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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  • Authorization to Electronically Transmit Information (Pension)
  • Pension Credit Inquiry Form
  • Vacation Relief Request Form
  • UEBT Retiree Enrollment Form
  • Kaiser Medicare Election Enrollment Form
  • UEBT Retiree Other Insurance Information (OII) Form
  • Appointment of Personal Representative Form
  • Authorization to Release Medical Information
  • 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
  • Blue Shield UEBT OTC COVID Test Reimbursement Form for Medicare Retirees
  • Blue Shield UCBT OTC COVID Test Reimbursement Form Medicare Retirees