When you need to enroll in a program, add a dependent, or file a claim, just print the appropriate form, complete it as instructed, and then mail it to the following address:
Make sure that you forward any required documentation along with your form. If you are enrolling/adding a dependent due to marriage, a child’s birth, or an adoption, be sure to provide proof of dependency. A certified copy of your marriage certificate, or a child’s birth certificate, or a court order showing legal responsibility will be acceptable.
If you ever need assistance, feel free to contact the Administrative Office at 714-898-2200 or 1-800-499-8121.
