[et_pb_section fb_built=”1″ fullwidth=”on” _builder_version=”4.22.1″ _module_preset=”default” background_image=”https:\/\/mybenefits.cc\/ekhealth2624\/wp-content\/uploads\/sites\/3694\/2020\/08\/medca-copy.png” border_width_top=”36px” border_color_top=”#404143″ global_colors_info=”{}”][et_pb_fullwidth_header title=”Forms” _builder_version=”4.16″ _module_preset=”default” background_enable_color=”off” global_colors_info=”{}”][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=”1″ custom_padding_last_edited=”on|desktop” admin_label=”section” _builder_version=”4.16″ background_color=”#ededed” min_height=”405px” custom_padding_tablet=”50px|0|50px|0″ custom_padding_phone=”” transparent_background=”off” padding_mobile=”off” global_colors_info=”{}”][et_pb_row column_padding_mobile=”on” admin_label=”row” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”0|0px|27px|0px|false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_tabs active_tab_background_color=”#9cb938″ inactive_tab_background_color=”#404143″ active_tab_text_color=”#ffffff” admin_label=”Coverage Tabs” _builder_version=”4.27.4″ tab_text_color=”#ffffff” tab_font=”|700|||||||” tab_font_size=”12″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” hover_enabled=”0″ border_color_all=”#d8d8d8″ use_border_color=”on” saved_tabs=”all” global_colors_info=”{}” sticky_enabled=”0″][et_pb_tab title=”Medical” _builder_version=”4.27.4″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}”]<\/p>\n
Healthnet Prescription Transition of Care Form (English)<\/a> Healthnet Prescription Transition of Care Form (Spanish)<\/a> [\/et_pb_tab][et_pb_tab title=”Dental ” _builder_version=”4.27.2″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}”]<\/p>\n Anthem Dental Claim Form<\/a><\/p>\n [\/et_pb_tab][et_pb_tab title=”Vision” _builder_version=”4.27.2″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}”]<\/p>\n Anthem Vision Claim Form<\/a><\/p>\n [\/et_pb_tab][et_pb_tab title=”Life & AD&D and Disability” _builder_version=”4.24.2″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}”]Guardian Beneficiary Designation Form<\/a> Healthnet Prescription Transition of Care Form (English)Healthnet Continuity of Care Request Form (English) Healthnet Prescription Transition of Care Form (Spanish)Healthnet Rx Claim Form (Spanish)Anthem Dental Claim FormAnthem Vision Claim FormGuardian Beneficiary Designation Form Guardian LTD Claim Form Guardian STD Claim Form Guardian Evidence of Insurability Form Guardian Portability vs Conversion Guardian Life Portability Form Guardian […]<\/p>\n","protected":false},"author":492,"featured_media":0,"parent":0,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-36","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/pages\/36","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/users\/492"}],"replies":[{"embeddable":true,"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/comments?post=36"}],"version-history":[{"count":0,"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/pages\/36\/revisions"}],"wp:attachment":[{"href":"https:\/\/mybenefits.cc\/ekhealth\/wp-json\/wp\/v2\/media?parent=36"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Healthnet Continuity of Care Request Form (English)<\/a><\/p>\n
Healthnet Rx Claim Form (Spanish)<\/a><\/p>\n
\nGuardian LTD Claim Form<\/a>
\nGuardian STD Claim Form<\/a>
\nGuardian Evidence of Insurability Form<\/a>
\nGuardian Portability vs Conversion<\/a>
\nGuardian Life Portability Form<\/a>
\nGuardian Life Conversion Form<\/a>
\nGuardian Accident Portability Form<\/a>
\nGuardian Critical Illness Portability Form<\/a>
\nGuardian Life Portability Rates<\/a>
\nGuardian Life Conversion Rates<\/a>
\nGuardian Wellness\/Health Screening Benefit Claim Form<\/a>[\/et_pb_tab][et_pb_tab title=”FSA \/ Commuter ” _builder_version=”4.24.2″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” hover_enabled=”0″ body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}” sticky_enabled=”0″]Paylocity FSA Claim Form<\/a>
\nPaylocity FSA Letter of Medical Necessity Form<\/a>
\nPaylocity Commuter Claim Form<\/a>[\/et_pb_tab][et_pb_tab title=”Voluntary” _builder_version=”4.24.2″ body_font=”||||” body_line_height=”2em” tab_font=”||||” tab_line_height=”2em” body_line_height_tablet=”2em” body_line_height_phone=”2em” tab_line_height_tablet=”2em” tab_line_height_phone=”2em” global_colors_info=”{}”]Guardian Accident Claim Form<\/a>
\nGuardian Wellness Benefit Claim Form<\/a>
\nGuardian Critical Illness Claim Form<\/a>[\/et_pb_tab][\/et_pb_tabs][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"