Blue Cross Blue Shield of North Carolina

Health: Blue Options

Dental: Dental Blue

To download forms in Acrobat Reader, click on the links below:

Enrollment/Change Form

Medical Reimbursement Claim Form

Prescription Drugs Reimbursement Claim Form

Dental Reimbursement Claim Form

BCBSNC Membership Guide

Retirement

North Carolina Local Governmental Employees' Retirement System

North Caorlina Local Governmental Law Enforcement Officers' Retirement System

To download forms in Acrobat Reader, click on the links below:

Enrollment Form

Change of Beneficiary, Address or Personal Information

Application for Refund

401(k )/ 457(b) Payroll Deduction Change Form (Word format)

North Carolina (NC-4) Tax Withholding Form

Federal (W-4) Tax Witholding Form

Flexible Spending Account Claim Form

Family Medical Leave (FMLA)

Automobile Accident Report Form

Citizen Incident Report Form

Property Damage Report Form

Nonexempt Employee Timesheet

HCSO Nonexempt Employee Timesheet (in Excel)