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Forms for all groups
- Oregon enrollment/change of status/waiver of coverage (PDF)
- Oregon enrollment/change of status/waiver of coverage – Spanish (PDF)
- Washington enrollment/change of status/waiver of coverage (PDF)
- Out-of-area dependent enrollment (PDF)
- Transition of care (PDF)
- Medical claim form (PDF)
- Alternative care claim form for providers (PDF)
- Mental health/chemical dependency claim form (PDF)
- Prescription drug reimbursement request form (PDF)
- Other member forms and notices
- Medicare secondary payer form and waiver (DOC)
Continuation of coverage forms
Health information disclosure forms for all groups
Dental insurance information for all groups
Oregon small-group forms
Washington small-group forms
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