Employer Forms

Download and print commonly used forms.

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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.

Employer Site Training Guide

Use this training guide to learn how to login, manage your enrollment, assist employees, see your bill, access forms and other helpful information.

Rx Tools

Find important information on your prescriptions, including how to select a pharmacy, request prescription benefits, and more.

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