UEBT Active Premier Enrollment Form
UEBT Active Ultra Enrollment Form
UEBT Active Annual Verification Form
UEBT Active Other Insurance Information (OII) Form
Adopted or Step Child Verification Form
Appointment of Personal Representative Form
Authorization to Release Medical Information
Benefits Registration Form
Blue Shield UEBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
Blue Shield UCBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
UCBT Active Premier Enrollment Forms Packet
UCBT Standard Clerk's Helper Enrollment Forms Packet