Notice

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Friday, September 26th, 2025: Customer Service hours will be 9:45 AM – 4:00 PM ET for staff development.
To view benefit information and claim status at any time, you can sign into your account or use our Interactive Voice Response System 24/7 at 800-452-9310.

Standard Forms for Brokers

Easily access and download the standard forms and applications you need.

Authorization Form Granting Access to PHI  (PDF, 1 page, 52kb)