Benefits
Health Forms and Resources
Medical - BlueCross BlueShield of Texas
Prescription - Prime Therapeutics
- Prescription Drug Claim Form
- PrimeMail New Prescription Fax Order Form
- PrimeMail Prescription Order Form
Dental - BlueCross BlueShield of Texas
Vision - VSP
Flexible Spending Accounts - Discovery Benefits
- Automatic Dependent Care Request Form
- Automatic Orthodontia Request Form
- Direct Deposit Enrollment/Change Form
- Reimbursement Request Form
- Instructions: Request a Debit Card Online
- Medical Necessity Form
- Receipt and Substantiation Form
Health Savings Account - BenefitWallet
Leave of Absence
- Family Medical Leave Act - Certification for Dependents
- Family Medical Leave Act - Certification of Health Provider
- Leave of Absence Form - Staff