Forms and Information
Below you'll find links to information and forms, which you can view or download and print.
Enrollment Material
Medical SOB
This document outlines your medical benefits. For a complete explanation of your plan, login and review your SPD (Summary Plan Description) on the "Plan Documents" page.
2009 Enrollment Kit
This kit contains all the 2009 benefit enrollment information, including the Health Enrollment Form and the HealthEZpay Application.
Network Forms/Documents
Finding a Doctor in the First Health Network
If you need to find a provider in the First Health network, this tip sheet will help.
Health Savings Account (HSA) Forms
Transfer Funds Request Form
Use this form to authorize U.S. Bank to receive a transfer of assets directly from an HSA, Archer MSA or IRA trustee or custodian or a direct rollover
from an FSA or HRA into your U.S. Bank HSA.
Pharmacy Forms & Information
Caremark Mail Service Order Form
Use this form for mail order prescriptions from Caremark.
How to Use Mail Order
Use this informational brochure to learn more about the Mail Order program.
Generic Drugs - Big Savings
Save big by getting generic drugs at the pharmacy instead of brand name.
Generic Drugs - FDA Approved
The FDA has to approve all drugs whether or not they are brand or generic, meaning that they are all safe for consumers.
Generic Drugs - Better Value
Generic drug companies spend less money on marketing and research and pass these savings along to you.
Caremark Web Site Information
Manage your family's prescription benefits in one convenient location.
Other Forms/Documents
Common Healthplan Terms
This document provides some easy definitions of terms you may find in your health plan.
Don't pay at the doctors office
Increase your take-home amount by utilizing these cost savings tips: 