Forms Directory

See below for a general list of forms that can be downloaded or printed. Please use the search bar or filter buttons to find a specific form. (Some forms may only be found behind your secure participant login.)

Filter
  • Blue Shield UCBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
  • Blue Shield UEBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
  • CA State Disability Insurance Form (EDD)
  • CA State Withholding Election Form
  • Death Beneficiary Designation Change Form
  • Direct Deposit Authorization Form
  • Dismemberment and Loss of Sight Form
  • Domestic Partner Declaration of Dependency for Tax Purposes
  • Elixir Designation of Personal Representative (English)
  • Elixir Designation of Personal Representative (Spanish)
  • Enrollment Tutorial
  • Federal Tax Withholding Form (W-4P)