Forms
NBPA provides the necessary forms for enrollment, enrollment changes and other status changes. These forms can be printed and filled out by the appropriate broker, group representative or member. If you need assistance choosing and/or filling out these forms, or need to know where to send them, please contact us.
Please note that you will need Adobe Acrobat to gain access to these documents. You can download the software for free from the Adobe web site.
NBPA Enrollment Changes
NBPA Generic Claim Form
NBPA Authorization for release of Health Information
NBPA Caremark HIPAA Authorization
NBPA Caremark Claim Form
NBPA Short-term Disability Claim