SBCs, Forms & Legal Docs

Eligibility

• Dependent Verification Requirement
• Domestic Partner Tax Certification Form

Medical

• BCBS Disabled Dependent Certification Form
• BCBS Medical Claim Form

Prescription Drug

• 2026 Express Scripts National Preferred Formulary (includes exclusions)
• 2026 Preventive Medications Drug List
• Kaiser Permanente Drug Formulary
  (select your Region > Large Employer Group Plans (50+ Employees))

Vision

• VSP Vision Out-of-Network Claim Form

COBRA

• COBRA Change Form
• Inspira Financial Depositor Authorization Form

Retirees

• 2026 BMO Medical Election/Waiver Form