Claim Forms

​Below, please find various flexible benefit claim forms to aid in the process of processing a claimed benefit. 

 

 

Claim FormsClaim Formshttp://doas.ga.gov/human-resources-administration/contact404-463-3589HRA.Flexbenefits@doas.ga.govClaim Formshttps://www.facebook.com/GeorgiaDOAS, DOAS Facebookhttps://twitter.com/GeorgiaDOAS, DOAS Twitterhttps://www.linkedin.com/company/georgia-department-of-administrative-services, DOAS LinkedInhttps://plus.google.com/+DepartmentofAdministrativeServicesAtlanta, DOAS Google PlusFlexible Benefits Specialist0

Claim Forms And Documents

01/13/15

Specified Illness Claim Form

01/13/15

Delta Dental Claim Form

01/13/15

Long Term Care Coverage Form

01/13/15

Blue View Walmart Claim Form

01/13/15

Accelerated Benefit Option Claim Form

01/13/15

Accidental Death & Dismemberment Claim Form

01/13/15

Life Waiver of Premium Claim Form

01/13/15

Vision ID Card Printing Instructions

01/13/15

Dependent Care Spending Account Claim Form

01/13/15

Health Care Spending Account Claim Form

01/13/15

Aflac CAIC Specified Illness Health Screening Form

10/17/17

How to File a Disability Claim

10/17/17

Disability Claim Form