Claim Forms
- Hospital Indemnity and Outpatient Surgery Claim Form & Instructions
- Rapid Pay Income Replacement Form & Instructions
(Ask your employer if you are eligible for Rapid Pay claim processing.)
- STD Claim Form & Instructions
- LTD Claim Form
- Life and AD&D Claim Form
- Beneficiary Designation Form
- Authorization to Disclose Health-Related Information
- Davis Vision Claim Form
(Mail completed form to Vision Care Processing Unit, P.O. Box 1525, Latham, NY 12110)
