- Generic Forms and Notices
- Dental
- Medical
- Vision
- Group Term Life
- Long Term Disability
- Continuation of Coverage for Disabled Dependents Form PDF
- Language Assistance Program Notice (for CA groups) PDF
- HIPAA Notice English | Spanish
- Termination Form (for terming an employee's coverage) Word | PDF
- COBRA Form PDF
-
UT Universal Employee Enrollment Form
PDF
- Dental Group Roster (to enroll more than one employee) Word | Excel
- English Dental Only Enrollment Form Online | Word | PDF
- Spanish Dental Only Enrollment Form Word | PDF
- English Dental/Vision Enrollment Form Online | Word | PDF
- Spanish Dental/Vision Enrollment Form Word | PDF
- Affidavit of Domestic Partnership Form Word | PDF
- Dental Claim Form PDF
Health Solutions II - Medical Co-pay
- Health Solutions II Enrollment Form (National) Online | Word | PDF
- Health Solutions II Enrollment Form (Texas) Online | Word | PDF
- Health Solutions II Enrollment Form (Arizona) PDF
-
UT Universal Employee Enrollment Form
PDF
- Idaho Universal Enrollment Form (for all medical plans) Online | PDF
- Group Medical Claim Form PDF
- Caremark Mail Order Form PDF
- View a Current Drug List PDF
- Caremark Prescription Drug Claim Form PDF
Health Solutions I - HDHP
- HDHP Employee Enrollment Form Online | Word | PDF
- HDHP Employee Enrollment Form (Texas) Online | Word | PDF
- HDHP Employee Enrollment Form (Arizona) PDF
-
UT Universal Employee Enrollment Form
PDF
- Idaho Universal Enrollment Form (for all medical plans) Online | PDF
- Group Medical Claim Form PDF
- Caremark Mail Order Form PDF
- View a Current Drug List PDF
- HDHP Prescription Drug Claim Form PDF
- English Enrollment Card Online | Word | PDF
- Spanish Enrollment Card Word | PDF
-
UT Universal Employee Enrollment Form
PDF
- Vision Claim Form PDF
- Gold, Silver and Bronze Life Enrollment Form Word | PDF
- Essential Life Enrollment Form Word | PDF
- Passport Life Enrollment Form Word | PDF
- Flex Life Enrollment Form Word | PDF
- Group Term Life Roster (to enroll more than one employee) PDF
- Change of Beneficiary Word | PDF
- Employee Death Benefits Claim Form PDF
- Dependents Death Benefits Claim Form PDF
- AD&D Claim Form PDF
- Accelerated Benefits Claim Form PDF
- Waiver of Premium Claim Form PDF
- Long Term Disability Enrollment Form Word | PDF