{"id":55,"date":"2019-07-07T01:24:45","date_gmt":"2019-07-07T07:24:45","guid":{"rendered":"https:\/\/www.aboutroswell.net\/web\/?page_id=55"},"modified":"2023-11-13T11:06:17","modified_gmt":"2023-11-13T18:06:17","slug":"bis-forms","status":"publish","type":"page","link":"https:\/\/bisnm.com\/web\/bis-forms\/","title":{"rendered":"BIS Forms"},"content":{"rendered":"

Download & Print Forms<\/strong><\/h2>\n

Just click on the name of the form you want to download and print
\nNOTE<\/strong>: To download and print a form, you must have
\nAdobe Acrobat Reader, download it for free<\/a>.<\/p>\n

\"\"<\/a>note: Remember to Uncheck the Optional Install if you do not want to install them.<\/p>\n<\/div>

<\/div>
<\/div><\/div>
<\/div>
<\/div><\/div><\/div><\/div><\/div>

Section 125 (Cafeteria Plan Administration) Forms, Information & Links<\/span>
\nNBS (National Benefit Services)<\/span>
\nAccess Your Account Online click here<\/a><\/span><\/p>\n<\/div>

Insurance Carriers \u2013 Forms & Links<\/span><\/strong><\/p>\n<\/div>

<\/div><\/div><\/div><\/div><\/div>

American Fidelity Assurance Company<\/strong>
\nWell Check Claim Form<\/a>
\nCancer Claim Form<\/a>
\nDiagnostic Form<\/a>
\nBeneficiary Change Request<\/a>
\nName Change Request<\/a>
\nBank Draft Authorization<\/a>
\nA<\/a>ddress Change Form<\/a><\/p>\n

American Public Life<\/strong>
\nChange Request Form<\/a>
\nAccident Policy Claim Instructions<\/a>
\n<\/strong>Cancer Policy Claim Instructions<\/a>
\n<\/strong>Claim Form<\/a><\/p>\n

Bay Bridge Humana Cancer
\n<\/strong>Requirements for Consideration<\/a>
\nPrevious Cancer\/Specified Disease\/Heart History<\/a>
\nHumana Wellness Claim Form<\/a>
\nHumana Cancer Claim Form<\/a>
\nBay Bridge Bank Draft Authorization<\/a>
\nService & Change Request<\/a><\/p>\n<\/div>

<\/div><\/div><\/div>

Conseco\/Jefferson National Life Ins. Co.<\/strong>
\nCancer, Specified Disease & Intensive Care Claim Form<\/a>
\nCancer Bank Draft Authorization<\/a>
\nChange Request Form<\/a>
\nAdd or Remove Family Members<\/a>
\nHIPAA Authorization Form<\/a><\/p>\n<\/div>

<\/div><\/div><\/div>

One America<\/strong>
\nEducator Disability
\nTelephone Claim Instructions<\/a>
\nGroup Term Life
\nClaim Form<\/a>
\nGroup Life Conversion Application<\/a>
\nGroup Life Portability Application<\/a><\/p>\n

Reliance Standard AD&D<\/strong>
\nChange of Beneficiary<\/a>
\nAD&D Application<\/a>
\nADD claim form<\/a><\/p>\n

Texas Life
\n<\/strong>Change Forms Link<\/a><\/p>\n

Transamerica<\/strong>
\nCancer, Specified Disease & Intensive Care
\nClaim Form<\/a>
\nInstructions<\/a>
\nBank Draft Authorization<\/a>
\nGroup Term Life
\nContinue Group Term Life Policy<\/a>
\nService Change Form<\/a>
\nChange Beneficiary Form<\/a><\/p>\n<\/div>

<\/div><\/div><\/div>

Bay Bridge Administrators, LLC
\nHartford\/AIG\/Nat\u2019l Union Fire Ins. Co.<\/strong>
\nWell Check Claim Form<\/a>
\nCancer, Specified Disease & Intensive Care Claim Form<\/a>
\nService & Change Request<\/a>
\nBay Bridge Bank Draft Authorization<\/a><\/p>\n

Dental<\/strong>
\nFind a Dentist – click here<\/a><\/p>\n

Vision Service Plans (VSP)<\/strong> \u2013 click here<\/a>
\nFind a doctor<\/strong> – click here<\/a><\/p>\n

VOYA (ING)\u00a0– ReliaStar
\n<\/strong>Account Access<\/a><\/p>\n<\/div>

<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-55","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/pages\/55","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/comments?post=55"}],"version-history":[{"count":71,"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/pages\/55\/revisions"}],"predecessor-version":[{"id":3031,"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/pages\/55\/revisions\/3031"}],"wp:attachment":[{"href":"https:\/\/bisnm.com\/web\/wp-json\/wp\/v2\/media?parent=55"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}