Health Benefits Forms

Health and Dental Plan

• Blue Cross Health Services Claim Form (2011)
• Blue Cross Dental Claim Form (2011)
• Blue Cross Out of Province, Out of Country Claim Form ( 2011)
• AHS Appointment of Beneficiaries Form (2011)

Flexible Spending Account (for use as of September 1, 2011)

• Blue Cross Health Spending Account Claim Form (2011)
• Personal Spending Account Claim Form (2011) - you will need to log in to the secure part of the Blue Cross plan member website to access this form. Once inside the site, navigate to the "Forms" area to use the Taxable Spending Account Form that is prepopulated with your name and address and includes a list of expenses that are eligible under your specific plan.