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Benefits

Benefit resources

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Claims Forms

Claims Forms | Enrollment Forms | Other Forms & Info | Plan Documents

Health - Medical / Dental
Aetna Medical Claim Form   Acrobat Reader Required
Aetna Prescription Home Delivery Order Form   Acrobat Reader Required
YHP Claim Form   Acrobat Reader Required
Delta Dental Claim Form   Acrobat Reader Required
EyeMed Vision Claim Form   Acrobat Reader Required
Short Term Disability
Short Term Disability (STD) Telephone Filing Instructions   Acrobat Reader Required
Long Term Disability
Long Term Disability (STD) Telephone Filing Instructions   Acrobat Reader Required
Your Spending Account (YSA) Forms for Flexible Spending Accounts and Tuition Assistance (Reimbursement)
Medical/Dental Reimbursement Claim Form - YSA   Acrobat Reader Required
Statement of Medical Necessity (SOMN) - YSA   Acrobat Reader Required
Dependent/Child Care Reimbursement Claim Form - YSA   Acrobat Reader Required
Tuition Assistance (Employee) - YSA   Acrobat Reader Required
Life Insurance Documents
Standard Life Insurance - Death Claim Form   Acrobat Reader Required
Adoption Reimbursement
Adoption Reimbursement Claim Form   Acrobat Reader Required
Education Assistance
Tuition Reduction Application   Acrobat Reader Required

PDF format requires Adobe Acrobat Reader which can be downloaded from www.yale.edu/software.