If You received a PINK Claim Form in the mail and You would like to submit Your CLS Affirmation online because You do not have any changes to make regarding the information contained on the Claim Form You received, You may do so by entering Your CLAIMANT # AND CONFIRMATION CODE that appear in the upper right hand corner of Your Claim Form. Please be sure to include all characters in the CLAIMANT #, including the letters. If the name and/or address information on Your PINK form is not accurate, You will need to file Your Claim Form by mail.
If You received a YELLOW, BLUE or WHITE Claim Form in the mail, You will need to file Your Claim Form by mail. If You have questions regarding Your Claim Form, You can view the Frequently Asked Questions section of this website, call toll-free 1-855-441-2329 or send an email to: Questions@CareFirstBreastfeedingSupportClassAction.com.
If You received more than one Claim Form, You may only file online if You received a PINK Claim Form. If You received more than one PINK Claim Form, you will need to login with EACH CLAIMANT # AND CONFIRMATION CODE to submit EACH Claim Form online.
If You want to make a claim for a Balance Bill Settlement Payment, You cannot submit such claim and Your CLS Affirmation online. You must complete and return by mail your proof(s) of claim with the requested proof of having paid a Balance Bill to an out-of-network provider for an eligible CLS Claim and the amount actually paid to an out-of-network provider.
If You did not receive a Claim Form, but believe You may be eligible, please click here to download a blank Claim Form that can be printed out, completed and mailed to the address on the form.