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Forms From Companies We Represent

Tired of searching through piles of papers for a form to fill out for your insurance claim?  We make it easy.  Click on the form that suits you and find the up to date form you need.  If you need a form not listed here, please contact us so that we may better serve you. 

Blue Cross Blue Shield of Texas-Group

Group Enrollment Application/Change Form

Student Dependent Certification

Dental Claim Form

Medical Claim Form

HMO Blueż Texas Medical Claim Form

Change Life Insurance Beneficiary

Standard Authorization to Use or Disclose Protected Health Information (PHI)

Blue Cross Blue Shield of Texas-Individual

Court-Mandated Health Coverage Change Form

Continuation of Coverage Request Form

Mail Order Prescription Form

Standard Authorization to Use or Disclose Protected Health Information (PHI)

 

Fortis Benefits

This link takes you directly to Fortis's website to download forms.  If you are unsure which form to download and fill out, please contact us.

Standard

Dental Claim Form

 

 

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