FORMS AND RESOURCES LIBRARY
For your convenience, electronic versions of some frequently used forms are provided below. For other forms, please contact the Welfare Plan office.
- PBC Claim Form – Active Employees
- PBC Claim Form – Retired
- Childrens Orthodontics Reimbursement Slips 2021
- Bereavement Wage Loss Reimbursement Form
- Jury Duty Reimbursement Form
- Pro-Rating on Dental/Hearing Aids – How it Works
PACIFIC BLUE CROSS BOOKLETS, ETC.
- Local 213 Active Employees Pacific Blue Cross booklet
- Local 213 Retired Employees Pacific Blue Cross booklet
- PBC Medi-Assist Brochure
MEMBER & FAMILY ASSISTANCE PROGRAM MATERIALS
- Members and Family Assistance Program Overview
- Homeweb – Online Resources Fact Sheet
- EFAP Orientation Registration