Benefit Resource Hub

2018 Insurance Carrier Forms

Regence BlueShield/Asuris Northwest Health Medical Forms
Regence/Asuris Domestic Partner Affidavit Regence
Asuris
Cambia Health Solutions HSA Health Equity Banking Agreement Click Here
Regence/Asuris Member Reimbursement Claim Form  Click Here
Regence/Asuris Authorization to Disclose Protected Health Information  Click Here
Delta Dental of Washington Forms
Delta Dental of Washington Claim Form Click Here
Delta Dental of Washington Domestic Partner Affidavit Form Click Here
Delta Dental of Washington Disabled Dependent Application  Click Here
Delta Dental of Washington Domestic Partner Directive Form Click Here
Delta Dental of Washington Custodial Parent Application Click Here
VSP Vision Care Inc. Plan Forms
VSP Vision Care Inc. Member Reimbursement Form Click Here
Basic Life, AD&D and Disability Forms
The Standard Evidence of Insurability Form Click Here
The Standard Life Claim Form Click Here
The Standard STD Claim Form Click Here
The Standard LTD Claim Form Click Here
The Standard AD&D Claim Form Click Here
The Standard Life Portability Form Click Here
The Standard Individual Life Conversion Form Click Here
The Standard Waiver of Premium Form Click Here