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Please note: The state field refers to the location where your employer is headquartered.
| Title | Download | Online Form | State |
|---|---|---|---|
| Accident Claim Form |
 Download Form (382.46 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Accidental Death & Dismemberment Employee Flyer |
Download Form (1.99 MB) |
AK, CA, MT, OR, UT, WA, WY | |
| Accidental Death & Dismemberment Employee Flyer - ID |
Download Form (1.99 MB) |
ID | |
| Accidental Dismemberment Claim Form |
Download Form (339.79 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Affidavit of Non-State Certified Domestic Partnership |
Download Form (69.45 KB) |
OR | |
| Affidavit of Non-State Registered Domestic Partnership |
Download Form (69.06 KB) |
WA | |
| Affidavit of Qualified Disabled Dependent |
Download Form (615.74 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Affidavit of Qualifying Domestic Partnership |
Download Form (68.82 KB) |
AK, CA, ID, MT, UT, WY | |
| Assignment of Life Insurance Proceeds Form for Life Claim Benefits |
Download Form (194.5 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Authorization for LifeMap to Release Information |
Download Form (179.09 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Beneficiary Designation Form |
Download Form (60.78 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Billing FAQ |
Download Form (60.86 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Cancer Only Critical Illness Employee Flyer |
Download Form (2.04 MB) |
AK, MT, OR, UT, WA, WY | |
| Cancer Only Critical Illness Employee Flyer - ID |
Download Form (2.04 MB) |
ID | |
| Cancer Plus Critical Illness Employee Flyer |
Download Form (2.17 MB) |
AK, MT, OR, UT, WA, WY | |
| Cancer Plus Critical Illness Employee Flyer - ID |
Download Form (2.17 MB) |
ID | |
| Critical Illness Cancer Care Claim Form |
Download Form (148.39 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Dental Health Article for Employees |
Download Form (91.36 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Dental Overview for Employers 2-299 |
Download Form (232.16 KB) |
AK, MT, OR, UT, WA, WY | |
| Dental Overview for Employers 300+ |
Download Form (189.4 KB) |
AK, MT, OR, UT, WA, WY | |
| Dental Overview for ID Employers 2-299 |
Download Form (232.99 KB) |
ID | |
| Dental Overview for ID Employers 300+ |
Download Form (189.99 KB) |
ID | |
| Dental Voluntary Group Employee Flyer |
Download Form (2.16 MB) |
AK, MT, OR, UT, WA, WY | |
| Dental Waiver Form |
Download Form (77.75 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Employer Admin Center User Guide and FAQ |
Download Form (1.47 MB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Employer Admin Guide |
Download Form (681.95 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Evidence of Insurability (EOI) Frequently Asked Questions |
Download Form (196.59 KB) |
AK, ID, MT, OR, UT, WA, WY | |
| Evidence of Insurability (EOI) with HIPAA Authorization |
Download Form (957.47 KB) |
Online Form | AK, ID, MT, OR, UT, WA, WY |
| Extended Life Insurance Claim Form |
Download Form (163.23 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Find a Dentist |
Download Form (82.62 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Find a Vision Provider - Group |
Download Form (185.93 KB) |
AK, ID, MT, OR, UT, WA, WY | |
| Group Dental Employee Flyer |
Download Form (1.59 MB) |
AK, CA, MT, OR, UT, WA, WY | |
| Group Dental Employee Flyer - ID |
Download Form (1.59 MB) |
ID | |
| Group Products Overview 10+ |
Download Form (760.88 KB) |
AK, MT, OR, UT, WA, WY | |
| Group Products Overview 10+ CA |
Download Form (2.3 MB) |
CA | |
| Group Products Overview 10+ ID |
Download Form (763.5 KB) |
ID | |
| HIPAA Authorization to Disclose Protected Health Information |
Download Form (259.78 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Life Conversion Request for Information Form |
Download Form (228.07 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Life Employee Flyer |
Download Form (2.15 MB) |
AK, CA, MT, OR, UT, WA, WY | |
| Life Insurance Claim Form |
Download Form (284.21 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Life Insurance Worksheet |
Download Form (142.3 KB) |
AK, CA, MT, OR, UT, WA, WY | |
| Life Insurance Worksheet - Idaho |
Download Form (141.89 KB) |
ID | |
| LifeMap Advantages Member Flyer |
Download Form (885.84 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Long Term Disability Claim Form |
Download Form (570.96 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Long Term Disability Employee Flyer |
Download Form (2.09 MB) |
AK, CA, MT, OR, UT, WA, WY | |
| Long Term Disability Employee Flyer - ID |
Download Form (2.09 MB) |
ID | |
| Notice of Privacy Practices - STM, Vision, Dental |
Download Form (126.25 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Privacy Notice |
Download Form (24.05 KB) |
AK, CA, ID, MT, OR, UT, WA, WY | |
| Short Term Disability Claim Form |
Download Form (803.12 KB) |
AK, ID, MT, OR, UT, WA, WY | |
| Short Term Disability Claim Form - Employee's Statement | Online Form | AK, ID, MT, OR, UT, WA, WY | |
| Short Term Disability Overview for Employers |
Download Form (486.03 KB) |
AK, MT, OR, UT, WA, WY | |
| Short Term Disability Overview for ID Employers |
Download Form (486.52 KB) |
ID | |
| Vision Employee Flyer |
Download Form (1.31 MB) |
AK, MT, OR, UT, WA, WY | |
| Vision Employee Flyer - ID |
Download Form (1.31 MB) |
ID | |
| Vision Employee Waiver Form |
Download Form (243.78 KB) |
AK, ID, MT, OR, UT, WA, WY | |
| Vision Out of Network Reimbursement Form |
Download Form (293.57 KB) |
AK, ID, MT, OR, UT, WA, WY | |
| Voluntary Accident Employee Flyer |
Download Form (3.09 MB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Accident Employee Flyer - ID |
Download Form (3.09 MB) |
ID | |
| Voluntary Accidental Death & Dismemberment Employee Flyer |
Download Form (1.99 MB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Accidental Death & Dismemberment Employee Flyer - ID |
Download Form (1.99 MB) |
ID | |
| Voluntary Group Dental Employee Flyer |
Download Form (1.09 MB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Group Dental Employee Flyer - ID |
Download Form (2.41 MB) |
ID | |
| Voluntary Life Employee Flyer |
Download Form (2.16 MB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Life Employee Flyer ID |
Download Form (2.16 MB) |
ID | |
| Voluntary Long Term Disability Employee Flyer |
Download Form (260.77 KB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Long Term Disability Employee Flyer - ID |
Download Form (261.1 KB) |
ID | |
| Voluntary Short Term Disability Employee Flyer |
Download Form (1.33 MB) |
AK, MT, OR, UT, WA, WY | |
| Voluntary Short Term Disability Employee Flyer - ID |
Download Form (1.33 MB) |
ID | |
| Wellness Benefit Statement |
Download Form (65.09 KB) |
AK, CA, ID, MT, OR, UT, WA, WY |