Forms and Brochures
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2019 Forms and Brochures
- Medical Claim Form (PDF)
Complete the claim form for each member submitting bills for reimbursement of covered services. To avoid any delay, be sure to answer each question completely. PLEASE ATTACH FULLY ITEMIZED BILLS AND PROOF OF PAYMENT.
Glossary of Health Coverage and Medical Terms (PDF)
Glossary of Health Coverage and Medical Terms - Spanish (PDF)
Glossary of Health Coverage and Medical Terms - Chinese (PDF)
Glossary of Health Coverage and Medical Terms - Korean (PDF)
Glossary of Health Coverage and Medical Terms - Navajo (PDF)
Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer understand some of the most common language used in health insurance documents. Please log in to request a hardcopy of the document by mail.