Ensure your coverage gets off to a smooth start.
Please complete and return these forms promptly to help ensure the best experience when using your health plan.
Key plan forms and resources.
Permission to Speak with Others
To let us discuss your health care with family or others, please complete and return this form. You may include any power of attorney documentation with this form.
Appointment of Representative
Use this form to appoint a representative to take action on your behalf for any claim, appeal, grievance, or request. This form is valid for 365 days from the date we receive it.
VA Health Coverage
If you also receive health benefits through the Veterans Administration, please fill out, sign, and return this form.
Continuity of Care
If you also receive health benefits through the Veterans Administration, please fill out, sign, and return this form.
CVS/Caremark Mail-Order Prescriptions
If your plan includes Part D Prescription Drug coverage and you would like to receive your prescription by mail, please fill out the CVS Caremark Mail-Order form and mail to CVS.
Find more important documents, including the ones listed above, on our Member Resources Page.
Plan Resources
Explore our most commonly used resources when getting started on your plan.