Forms and Handouts

Forms & Handouts

Benefits Forms

Benefits While Traveling: BCBS Core International Claim Form

BHS Member Reimbursement Form

Delta Dental Claim Form

Evidence of Insurability Forms: DIAM, DMAR, DMAT, DMMI, DMNC, DMTN, DPAM

Family Status Change: Mid-year changes to your benefits, if eligible, can be completed at myDENSObenefits.com. There is no form to complete.

MetLife Superior Vision Claim Form

Physician Screening Form (Healthy Horizons)

Reliance Life Insurance Beneficiary Form

Transition of Care: ExpressWay, MainStreet, or OpenRoad enrollees
Transition of Care: Surest

UMB HSA Beneficiary Form

Voluntary Accident Claim Form

Voluntary Critical Illness Claim Form

Handouts