Benefits Forms
Access your documents.
Forms
The Joint Health Management Board (JHMB) seeks to make it easier for participants in the District’s health plan to have quick access to important forms related to our benefit offerings. Simply download the form you need, complete it, and return it to the appropriate vendor/office noted on the form.
Address & Life Event Changes
Dental
- Delta Dental – Claim Form (Coming Soon)
Medical
- Delta Health Systems – Accident/Illness Questionnaire (Coming Soon)
- Delta Health Systems – Coordination of Benefits Letter
- Delta Health Systems – Designation of Authorized Representative (Coming Soon)
- Delta Health Systems – Medical Claim Form
- Kaiser Permanente – Emergency Claim Form
- Kaiser Permanente – HIPAA Release Form