Employer Forms & Resources

Download and print commonly used forms. All forms are in PDF format. Download Acrobat Reader.

FORM: DESCRIPTION
Medical Claim Form: Use this form to file a claim for medical services, such as office visits, physical therapy, laboratory services and radiology services such as X-rays.
Transaction Transmittal: Use this form to notify us of a name or address change, or to cancel, transfer or reinstate an employee’s coverage.