Blue Cross and Blue Shield of Kansas online payment form If you are human, leave this field blank.Monthly Payment CalculatorThe amount due will depend on how many weeks were in the last month and if you had any special orders or used one of your vacation weeks. If you have any questions you can contact your coordinator for an up to date amount. 1 week = $19 2 weeks = $38 3 weeks = $57 4 weeks = $76 5 weeks = $95Name *Email *Amount due *Enter the amount you will be paying this month. Note to monthly coordinatorCaptcha *reCAPTCHA is required.Submit