Below are links to benefit forms that you can download, print and fill out.

• Address Change Form
• Beneficiary Designation Form
• Caremark Mail Order Form
• Caremark Claim Form
• Contact List
• Dependent Care Spending Account Form
• Designation of Authority
• Flexible Spending Account Reimbursement
• Health Reimbursement Arrangement (HRA) Claim Form
• HIPAA form 2020
• Medical Pretreatment Estimate Form
• Member Communication/Complaint Form
• Municipal Preferred Providers
• Travel Expense Voucher
• Travel Preauthorization Form (Trust Fund)
• Vision Service Plan Out of Network Reimbursement Form
• Zenith Medical/Dental Claim Form

Click Here to read the latest Health Trust Newsletter