Forms & documents for plan administrators
All the forms and documents you need to manage your plan and take care of your plan members.
Portal forms
Group Administrator Portal Application
Complete this form for access to the secure Group Administrator Portal (GAP)
DOWNLOAD
pdf • 93 KB
Employee forms
Individual Application for Group Benefits
pdf • 168 KB
New employees should complete this form to enroll in your Group Benefits plan.
Electronic Funds Transfer (EFT) Authorization
pdf • 198 KB
Your employees can use this form to sign up for direct deposit of their claim reimbursements.
Employee Change Form
pdf • 253 KB
Employees should complete this form to notify us of any changes to their information.