2021 Employer group plan and coverage documents

Mail order, automatic payment and claims documents

  • Coverage redetermination
    If you are appealing a previously denied coverage decision, use the forms below.

Drug policies and programs

  • High-risk medication alternatives
    See alternatives for some commonly prescribed high-risk medications. Talk with your doctor or pharmacist if you re interested in learning more about alternatives for high-risk medications.

Appointing a representative and confidential information documents

  • Appoint a representative
    You can choose someone to file grievances, request coverage decisions and redeterminations on your behalf.
  • Our privacy practices
    Learn how information about you may be used and disclosed and how you can get access to this information.

Medicare resources