How to Apply
(Over 65? Click here)
Step 1: Become a JACL Member
First, both you and your spouse (if applying) need to become JACL members. Complete the JACL Membership application and make your check payable to: "JACL". If you are already a current JACL member, please indicate your chapter name on the Blue Shield application.
Step 2: Choose one of our four plans
If you haven't already, you can compare plans that JACL HBA offers here. After you've chosen your plan, download and fill out the Blue Shield Application.
If you are applying for our HMO plan go to Step 3 otherwise proceed to Step 4.
Step 3: For HMO plans only
If you are applying for our HMO plan, then you should choose a Blue Shield HMO Personal Physician for yourself and each family member, otherwise Blue Shield will select one for you. If you have questions in choosing a physician, please call 1-800-424-6521 or click here.
Step 4: Send Application
Return the completed forms and check to our office at 220 Sansome Street, Suite 1360, San Francisco, CA 94104. Remember to include the following:
- JACL Membership Application
- Check payable to: "JACL"
- Blue Shield Application
Incomplete or illegible applications can be delayed, so be sure to carefully review the entire form and print clearly in ink (or type). Don't forget to sign your application.
Step 5: Approval Process
Blue Shield will either approve or decline your application for health coverage within one to twelve weeks. If your application is approved by Blue Shield of California, then you will be notified of the effective date of your coverage. If your application is declined by Blue Shield then you will receive an explanation by Blue Shield, and your JACL membership check will be returned to you.
If you have any questions, please call us at 1.800.400.6633.
