Enrollment assistance request

Complete the form to get help enrolling in a 2017 individual or family health plan. A salesperson will reach out to you during normal business hours to help you enroll.

First name

Last name

Email address

Phone number

Premera Blue Cross Blue Shield of Alaska will use the email address or phone number you provided above to communicate with you about open enrollment and Premera health plans. You may opt out at any time. We will never sell your email address.

View our Notice of Privacy Practices for Alaska or Washington and other states and our website Terms and Conditions for Alaska or Washington and other states.