For your convenience all of the required forms are now online. Each form comes in an easy to read and use pdf format.
The forms maybe completed in one of two ways:
- Print the form and complete by hand, OR;
- Complete the form on your computer, then print and sign.
Send completed forms via interoffice mail, postal service, or in person, to CAPC's benefits staff representative listed in the Contact information of this website. FORMS MAY NOT BE ELECTRONICALLY TRANSMITTED
If you need assistance with a health coverage or a claim issue, contact J.O. Services at 850-266-7939.
Health Application
For NEW Enrollment, please read plan coverage terms and complete ALL sections of this form.
Health Change
When covered employees need to make a change to their coverage or add/delete dependent(s).
Health Benefits
Plans Summary
Medical Information
Medical Forms and Information
Prime Therapeutics
Medication Guide
PHI Authorization
Authorization to use/access Protected Health Information
Rx Forms
Quantity Limit physician fax form and Prior Authorization information
For Open Enrollment Information and Claims help please contact:
J.O. Services:
BCBS/Florida Blue Customer Service 1-800-352-2583