Health Forms and Documents:
Here you'll find helpful resources to make the most of your benefits, as well as some specific forms you may need throughout the year.
Benefit Documents
Gillespie County Resource Guide
Gillespie County SBC
Dental Plan Benefit Booklet
Dental Plan w/ No Ortho Benefit Booklet
TAC Vision Insurance informational flyer
Grandfathered Medical and RX Plan Benefit Booklet
Enrollment Forms
TAC HEBP Enrollment Change Form - All Products
Health Forms
BCBSTX Medical Claim Form
Compound Claim Form
Costco Pharmacy Mail Order Form
Direct Member Reimbursement
Navitus Claim Form
BCBSTX Dental Claim Form
Navitus Prescription Drug Formulary
BCBSTX COBRA Application
COBRA Notice
Other Forms
Life Insurance and Minor Beneficiaries Flier
Vision Forms
Davis Vision Member Flier
EyeMed Vision Discount Program
Voya Forms
Voya Accidental Dismemberment Claim Form
Voya Beneficiary Designation Form
Voya Pre-Populated Death Claim Form
Voya Attending Physician's Statement of Dismemberment Form
Voya EOI Form
Voya EOI Instructions
Voya Death Claim FAQ
Voya Consumer Privacy Notice
Voya Authorization for Release of Health-Related Information Form
Other Documents
Blue Resource Bouncing Back Poster
Blue Resource Hand Washing Poster
Summary Plan Descriptions:
These documents provide detailed summaries of your benefits and important information about claims and appeals.
Medical
Prescriptions
Dental
Vision
Life
Links & Contacts:
For each of the benefits listed below, you'll find important website links and contact information.
Medical
Prescriptions
Dental
Vision
Life Insurance
Other
Video Library
Naturally Slim
Welcome to Omada
Fraud during Covid-19