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Forms & Manuals


Group Administration Manual
The redesigned, easy-to-use GAM keeps you on top of the latest administrative and legislative topics. The manual includes links to applications and forms, a qualifying events chart, billing information, summary of benefits and coverage details and much more.

eBilling User Guide - Special Funded Groups
(PDF, 1.6MB - updated 03/09)

You can find the CMS Creditable Coverage Disclosure Web page at http://www.cms.hhs.gov/creditablecoverage. On the left-hand column, you'll find useful links that can take you to the Disclosure to CMS Form. You will also find links that provide you the model disclosure language for Beneficiary Creditable and Non-Creditable Coverage to be used after Jan. 1, 2009.

Online Forms

Information about PDF Files The following forms were created with Adobe Acrobat. Visit the Adobe website to download the latest version of Acrobat Reader. Version 9.0 or higher is required.

Miscellaneous Forms

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Claim Forms

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SelectAccount Forms/Guides

* documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 or higher to view, download Adobe Acrobat Reader.