EXC-SHP-Print Forms

Use the links below to print/view copies of our most frequently used forms.

Prescription Claim Forms

Claim Forms

Flexible Spending Account or Medical Reimbursement Account

General Forms

Membership & Enrollment Forms

Reimbursement Forms

Some forms may not apply to your coverage and benefits. To obtain other forms not listed here, please contact Customer Services.

GLO-Print Forms - 1095B sidebar

Form 1095-B

Taxpayers are not required to include a Form 1095-B when filing their taxes.

Health insurers are no longer required to mail Form 1095-B to their members.

Click Learn More for your options.

Learn More