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Important Notice
WellChoice New Jersey exiting New Jersey market
WellChoice New Jersey (“WellChoice”) is exiting the New Jersey market and will cease providing health insurance coverage in the state...Learn More.

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GBA Newsletter
Inside Benefits, a new semiannual publication that combines analyses of trends in the marketplace with plan news.
Current Issue
Summer 2006
Past Issues
Winter 2005/2006
Spring 2005
Fall 2004
Spring 2004
Winter 2003
Find a Doctor or Specialist
Select a doctor from up to 92,000 provider locations and 231 leading hospitals, depending on your health plan.
Or choose the form you need to do the following:

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Note - Small Group: 2-50 employees. Large Group: above 51 employees.
- To apply to our Large Group HMO or PPO:
Large Group Application/Change form
- To apply to our Large Group HMO:
Large Group HMO  Application/Change form
- To apply to our Small Group HMO or PPO:
Small Employer Health Benefits Application
- To enroll an employee in your Large Group HMO or PPO plan:
Employee Application/Change Form
- To enroll an employee in your Small Group HMO or PPO plan:
Employee Application/Change Form
- To determine that your group meets yearly guidelines required by the State of New Jersey:
Certification Form
- To file an out of network medical claim:
Medical Claim Form
- To receive reimbursement for prescriptions paid for out-of-pocket:
Prescription Claim Form
- To allow your employees to receive prescriptions by mail:
Advance Rx Mail Order Form
- To fill out a pre-existing condition statement (for groups 2-5 in size as required by the State of New Jersey):
Pre-Existing Condition Statement
- To determine if a dependent is a valid student and still eligible for coverage:
Student Coverage Questionnaire
- To have an employee waive WellChoice coverage:
Waiver of Coverage Form
- To nominate a provider who is not listed in our directory:
Provider Nomination Card
- To determine that your company still meet the yearly guidelines required by the State of New Jersey on renewals:
Re-Certification Form
If the form you're looking for isn't here, check our Find a Form or Brochure section.
Learn More About Our Plans and Programs
Find out how WellChoice's healthcare plans and special programs can better serve your employees and their families.