Member Guidelines

Member Handbooks

Instructions When Completing Easy Choice Heath Plan Claim Form

  • Complete Sections 1-13 to the best of your ability
  • Complete new form for each member of the family that you are submitting medical expenses
  • New forms must be used on subsequent submissions
  • Photo-copy or faxes are not acceptable
  • Mail claims to address listed on upper right corner of HCFA 1500 form
  • Adherence to these guidelines will enable us to process your claims in at timely manner.

  Employer Update/Termination/Deletion Form   Credit Card Authorization
  Easy Choice Rewards Program Application   Age 29 Enrollment Form - Group Employees
  Health Insurance Claim Form (HCFA 1500)   HIPAA Authorized Form
  Catalyst Mail Order Form (IPS)   Employer Member Enrollment & Physician Selection Application

Other Resources

In addition, there are a variety of riders available to you and your employees which offer a number of prescription drug benefits, including mail order, vision benefits, student coverage and enhanced benefits for mental health/substance abuse and skilled nursing facilities.