Member Forms

These forms are for our members to use in managing their benefit plans. The benefit plan forms posted here are general forms. Your employer may have made arrangements to create customized forms for your particular health plan. Should you require assistance or have questions please do not hesitate to call: (800) 249-8440

I want to

Login or register to online portal
Login to EBA&M HRA/FSA/debit card
Find a provider
Understand my EOB
Download forms
Email a claim
Know Your Health Plan Rights