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Claims Access

• Member claims login

Mobile Claims

• Mobile claims instructions
• Quick reference user guide

Group Benefits

Administrative Forms

• Employer Group Benefit Plan Application
• Employer Application - Health Care Spending Account (HCSA)
• Pre-authorized Debit (PAD) Form
• Employee Enrolment Application with HSCA Option
• Health Care Spending Account (HCSA) Employee Enrollment Application
• Authorization for Direct Deposit of Claim Reimbursement
• Over Age Dependant Application
• Employee Change Form
• Salary Change Request
• Health Care Spending Account (HCSA) - Overview
• ESC Prior Authorization Drug Listing
• What is Prior Authorization
• Prior Authorization Drug Forms

Dental Claim Forms

• Dental Claim Form - English (PDF)
• Cost Plus Benefit Claim Statement (PDF)

Health Claim Forms

• Extended Health Claim Form (PDF)
• Cost Plus Benefit Claim Statement (PDF)
• Health Care Spending Account (HCSA) Claim Form (PDF)

 

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