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Can't find what your looking for?  If you are our current client or in the St. Louis Metro area call us at 314-438-0222

 

 

 

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Have you ever considered adding accident or cancer coverage to your benefits?  These are available to individuals and groups.

   

Below are links to Claim Forms.  If you canít find something please call or contact us.  If you find a dead link let us know as some carriers tend to change their pages.  Thank you.

Some carriers don't publish direct links to their forms. If you don't see what you are looking for in the table check the list at the bottom of the page.  Call the office at 314-438-0222 if you canít print one or would like one mailed directly to you. Most of the forms are published with Adobe Acrobat.   If you don't have Adobe Acrobat you can get the free reader.

Aetna

Cigna Humana Reliance
AFLAC CNA/The Hartford Jefferson Pilot Standard Insurance
Allied National GHP Kansas City Life United American
A M S Golden Rule Mercy Health Plans United HealthCare
Ameritas Guardian MetLife UNUM
BCBS-MO Hartford Life Mutual of Omaha  

 

Aetna - You even have a personal online library of your claim explanation of benefits available in a printer-friendly format. Aetna Complete Forms Library

 

Medical Claim Form

Dental Claim Form

Vision Claim Form

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AFLAC - The link to General Claim Forms for Aflac will no longer be provided on our website.  AFLAC will not allow me to provide you with links to the forms that you need.  I received a call from Phyllis Dent on 8/26/08 at 3:05 pm telling me that I could not help clients get access to the Aflac forms they needed by putting a link on my website that went directly to Aflac.  I have been fighting this with Aflac for several years and am just very tired of them calling and telling me that I can't help out employer groups with this.  Please call my office and we can move your voluntary plans to another company that allows the agents to help their employer clients.

 

Claim Forms

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Allied National -  Claim form for Dental only

 

Horizons Dental Claim Form

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American Medical Security  - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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Ameritas - Claim form for Dental only

 

Dental Claim Form

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BCBS-MO -  Check on your member's eligibility, obtain forms, contact Customer Service.

 

STD Claim Form

Prescription Drug Claim Form

Medical Claim Form

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Cigna - Forms for Dental, RX, STD and LTD

 

Member Claim Form

Dental Claim Form

Prescription Drug Claim Form

STD Claim Form

LTD Claim Form

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CNA/The Hartford - On January 1, 2004 The Hartford acquired CNA's group life and accident, and short-term and long-term disability business, including CNA Group Life Assurance Company.

 

STD Claim Form

LTD Claim Form

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GHP -  In support of HIPAA and its goal of administrative simplification, Group Health Plan & Coventry Health Care of St. Louis encourages physicians and medical providers to submit claims electronically.

 

CareMark c/o GHP Prescription Reimbursement Form

Medical Claim Form

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Golden Rule - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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Guardian - No Dental links are available as of 4/27/05.  Contact us for their current forms.

 

Medical Claim Form

STD Claim Form

LTD Claim Form

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Hartford Life - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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Humana - No links are available as of 4/27/05.  Contact us for their current forms.

 

Dental Claim Form

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Jefferson Pilot - Forms for Dental, Life, LTD & STD  

Dental Claim Form

Life Claim Form

LTD Claim Form

STD Claim Form

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Kansas City Life - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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Mercy Health Plans - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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MetLife - A forms library is available that includes many different forms.

 

Dental Claim Form

MetLife Forms Library

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Mutual of Omaha - Forms for Health, Dental, Vision, Disability  

Medical Claim Form

Dental Claim Form administered thru United Concordia

STD Claim Form

LTD Claim Form

Vision Claim Form

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Reliance - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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Standard Insurance - Forms for Life & Disability

 

STD Claim Form

LTD Claim Form

Life Ins. Claim Form

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United American - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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United HealthCare (UHC) - No links are available as of 4/27/05.  Contact us for their current forms.

 

 

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UNUM - Use this form for both STD and LTD claims

 

Disability Claim Form

 

 
     

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