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Contacts

Forms

Affidavit of Domestic Partnership

Affidavit of Tax Qualified Dependents

Ohio Bureau of Workers Comp Form

Dental Claim Form

FSA Forms

HSA Forms

HIPAA Forms

Life/AD&D Forms

Medical Claims Forms

OptumRx Forms

AG Retirement Savings Plan Beneficiary Form

Vision Claim Form

Contacts/Forms Forms Landing page

May 15, 2024

Welcome to Benefit Forms

The Forms Menu on the left provides commonly used forms including claims forms. If you do not see the form you are looking for, go to the vendor website or call AGBenefits Advisor at (800) 397-9249.