Group Enrollment/Change Form
Group Enrollment/Change Form (Spanish)
Group Medical Claim Form
Group Dental Claim Form
Group Vision Claim Form
FSA / Flex Benefits Forms
Flexible Benefits Enrollment/Change Form
Flexible Benefits Plan Claim Form
HRA Claim Form
HRA Enrollment/Change Form
Authorization to Obtain Records
Authorization to Obtain Medical Records (Spanish)
Claims - Pre Cert Form
Claims - Request of Accident Details
Claims - Request for Accident Information (Spanish)
Claims - Request for Other Insurance Information
Claims - Request for Other Insurance Information (Spanish)
Claims - Request for Primary EOB/Secondary EOB
Claims - Request for Student Status
Claims - Request for Student Status (Spanish)
Request for HIPAA Certificate
Request for HIPAA Certificate (Spanish)
Request for Physicians Seen
Request for Physicians Seen (Spanish)
Health Risk Assessment
Health Risk Assessment (Spanish)
Sample Explanation Of Benefits
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HealthComp's Online Eligibility, Open Enrollment and Claims Inquiry System.
Online applications, including HCReporting.
HealthComp's Online Flexible Spending Account Site. For additional information contact your Employer.
A listing of provider directories.
Provider Claim Search
Secure provider search for claim status.
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Mailing Address: P.O. Box 45018, Fresno, CA 93718-5018
Phone: (800)442-7247 Fax: (559)499-2464