Personal Representative Registration

  1. Current: Your Info
  2. Create Account
  3. Security Questions
  4. Review & Submit

Use this form to register as a personal representative for an Excellus BCBSUnivera Healthcare member.
Not a personal representative? Use this link to register as a member.

Enter the 9-digit authorization number. Don't have an Authorization ID?

Modal for Legal Statement

 

GDPR Notification Content