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Benefits

Benefit resources

Other Yale benefits

Claims Forms

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

Health - Medical / Dental
Aetna Medical Claim Form   Acrobat Reader Required
YHP Claim Form   Acrobat Reader Required
Delta Dental Claim Form   Acrobat Reader Required
EyeMed Vision Claim Form   Acrobat Reader Required
Flexible Spending Account and Commuter Benefits
Medical/Dental Reimbursement Claim Form   Acrobat Reader Required
Dependent/Child care Reimbursement Claim Form   Acrobat Reader Required
Commuter Benefits Cash Reimbursement Form- Parking only   Acrobat Reader Required
Commuter Benefits Interim Claim Form- Transit only   Acrobat Reader Required
Life Insurance & Long-Term Disability
Standard Long-Term Disability Benefits Claim Form   Acrobat Reader Required
Standard Life Insurance - Death Claim Form   Acrobat Reader Required
Retirement
YURAP Distribution Request
MS Word Document
  
YHP Retiree Major Medical Claim Form   Acrobat Reader Required
The Hartford Supplemental Medical Claim Form    
Other Claim Forms
Tuition Assistance - Employee   Acrobat Reader Required

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