No Surprise Billing
Learn more about "Your Rights and Protections Against Surprise Medical Bills".
Extended Plan Deadlines
New guidance from the Federal Government as to extended deadlines for 1) COBRA, 2) special enrollment, and 3) healthcare claim filings/appeals. Click here to learn more.
Resources
Take control of your own healthcare with access to our comprehensive toolkit of forms and resources. With the right information, you can make more responsible, financial healthcare decisions.
Important Notices
Medical, Dental and Vision Claim Forms
- Claim Form - Medical
- Claim Form - Dental
- Claim Form - Vision
- International Medical Claim Form
- Claims Fax Cover Sheet
Individual & Family Plan Forms
Exchange Model Notices & Rights Notification
- Exchange Model Notice (Coverage Provided)
- Exchange Model Notice (No Coverage Provided)
- Exchange Model Notice Sample Cover Letter
- Women's Cancer Rights Notification
- Children's Health Insurance Program (CHIP) Notice
Medicare Documents & Information
Provider Pre-Authorization Forms
- Retail Pharmacy Prior Authorization Request Form
- Specialty Pharmacy Request Form
- Formulary Exclusion Prior Authorization Form
Pharmacy Mail-Order, Pre-Authorization Forms & Documents
Security & Privacy Forms & Documents
- HIPAA Authorization Form
- Notice of Privacy Practice
- Sample HIPAA Business Associate Agreement
- Sample HIPAA Business Associate Subcontractor Agreement
Flexible Spending Account Reimbursement (FSA)
Miscellaneous
