Community Meeting Request Form 
Paper Claim Form for Medicare members
Paper Claim Form for Non Medicare members
Mail Order Prescription Form for members only
Prescription Advantage Non Medicare Fact Sheet 
Prescription Advantage Medicare Fact Sheet
Instructions for Online Application Only
Non Medicare Prescription Value Guide
Prescription Advantage Disability Status Documentation
Prescription Advantage Income Documentation
Prescription Advantage Rate Schedule Guide for Members Eligible for Medicare
Prescription Advantage Rate Schedule Guide for Members Not Eligible for Medicare
Representative Authorization Forms
Please note: If you need assistance with any of these documents in any other language, please call our customer service line at 800-243-4636 for translation assistance.