Forms
- Appointment of Personal Representative
- Coordination of Benefits
- Pharmacy Prior Authorization Request (PAR) / Exception Request
- Authorization to Use and Disclose PHI
- Emancipated Minor Restriction of Claims Access
- Subscriber Access to Spouse or Adult Dependent Claims
- Commercial Dependent Eligibility Beyond Limiting Age
- Member Reimbursement Form (DHHA)
- Transition of Care Request
- Commercial Products Member Complaint and Appeal Form
Documents
- Advance Directive / Living Will
- Employer Group Plans Service Standards
- Medical Prior Authorization List
- Employer Group Plans Access to Care
- How to Read Your EOB
- Out-of-Area Coverage for Dependents