|
Aetna - You even have a personal online
library of your claim explanation of benefits available in a printer-friendly
format. Aetna
Complete Forms Library
|
|
Medical Claim Form
Dental Claim Form
Vision Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
AFLAC - The link to General Claim Forms for Aflac will no longer be provided on our website. AFLAC will not allow me to provide you with links to the forms that you need. I
received a call from Phyllis Dent on 8/26/08 at 3:05 pm telling me that I could
not help clients get access to the Aflac forms they needed by putting a link on
my website that went directly to Aflac. I have been fighting this with Aflac
for several years and am just very tired of them calling and telling me that I
can't help out employer groups with this. Please call my office and we can move
your voluntary plans to another company that allows the agents to help their
employer clients.
|
|
Claim Forms
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Allied National - Claim form for Dental only
|
|
Horizons Dental Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
American Medical Security - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Ameritas - Claim form for Dental only
|
|
Dental Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
BCBS-MO - Check on your member's
eligibility, obtain forms, contact Customer
Service.
|
|
STD Claim Form
Prescription Drug Claim Form
Medical Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Cigna - Forms for Dental, RX, STD and LTD
|
|
Member Claim Form
Dental Claim Form
Prescription Drug Claim Form
STD Claim Form
LTD Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
CNA/The Hartford - On January 1, 2004 The Hartford acquired CNA's group life and accident, and
short-term and long-term disability business, including CNA Group Life Assurance
Company.
|
|
STD Claim Form
LTD Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
GHP - In support of HIPAA and its goal of administrative simplification, Group Health
Plan & Coventry Health Care of St. Louis encourages physicians and medical
providers to submit claims electronically.
|
|
CareMark c/o GHP Prescription Reimbursement Form
Medical Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Golden Rule - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Guardian - No Dental links are available as of 4/27/05. Contact us for their
current forms.
|
|
Medical Claim Form
STD Claim Form
LTD Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Hartford Life - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Humana - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
Dental Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
| Jefferson Pilot - Forms for Dental, Life, LTD & STD |
|
Dental Claim Form
Life Claim Form
LTD Claim Form
STD Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Kansas City Life - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Mercy Health Plans - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
MetLife - A forms library is available that includes many different forms.
|
|
Dental Claim Form
MetLife Forms Library
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
| Mutual of Omaha - Forms for Health, Dental, Vision, Disability |
|
Medical Claim Form
Dental Claim Form administered thru United Concordia
STD Claim Form
LTD Claim Form
Vision Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Reliance - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
Standard Insurance - Forms for Life & Disability
|
|
STD Claim Form
LTD Claim Form
Life Ins. Claim Form
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
United American - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
United HealthCare (UHC) - No links are available as of 4/27/05. Contact us for their
current forms.
|
|
|
|
- - - - - - - - - - -
|
|
- - - - - - - - - - -
|
|
UNUM - Use this form for both STD and LTD claims
|
|
Disability Claim Form
|
