Forms Directory

See below for a general list of forms that can be downloaded or printed. Please use the filter buttons to help search for a specific form by category. Some forms may only be found behind your secure participant login.

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  • OTC COVID Test Reimbursement Form for UEBT Blue Shield Plan Actives and Non-Medicare Retirees
  • OTC COVID Test Reimbursement Form for UCBT Blue Shield Plan Actives and Non-Medicare Retirees
  • OTC COVID Test Reimbursement Form for UEBT Medicare Retirees
  • OTC COVID Test Reimbursement Form for UCBT Medicare Retirees
  • Kaiser 2022 Medicare Election Form
  • UEBT Preventive Care Guidelines 2022
  • Kaiser 2022 HIPAA Authorization Form