Tobacco Usage Form

Group Members

If you have a Business BlueEssentialsSM plan through your employer and currently pay a tobacco surcharge, you can have the surcharge removed if you enroll in or have recently completed a smoking cessation program.

Here's how to have the surcharge removed.

  1. Enroll in a tobacco cessation program. There are several programs available. The Department of Health and Environmental Control (DHEC) offers a free program called the South Carolina Tobacco Quitline. Quitline offers:
    • Free nicotine patches, gum or lozenges to eligible enrollees
    • Free one-on-one coaching session with a Quit Coach
    • Help developing a personalized quit plan
    Visit the South Carolina Tobacco Quitline website to enroll.
  2. Complete the Tobacco Usage Form. You must include the name and start date of the smoking cessation program you are enrolled in or have completed.
  3. Submit the form. You can email it to Group.Membership@bcbssc.com or ask your benefits coordinator to submit it on your behalf.

Download the Tobacco Usage Form.


Once this form is received and processed, the surcharge will be removed on the next billing cycle. The surcharge can't be removed retroactively.

Individual Members

During the application process for your BlueEssentialsSM plan, you were asked if you or anyone else on your plan used tobacco in the previous six months. If you answered yes and you're currently paying the 20 percent tobacco surcharge, the surcharge can't be removed until the next enrollment period.


If you have been tobacco-free for at least six months, you should update the tobacco usage portion of your application on www.HealthCare.gov to indicate your smoke-free status when the next enrollment period arrives. If you don't make this change, the tobacco surcharge will apply when your plan automatically renews for the next benefit year.


Need help quitting? DHEC offers a free program called the South Carolina Tobacco Quitline. Quitline offers:

  • Free nicotine patches, gum or lozenges to eligible enrollees
  • Free one-on-one coaching session with a Quit Coach
  • Help developing a personalized quit plan

Visit the South Carolina Tobacco Quitline website to enroll.