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Blue Cross and Blue Shield of Louisiana (Louisiana Health Service & Indemnity Company) fax number
(225) 297-2820
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Individual Membership & Billing Department
Used for: Cancel an individual health plan due to the death of the policyholder (use the Death of Policyholder cancellation form).
Fax destination details
- Department
- Individual Membership & Billing Department
- Purpose
- Cancel an individual health plan due to the death of the policyholder (use the Death of Policyholder cancellation form).
- Form
- 14CS1033R0820 — Individual Plan Cancellation Form - Death of Policyholder
- Address
- 5525 Reitz Ave, Baton Rouge, LA 70809
- Voice phone
- 1-800-495-2583
- Website
- Visit organization website
Before you send
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Complete the form with subscriber name, relationship to subscriber, date of death, and contract numbers; sign. Submit via email, fax (225-297-2820), or mail as directed on the form.
Official form instructions are published as a downloadable file on the organization's website.
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