  Individual and Family Health Care Plans

Anthem Custodial Verification Form

Anthem HIPAA Plans

Anthem Checking Account Automatic Premium