• Home
  • Group Client Access
  • Individual-Family Health
  • Forms
  • Travel Insurance
  • Individual Insurance
  • EN Enrollment
  • More
    • Home
    • Group Client Access
    • Individual-Family Health
    • Forms
    • Travel Insurance
    • Individual Insurance
    • EN Enrollment
  • Sign In
  • My Account

  • Signed in as:

  • filler@godaddy.com

  • My Account

  • Sign out

Signed in as:

filler@godaddy.com

  • Home
  • Group Client Access
  • Individual-Family Health
  • Forms
  • Travel Insurance
  • Individual Insurance
  • EN Enrollment

Account

  • My Account

  • Sign out

  • Sign In
  • My Account

GROUP - EMPLOYEE ENROLLMENT FORMS

Add a footnote if this applies to your business

Forms

Blue Cross Blue Shield LA

Add a description about this category

Authorized Delegate Form - Adult

Use this form when requesting Authorization for a person 18 or older.

Add a footnote if this applies to your business

  • Privacy Policy

Acadiana Benefits Group

2020 W. Pinhook Rd, Ste 301, Lafayette, LA 70508, US

(337) 237-9934

Breaux & Broussard, LLC - dba: Acadiana Benefits Group   (C) 2025

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

DeclineAccept