Benefits Vendor Forms and Information
Click on one of the links below to view information about claim forms.
CDHP Frequently Asked Questions
FSA Claim Form - Dependent Daycare
FSA Claim Form - Healthcare
Highmark BCBS Medical Claim Form
Highmark BCBS Mobile Website Information Flyer
Highmark BCBS Transition of Care (TOC) Form
Instructions for Accessing FSA Information on myuhc.com
MetLife Dental Claim Form
Optum Rx - Health, Allergy & Medication Questionaire (HMQ)
Optum Rx - Pharmacy Reimbursement Claim Form
Optum Rx - Prescription Mail-in Order Form
UHC - Health Provider Preventive Screening Form (Waived Empl)
UHC - How to Find a Physician or Hospital
UHC - HRA How the Plan Works
UHC - Medical / Health Claim Transmittal
UHC - Preventive Care Services & Guidelines
UHC - Transition or Continuation of Care Form
UHC - What Can I Do At MyUHC.com
VSP - Out-of-Network Reimbursement Claim Form
Your Spending Account HRA Premium Claim Form
