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Save the forms to your computer. In some cases, you can fill them in directly before printing. Otherwise, print them out and complete them by hand before mailing to the address indicated on each form.

Looking for Critical Illness claims forms?

Group Critical Illness claim forms are illness specific and are not available on our website. Call 1-866-442-3098 and ask to speak with the Group Life Claims department. We will provide you with the appropriate claim forms and answer any questions you may have. If you would like to order more forms, please use the following links:

  • Order Form
  • Online Order Form

     

    Extended Health and Dental claim forms

  • Prior Authorization Form - Drug 
  • Prior Authorization Form - Forteo® 
  • Prior Authorization Form - Growth Hormones 
  • Prior Authorization Form - Xolair®
  • Supplementary Dental Accident Report 
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      Disability claim forms

       

      Life and AD&D Claim forms

       

      Administration forms