Forms & Applications
- Accidental Dismemberment or Loss of Sight Claim Form
- American Fidelity Health Savings Account
- Application for Life Premium Waiver- For use by Entities with the EGID Disability Plan
- Application for Life Premium Waiver–For use by Entities without the EGID Disability Plan
- Application for Medicare Advantage Prescription Drug (MAPD) Plan
- Application for Medicare Supplement With Prescription Drug Plan
- Application for Retiree/Vested/Non-Vest/Defer Insurance
- Beneficiary Designation Form
- Certification of Previous Coverage
- Change of Address Form
- Disability Benefits Beneficiary Designation
- Disability Reimbursement Agreement
- Durable Power of Attorney
- Electronic Fund Transfer Authorization
- Life Insurance Claim Form Packet
- Medicare Complaint Form - Health or Prescription Coverage
- Medicare Part D Prescription Claim Form
- Prescription Reimbursement Claim Form
- TRICARE Supplement
