Download & Print Forms

Just click on the name of the form you want to download and print
NOTE: To download and print a form, you must have
Adobe Acrobat Reader, download it for free.

Section 125 (Cafeteria Plan Administration) Forms, Information & Links

NBS (National Benefit Services)
Access Your Account Online  click here

Insurance Carriers – Forms & Links

American Fidelity Assurance Company
Well Check Claim Form
Cancer Claim Form
Diagnostic Form
Beneficiary Change Request
Name Change Request
Bank Draft Authorization
Address Change Form

American Public Life
Change Request Form
Accident Policy Claim Instructions
Cancer Policy Claim Instructions
Claim Form

Assurant Employee Benefits/Union Security Ins.Co.

Long Term Disability
  Assurant Disability Claim Form & Instructions
  ASI Educator Service Request Form

Group Term Life
  Life Claim Statement Employee/Employer
  Term Life Claim Form for Beneficiary
  Assurant Term Life Beneficiary Change Form
  Assurant Term Life Change Form
  Voluntary Life Portability Request
  Voluntary Life Conversion Request


  Find a Dentist - click here

Bay Bridge Administrators, LLC
Hartford/AIG/Nat’l Union Fire Ins. Co.

Well Check Claim Form
Cancer, Specified Disease & Intensive Care Claim Form
Service & Change Request
Bay Bridge Bank Draft Authorization

Bay Bridge Humana Cancer
        Previous Cancer/Specified Disease/Heart History

Humana Wellness Claim Form
Humana Cancer Claim Form
Bay Bridge Bank Draft Authorization
Service & Change Request

Conseco/Jefferson National Life Ins. Co.
Cancer, Specified Disease & Intensive Care Claim Form
Cancer Bank Draft Authorization
Change Request Form
Add or Remove Family Members

HIPAA Authorization Form


View details and Schedule an appointment

Reliance Standard AD&D

Change of Beneficiary
AD&D Application

ADD claim form

Texas Life

Change Forms Link

Cancer, Specified Disease & Intensive Care 
  Claim Form
  Bank Draft Authorization

Group Term Life
  Continue Group Term Life Policy     

  Service Change Form

Vision Service Plans (VSP)click here

Find a doctor - click here

VOYA (ING) - ReliaStar

Account Access
Change Request Form



Administrative Login   |   Database Login