.:: Morris Associates ::.

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BENEFIT

Employee Benefit Enrollment
Employee and Dependent Coverage Change Request
Request For Change
Dental Claim
Medical Claim
Vision Claim

FAX

Morris Fax Cover Page -- (Requires Microsoft Word) Use to submit faxes to either Customer Service, Claims, or Eligibility.

HIPAA

Spouse Authorization Form -- Allows spouse to receive PHI on entire family.
Non Custodial Parent or Guardian Authorization Form -- Allows Parent or Guardian to receive PHI on a particular child or children.
Blanket Authorization Form -- Allows a specific person to be able to receive PHI as long as the participant is covered under the plan.
Specific Authorization Form -- Allows a person to receive PHI for a specific event or claim.
Non Minor Dependent Authorization Form -- Allows Parent or Guardian to receive PHI for a non-minor dependent.

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