Forms
This is your one-stop resource for the most commonly requested forms. If you’re unable to find what you’re looking for here, or if you have a question that isn’t answered, please email Client Services at [email protected] and we will handle your request promptly.
All forms, including these, can be accessed on the miBenefits portal.
Looking for information or
forms for miRx or miCare?
Please follow the links below:
Members
Health Plan Claims Forms
Pharmacy Mail-Order
Privacy Forms
Spending account forms (FSA, HRA, HSA)
Providers
User Guides and Sample Documents
Can’t find what you are looking for?
For all other forms and to access your account information, login to the miBenefits portal today.
