Quick access to claim forms

Health & Dental Claims

  • Pacific Blue Cross Extended Health Care Standard Claim Form
Mail completed health and dental claims forms directly to Pacific Blue Cross
  •  Dental Claim Form (usually provided by your dentist)
  • Pacific Blue Cross Out-of-Country Claim Form

 

  • Health Spending Account Form
  • Nexus National Accounts Claim Form
  • Nexus Health Spending Account Claim Form

Life/Disability Claims

  • Great West Life Life Claim Form
Mail completed Life/Disability claims forms to the bClear benefits Office
  • Great West Life Short Term Disability Employee and Physician Form
  • Great West Life Short Term Disability Employer Form
  • Great West Life Long Term Disability Employee and Physician Form
  • Great West Life Long Term Disability Employer Form

 

When filling out your claim form

  • Make sure all information on the form is completed in ink and is easy to read.
  • Incomplete or missing information will delay the claim processing, so take the extra time while filling out the form(s).
  • Donít forget to sign and date the form!