Whether you focus on Medical, Dental, Vision, Disability, or supplemental products like Life, AD&D, Accident, Hospital Indemnity, Critical Illness, or something else, you’re bound to get a client request from time to time for a claim form.
What Are Claim Forms?
Claim forms are available for all sort of situations. Your clients may want to make a medical, prescription drug, dental, vision, life insurance, or AD&D claim. They may need to file paperwork related to a disability, supplemental health, or voluntary coverage claim.
Word & Brown delivers a broad range of products to help your clients. We offer more than 200 carrier and administrator claims-related forms available in our Online Insurance Forms Library. These include Individual, Small Group, and Large Group forms.
Most are self-explanatory, such as claim forms for Medical, Prescription Drugs, Dental, Vision, Life, AD&D, and Disability. Others are for advanced payout in the event of a critical illness diagnosis or reimbursement in connection with an accident. A few carriers offer collateral explaining their claims processes.
Group Health Claim Forms
Below is a roster of available forms, organized by product type and carrier. Bolding in the lists makes it easier for you to find the carrier/administrator for which you’re looking.
Medical and Prescription Claims
Aetna, Small Group, Commercial Prescription Drug Claim Form
Aetna, Small Group, Commercial Prescription Drug Claim Form, Spanish
Aetna, Small Group, Medical Claim Form
Aetna, Small Group, HMO Network Comparison Flyer, Southern California
Aetna, Large Group, HMO Network Comparison Flyer, Southern California
Aetna, Large Group, Nevada, Medical Claim Form/Benefits Request
Anthem, Ingenio Rx, Small Group, California, Prescription Reimbursement Claim Form
Anthem, Ingenio Rx, Large Group, California, Prescription Reimbursement Claim Form
Anthem Blue Cross, Individual, California, Medical Claim Form
Anthem Blue Cross, Small Group, California, Medical Claim Form
Anthem Blue Cross Blue Shield, Small Group, Nevada, Medical Claim Form
Anthem Blue Cross Blue Shield, Small Group, Nevada, Prescription Drug Claim Form
Anthem Blue Cross Blue Shield, Large Group, Nevada, Prescription Drug Claim Form
Anthem Blue Cross Blue Shield, Small Group, Nevada, Prescription Drug Claim Form, Spanish
Anthem Blue Cross Blue Shield, Large Group, Nevada, Prescription Drug Claim Form, Spanish
Anthem Blue Cross Blue Shield, Large Group, Nevada, Qualified Healthcare Expense Claim Form
Blue Shield of California, Small Group, California, International Claim Form
Blue Shield of California, Small Group, California, Prescription Drug Benefit Claim Form
Blue Shield of California, Small Group, California, Subscriber’s Statement of Claim
Blue Shield of California, Small Group, California, Waiver of Premium Claim Form
Cigna + Oscar, Small Group, California, Medical Claim Form
Cigna + Oscar, Small Group, California, Prescription Reimbursement Direct Claim Form
CalCPA (Anthem), Small Group, California, Medical Claim Form
CalCPA (Anthem), Small Group, California, Medical Claim Form
CalCPA (Blue Cross Blue Shield Global), Small Group, California, International (Medical) Claim Form
CalCPA (Express Scripts), Small Group, California, Prescription Drug Claim Form
CalCPA (Express Scripts), Large Group, California, Prescription Drug Claim Form
CaliforniaChoice, Small Group, California, Sample Professional Employer Organization (PEO) Letter
Evolved Benefits (Transamerica), Small Group, California, Claims Express Summary
Evolved Benefits (Transamerica), Large Group, California, Claims Express Summary
Evolved Benefits (Transamerica), Large Group, Nevada, Claims Express Summary
Health Net, Individual, Medical Reimbursement Form & Foreign Claim Questionnaire
Health Net, Individual, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish
Health Net, Small Group, Medical Reimbursement Form & Foreign Claim Questionnaire
Health Net, Small Group, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish
Health Net, Large Group, Medical Reimbursement Form & Foreign Claim Questionnaire
Health Net, Large Group, Medical Reimbursement Form & Foreign Claim Questionnaire, Spanish
Health Net, Large Group, California, Large Group Purchaser Claims Data Request and Attestation
Health Net, Small Group, Member Medical Reimbursement Claim Form
Health Net, Large Group, Member Medical Reimbursement Claim Form
Health Net, Small Group, California, Prescription Drug Claim Form
Health Net, Small Group, California, Prescription Drug Claim Form, Spanish
Health Net, Large Group, California, Prescription Drug Claim Form
Health Net, Large Group, California, Prescription Drug Claim Form, Spanish
Ingenio Rx (Anthem), Small Group, California, Prescription Reimbursement Claim Form
International Medical Group, Small Group, California, Claim Form and Authorization Filing Instructions
International Medical Group, Large Group, California, AGWM Claim Form and Authorization Filing Instructions
Nippon Life Benefits, Small Group, California, Medical Claim Form
Nippon Life Benefits, Large Group, California, Medical Claim Form
Oscar, Small Group, California, Member Claim Form
Prominence Health Plan, Small Group, Nevada, Member Claim Form (Medical/Dental/Vision)
Prominence Health Plan, Large Group, Nevada, Member Claim Form (Medical/Dental/Vision)
Prominence Health Plan, MedImpact, Small Group, Nevada, Medication Claim Form
Prominence Health Plan, MedImpact, Large Group, Nevada, Medication Claim Form
Sharp Health Plan, Individual, California, Prescription Reimbursement Claim Form
Sharp Health Plan, Small Group, California, Prescription Reimbursement Claim Form
Sharp Health Plan, Large Group, California, Prescription Reimbursement Claim Form
Sutter Health Plus, Small Group, California, Member Claim Form
Sutter Health Plus, Small Group, California, Prescription Reimbursement Claim Form, Express Scripts
Total Benefit Solutions, California, Small Group Medical Claim Form
Total Benefit Solutions, California, Large Group Medical Claim Form
Total Benefit Solutions, Nevada, Small Group Medical Claim Form
Total Benefit Solutions, Nevada, Large Group Medical Claim Form
UnitedHealthcare, California, Small Group, Medical Claim Form
UnitedHealthcare, California, Large Group, Medical Claim Form
UnitedHealthcare, California, Small Group, Prescription Reimbursement Request Form, OptumRx
Unum, Small Group, Nevada, Small Group, Claims Management Process Flyer
Unum, Small Group, Nevada, Large Group, Claims Management Process Flyer
Western Health Advantage, Individual, California, Claim Reimbursement Form
Western Health Advantage, Small Group, California, PDP Prescription Reimbursement Request Form, OptumRx
Western Health Advantage, Small Group, California, Provider Search Instructions
Western Health Advantage, Large Group, California, Provider Search Instructions
Dental Claims
Aetna, Small Group, California, Dental Claim Form
Ameritas, Small Group, California, Dental Claim Form
Ameritas, Small Group, California, Dental Claim Form, Spanish
Ameritas, Large Group, California, Dental Claim Form
Ameritas, Large Group, California, Dental Claim Form, Spanish
Ameritas, Small Group, Nevada, Dental Claim Form
Ameritas, Small Group, Nevada, Dental Claim Form, Spanish
Ameritas, Large Group, Nevada, Dental Claim Form
Ameritas, Large Group, Nevada, Dental Claim Form, Spanish
Ameritas, Large Group, Nevada, Dental Claim Form
Anthem Blue Cross, Small Group, California, Dental Claim Form
Anthem Blue Cross Blue Shield, Small Group, Nevada, Dental Claim Form
BEST Life, Small Group, California, Dental Claim Form
BEST Life, Small Group, Nevada, Dental Claim Form
BEST Life, Large Group, Nevada, Dental Claim Form
Blue Shield of California, Small Group, California,
Companion Life, Small Group, Nevada, Dental Claim Form
DeltaCare, Small Group, California, Claim Form
Delta Dental, Small Group, California, PPO Claim Form
Delta Dental, Small Group, Nevada, Claim Form
Delta Dental, Small Group, Nevada, PPO Claim Form
Delta Dental, CalCPA, Small Group, California, Claim Form
Delta Dental, CalCPA, Large Group, California, Claim Form
Delta Dental, MWG, Small Group, California, Claim Form
Delta Dental, MWG, Small Group, Nevada, Claim Form
Guardian, Small Group, California, Individual Dental Claim Form
Guardian, Small Group, Nevada, Group Dental Claim Form
Health Net, Individual, California, Dental Claim Form
Health Net, Small Group, California, Dental Claim Form
Health Net, Large Group, California, Dental Claim Form
Lincoln Financial Group, Small Group, California, Dental Claim Form
Lincoln Financial Group, Large Group, California, Dental Claim Form
Lincoln Financial Group, Small Group, Nevada, Dental Claim Form
Lincoln Financial Group, Large Group, California, Dental Claim Form
MetLife, Small Group, California, Dental Expense Claim Form
MetLife, Small Group, Nevada, Dental Expense Claim Form
Nippon Life Benefits, Small Group, California, Dental Claim Form
Nippon Life Benefits, Large Group, California, Dental Claim Form
Premier Access, Small Group, California, Dental Claim Form
Premier Access, Small Group, Nevada, Dental Claim Form
Principal, Small Group, Nevada, Dental Claim
Reliance Standard, Small Group, California, Group Dental Claim Form
Reliance Standard, Small Group, Nevada, Group Dental Claim Form
United Concordia Dental, Small Group, California, Specialty Referral Claim Form
United Concordia Dental, Large Group, California, Specialty Referral Claim Form
UnitedHealthcare, Small Group, California, Dental Claim
Unum, Small Group, Nevada, Dental Claim Form
Unum, Large Group, Nevada, Dental Claim Form
Vision Claims
Aetna, Small Group, California, Out-of-Network Vision Claim Form
Ameritas, Small Group, California, Vision Claim Form
Ameritas, Small Group, California, Vision Claim Form, Spanish
Ameritas, Large Group, California, Vision Claim Form
Ameritas, Large Group, California, Vision Claim Form, Spanish
Ameritas, Small Group, Nevada, Vision Claim Form
Ameritas, Small Group, Nevada, Vision Claim Form, Spanish
Ameritas, Large Group, Nevada, Vision Claim Form
Ameritas, Large Group, Nevada, Vision Claim Form, Spanish
Anthem Blue Cross, California, Small Group, Claim Form & Instructions, Blue View Vision, Out-of-Network
Anthem Blue Cross, Small Group, California, Vision Claim Form
BEST Life, Small Group, California, Vision Claim Form
BEST Life, Large Group, California, Vision Claim Form
BEST Life, Small Group, California, Vision PPO Claim Form (EyeMed)
Blue Shield of California, Individual, California, Vision Claim Form
Camden – Avesis, Small Group, Nevada, Vision Care Claim Form
Camden – Avesis, Large Group, Nevada, Vision Care Claim Form
Health Net, Large Group, California, Vision Out-of-Network Claim Form
Lincoln Financial Group, Small Group, California, Vision Claim Form (In-Network)
Lincoln Financial Group, Small Group, Nevada, Vision Claim Form (In-Network)
Lincoln Financial Group, Large Group, California, Vision Claim Form (In-Network)
Lincoln Financial Group, Large Group, California, Vision Claim Form (In-Network)
Lincoln Financial Group, Small Group, California, Vision Claim Form (Out-of-Network)
Lincoln Financial Group, Small Group, Nevada, Vision Claim Form (Out-of-Network)
Lincoln Financial Group, Large Group, California, Vision Claim Form (Out-of-Network)
Lincoln Financial Group, Large Group, California, Vision Claim Form (Out-of-Network)
MetLife, Small Group, California, Vision Out-of-Network Claim Form
MetLife, Small Group, Nevada, Vision Out-of-Network Claim Form
Nippon Life Benefits, Small Group, California, Vision Care Claim Form
Nippon Life Benefits, Large Group, California, Vision Care Claim Form
Premier Access, Small Group, California, Vision Care Claim Form
Premier Access, Small Group, Nevada, Vision Care Claim Form
Principal, Small Group, Nevada, Vision Care Claim Form
Reliance Standard, Small Group, California, Vision Group Claim Form
UnitedHealthcare, Small Group, California, Vision Plan Out-of-Network Claim Form
Vision Plan of America, Large Group, California, PPO Claim Form
VSP, Small Group, California, Out-of-Network Claim Form
Disability Claims
Anthem Blue Cross, Small Group, California, Short Term Disability Claim Form
Anthem Blue Cross Blue Shield, Small Group, Nevada, Employer Life & Disability Claims Guide
Anthem Blue Cross Blue Shield, Small Group, Nevada, Qualified Healthcare Expense Claim Form
BEST Life, Small Group, California, STD Claim Form
CalCPA/Lincoln Financial, Small Group, California, Group LTD Claim Form
Companion Life, Small Group, Nevada, Disability Insurance Claim Form
Guardian, Small Group, California, Group STD Claim Form
Guardian, Small Group, Nevada, Group STD Claim Form
MetLife, Small Group, California, Short Term Disability Claim Form
MetLife, Small Group, California, Long Term Disability Claim Form
Nippon Life Benefits, Small Group, California, Disability Claim Form
Nippon Life Benefits, Small Group, Nevada, Disability Claim Form, Spanish
Nippon Life Benefits, Large Group, Nevada, Disability Claim Form
Principal, Small Group, California, Short Term Disability Claim Form, Spanish
Principal, Small Group, California, Disability Claims FAQs
Reliance Standard, Small Group, California, LTD Claim Form
Reliance Standard, Small Group, California, LTD Claim Form
Reliance Standard, Small Group, Nevada, LTD Claim Form
Reliance Standard, Small Group, Nevada, Integrated STD, LTD, and Group Life Waiver of Premium Claim Form
Reliance Standard, Small Group, Nevada, STD Claim Form
Unum, Small Group, California, Disability Claims Management Process Workflow
Unum, Small Group, Nevada, Disability Claims Management Process Workflow
Unum, Small Group, Nevada, Claims and Customer Satisfaction
Unum, Large Group, Nevada, Claims and Customer Satisfaction
Unum, Small Group, California, Short Term Disability Claim Form
Unum, Small Group, California, Long Term Disability Claim Form
Unum, Small Group, Nevada, Short Term Disability Claim Form
Unum, Small Group, Nevada, Long Term Disability Claim Form
UnitedHealthcare, Small Group, California, Claim Form and Instructions for Group Short Term Disability, Employer
UnitedHealthcare, Small Group, California, Claim Form and Instructions for Group Long Term Disability, Employer
Supplemental Products
Guardian, Small Group, California, Submitting an Accident Claim
Guardian, Small Group, Nevada, Submitting an Accident Claim
Guardian, Small Group, California, Accident Claim Form
Guardian, Small Group, Nevada, Accident Claim Form
Guardian, Small Group, California, Submitting an Cancer Claim
Guardian, Small Group, Nevada, Submitting an Cancer Claim
Guardian, Small Group, California, Submitting a Critical Illness Claim
Guardian, Small Group, Nevada, Submitting a Critical Illness Claim
Guardian, Small Group, California, Critical Illness Hospital Admission Claim Form
Guardian, Small Group, Nevada, Critical Illness Hospital Admission Claim Form
Guardian, Small Group, California, Hospital Indemnity Claims Workflow
Guardian, Small Group, Nevada, Hospital Indemnity Claims Workflow
Principal, Small Group, California, Critical Illness Medical Claim Form
Principal, Small Group, Nevada, Critical Illness Medical Claim Form
UnitedHealthcare, Large Group, Nevada, Notice of Claim, Accelerated Benefits
Life and AD&D Claims
Anthem Blue Cross, Small Group, California, Individual Life Claim Form
Anthem Blue Cross Blue Shield, Small Group, California, Group Life Claim Packet
Anthem Blue Cross Blue Shield, Small Group, Nevada, Life Claim Package
BEST Life, Small Group, California, Dependent Death Benefits Claim Form
BEST Life, Small Group, Nevada, Dependent Death Benefits Claim Form
BEST Life, Small Group, California, Proof of Death Claim Form
BEST Life, Small Group, Nevada, Proof of Death Claim Form
Blue Shield of California, Small Group, California, Accelerated Death Benefit Claim
Blue Shield of California, Small Group, California, Dismemberment Claim Form
Companion Life, Small Group, Nevada, Dismemberment Claim Form
Companion Life, Small Group, Nevada, Group Life Insurance Claim Form
Guardian, Small Group, California, Instructions for Submitting a Group Life Claim
Guardian, Small Group, Nevada, Instructions for Submitting a Group Life Claim
Health Net, Large Group, California, Life Insurance Claim Form
Health Net, Large Group, California, Employer Life Insurance Claim Form
Health Net, Large Group, California, Employer Life Insurance Claim Form, Spanish
Humana, Small Group, California, Group Life Claim Form
Humana, Small Group, Nevada, Group Life Claim Form
Humana, Large Group, California, Group Life Claim Form
Humana, Large Group, Nevada, Group Life Claim Form
Lincoln Financial Group, Small Group, California, Life Claim Form
Lincoln Financial Group, Large Group, California, Life Claim Form
Lincoln Financial Group, Small Group, Nevada, Life Claim Form
Lincoln Financial Group, Large Group, Nevada, Life Claim Form
MetLife, Small Group, California, Life Claim Form
MetLife, Small Group, Nevada, Life Claim Form
Nippon Life Benefits, Small Group, California, Life Claim Form
Principal, Small Group, California, Group Life Claim Form
Principal, Small Group, Nevada, Group Life Claim Form
Reliance Standard, Small Group, California, Proof of Loss Claim Statement, Group Life/AD&D
Reliance Standard, Small Group, Nevada, Proof of Loss Claim Statement, Group Life/AD&D
UnitedHealthcare, Large Group, Nevada, Notice of Claim, Accelerated Benefits
Unum, Small Group, California, Portability Life and/or Accidental Death Claim Form
Unum, Small Group, California, Group Life and/or Accidental Death Claim Form
Unum, Small Group, Nevada, Group Accidental Dismemberment Claim Form
Unum, Large Group, Nevada, Group Accidental Dismemberment Claim Form
Voluntary Benefits
Aflac, Small Group, California, Cancer Indemnity, Cancer History Form, Payroll
Unum, Large Group, Nevada, Voluntary Claims Employer Flyer
Unum, Small Group, Nevada, Voluntary Claims Employer Flyer
Where to Get Claim Forms
Visit our Insurance Forms Library to download the form(s) you need. If you have questions, contact your Word & Brown representative or Broker Resources.
We add new forms to our Insurance Forms Library whenever we get updates from our carrier and administrator partners. Check back regularly to ensure you’re using the most recent forms.
