We offer online claims submissions for dental, paramedical services, vision and drug claims. Due to the documentation required, we can not offer online claim submission for Medical Travel or Co-ordination of benefits (second payor claims).
Cost Plus (PHSP) Benefit Claim Form - fillable
Cost Plus (PHSP) Benefit Claim Form - to print and manually fill out
Extended Health Claim Form - fillable
Extended Health Claim Form - to print and manually fill out
Please email your claims (receipts and signed claim Forms) to firstname.lastname@example.org.
Toll-free fax: 1-888-787-0727
We are here when you need us.
Talk to an advisor 8:30am to 4:30pm PST.