Benefits Overview

HPFR, Hypertension Prevention for First Responders

Body Scan - Inner Imaging

Whole-Life-Solutions-Overview_1093436310

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Vision-Now-Eye-Exam-Vision-Correction-Materials-Claim-Form-vision

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Waiver-of-Premium-Claim-Form

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Vision-Claim-Form-vision

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Term-Life-Solutions-Overview_1933669762

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SPECIFIED-HEALTH-EVENT-CLAIM-FORM

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remove-person-from-plan

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PROOF-OF-DEATH-PHYSICIANÔÇÖS-STATEMENT

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PHYSICIANS-TREATMENT-SUMMARY-accid-cancer-sickness

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PHYSICIAN-VISIT-BENEFIT-CLAIM-FORM

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NameChangeFormNY

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LONG-TERM-CARE-CONTINUING-CLAIM-FORM

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LONG-TERM-CARE-CLAIM-FORM

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Life-Rates-Whole-45k-100k-Tobacco-Bi-Week-2017

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LIFE-RATES-Whole-45k-100k-No-Tobacco-Bi-Week-2017

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INITIAL-DISABILITY-CLAIM-FORM

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HOSPITAL-INDEMNITY-CLAIM-FORM

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HOSPITAL-Choice-Brochure-NYB40175

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HOME-HEALTH-CARE-CLAIM-FORM

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hipaa-release-form

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HEALTH-SCREENING-WELLNESS-BENEFIT-CLAIM-FORM

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Disability-Guaranteed-Issue-Brochure-

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dental-claim-form

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DENTAL-Brochure-Level-3-2016

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CONTINUING-DISABILITY-CLAIM-FORM

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CHANGE_FORM_UNIVERSAL

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CANCER-WELLNESS-BENEFIT-CLAIM-FORM-cancer

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CANCER-VACCINE-BENEFIT-CLAIM-FORM

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CANCER-CLAIM-FORM

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Cancer-Care-Brochure-Classic-NY78375R

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CANCER-ANNUAL-CARE-BENEFIT-CLAIM-FORM

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BONE-MARROW-DONOR-SCREENING-BENEFIT-CLAIM-FORM

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BeneficiaryChangeFormNY

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BankDraftAuthorizationFormNY

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Application_for_Specified_Disease_Coverage

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Accident-Opt.4-Advantage-Brochure-NY36475-2018

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ACCIDENTAL-INJURY-CLAIM-FORM

See attached.

ACCELERATED-ADVANCED-DEATH-CLAIM-FORM

See attached.

UFADBA Education & Assitance Fund

All proceeds benefit the Uniformed Fire Alarm Dispatchers Benevolent Association Education and Assistance Fund, Inc. a not-for-profit 501(c)3 organization.