Order an Explanation of Benefits for an Employee

To order an Explanation of Benefits (EOB), please complete the information requested.

*All fields are required unless noted

Date of service: From Choose a date      
   To Choose a date
Provider name: Include All Providers
Type of claims requested All claims      Dental      Pharmacy
Company name:
Your e-mail address:
Your business title:
Your phone number: (Area code first)
Your name:
Employee's BCBSKS ID number:
Employee's name:
Patient's name:
Include all family members? Yes (optional)
The explanation will be mailed to the employee within two business days.