First Financial Group of America manages all supplemental benefits and insurances except medical. If you need a form to file a claim with one of these other insurances, please click the link below:
First Financial Group of America
Below are links to our Disability Claim Forms. Once they are completed, you will send them to us. We will submit them to the insurance company for you. Please DO NOT write ANY information in the EMPLOYER portions of these forms.
(tool tip...if the forms below open in a new window and nothing appears, open your downloads folder on your computer, right-click on the form and "Open With" Adobe Acrobat.)
American Fidelity Long Term Disability Claim Form
American Fidelity Long-term Disability Extension Claim Form
Manhattan Life Maternity Disability Claim Form
Manhattan Life Short-term Disability Claim Form
Manhattan Life Short-term Disability Continuation Form
For all of these forms, please fill your portion of the claim out, have your physician fill the physician portion out and return the ENTIRE form to this office at [email protected] or [email protected].
Looking for your Cancer Wellness Screening Benefit Claim Form?
Allstate Wellness Claim Form
Guardian Wellness Claims Form
Diagnosed with Cancer and need to make a claim?
Guardian Cancer Claim Form
Adding/Dropping a dependent or spouse to/from your health plan? You will need to complete an enrollment form.
Health Insurance Enrollment Form
(tool tip...if the form opens in a new window and nothing appears, open your downloads folder on your computer, right-click on the form and "Open With" Adobe Acrobat.)
HSA Contribution Form
Need help calculating your HSA contribution, here is a link to Health Equity to help you do that.
HSA Contribution Calculator
Looking for the Catapult Health PCP form? Click this link: Catapult Health PCP Form