Healthcare forms and useful links
Healthcare forms, useful links and additional information
Dental
Dental Claim Form (includes instructions and related documentation)
Healthcare forms, useful links and additional information
Dental Claim Form (includes instructions and related documentation)
Healthy Mouth = Healthy You
Key Health Insurance Words (video)
Medical Claim Form (Including instructions)
Medicare Supplement Plan Claim Form
Ordering medications from Express Scripts by mail (mail order pharmacy)
Prescriptions Claim Form (Express Scripts)
Employee Dependent Care Affidavit - Flexible Spending Account Dependent Care Reimbursement Account
Employee Health Care Affidavit - Flexible Spending Account Health Care Reimbursement Account
Health and Dependent Care Flexible Spending Account Claim Form
Click here to find the following IRS Publications located on the irs.gov website.
IRS Publication 502 - Medical and Dental Expenses
IRS Publication 503 - Child and Dependent Care Expenses
IRS Publication 2441 - Instructions for Child and Dependent Care Expenses
IRS Form 2441 - Child and Dependent Care Expenses
Anti-Malarial Mail Order Program Notice
ExxonMobil Expat Skill Center Letter to Employees Explaining the Program
ExxonMobil Malaria Chemoprophylaxis Prescription Fax Order Form