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 Forms Library

 
December 2011 - December 2012 Plan Year Forms
 December 2011 - December 2012 ALLtech Group Master Application Click Here
 December 2011 - December 2012 ALLtech Enrollment & Waiver Form Click Here
January 2011 - November 2011 Plan Year Forms
  January - November 2011 ALLtech Group Master Application Click Here
  January - November 2011 ALLtech Enrollment & Waiver Form Click Here
July 2010 - December 2010 Plan Year Forms
  July 2010 -- December 2010 ALLtech Group Master Application Click Here
  July 2010 -- December 2010 ALLtech Enrollment & Waiver Form Click Here
Insurance Carrier Claim and other Forms
   Voluntary Waiver of A.I COBRA Services Click Here
   COBRA Carryover Form Click Here
  ODS Deductible Credit Form Click Here
  ODS Prescription Drug Reimbursement Form Click Here
  ODS BioScrip Mail Order Prescription Form Click Here
  ODS Postal Prescription Service Mail Order Prescription Form Click Here
  ODS Transition of Care Form Click Here
  ODS Claim Form Click Here
  WDS Claim Form Click Here
  VSP Member Reimbursement Form Click Here
Life and Disability
  The Standard  STD Claim Form Click Here
  The Standard  LTD Claim Form Click Here
  The Standard  AD&D Claim Form Click Here
  The Standard  Accelerated Benefits Claim Form Click Here
  The Standard Individual Life Conversion Form Click Here
   The Standard Evidence of Insurability Form Click Here
  The Standard Waiver of Premium Form Click Here

The Standard Insurance Company does not issue a proof of death form. All that is required is the submission of a 'Certified Death Certificate."
 


 

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