For your convenience, all benefit forms are now available 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 the County’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 850-266-7939 at 850-266-7939.
BlueCrossBlueShield / Florida Blue Forms
For NEW Enrollment, please read plan coverage terms and complete ALL sections of this form.