Resources

We have created this page to provide you with easy and quick access to the various insurance forms you may need. As our customer, you can always count on excellent service from our agents and staff. If you do not find what you are looking for here, please don't hesitate to contact or call our office at (301) 214-7666 and your request will be answered as quickly as possible.

Insurance Forms

All forms are in PDF format.

AETNA

• Medical Benefits Claim Form

CareFirst

• Health Benefit Claim Form
• Authorization Form for Information Release
• Student Certification for Overage Dependent

DentaQuest

• Authorization for the Use and/or Disclosure of Protected Health Information

Guardian

• Authorization to Disclose Health Information

Humana

• Consent for Release of Personal and Health Information

MetLife

• Employer Instructions for Filing Group Life Insurance Claims
• HIPAA Authorization for Disclosure of Personal Health Information
• Long Term Disability Claim Form Employee Statement
• Disability Claim Form for Short Term Disability

United/MAMSI

• Health Insurance Claim Form
• Authorization for the Use and Disclosure of Information
• Confirmation of Full-Time Student Status for Health Benefits Eligibility