Annual Claim Form - 2010
By now, you should have received your annual claim form. This form must be completed and returned to our office before April 30, 2010. Please click HERE to download the form if you have not received this form.
Please complete the claim form in its entirety, including the section regarding your dependents and any other insurance coverage you or your dependents may have. Be sure you and your spouse sign the form at the bottom.
Failure to complete this form in full may result in delay of payment of your claims, denial of your request for a vision claim form for you or your dependents, or denial of coverage for LASIK surgery for you or your spouse.