Forms
- Appointment of Personal Representative
- Commercial Products Member Complaint and Appeal Form
- Pharmacy Prior Authorization Request (PAR) Exception Request
- Authorization to Use and Disclose PHI
- Coordination of Benefits
- Subscriber Access to Spouse or Adult Dependent Claims
- Care Management Referral Form
- Emancipated Minor Restriction of Claims Access
- Transition of Care Request
- Commercial Dependent Eligibility Beyond Limiting Age
Documents
- Advance Directive / Living Will
- Gender Affirming Care and Coverage
- Services Requiring Prior Authorization
- Elevate Exchange Access to Care
- How to Read Your EOB