Employee Forms Procedure
Employee Enrollment Form
Employee Change Form
Employee Termination Form
Employee Declination of Coverage Form
OneAmerica Life Insurance Beneficiary Form
III-A EAP Claim Form
Acupuncture Claim Form
When submitting a form to the III-A that has personal information, please request a secure email from admin@iii-a.org or fax to 208-575-6423. Must have Adobe Reader.
III-A Claims Form
ProAct Direct Member Reimbursement Form
BCI Member Claim Form
Coordination of Benefits Form
Disabled Member Form
