All forms must be delivered to the office of Employee Benefits at
708 Palm Blvd.
Brownsville, TX 78520

BISD Benefits
Core Plan Highlight Sheet
High Plan Highlight Sheet
State Plan Highlight Sheet

BCBS-TX Forms
Rate Sheet
Statement of Responsibility for a Dependent Child
Request for Continued Coverage for Incapacitated Child
Statement for Determination of Eligibility for Common Law Spouse
Service Request Forms

Accidental Insurance
AFLAC - Accidental Injury Claim Form
AFLAC - FSA Separation of Plan Form
AFLAC - Change in Status Form

Cafeteria Plan
Cafeteria Plan

Hartford Life Insurance
Hartford Life Insurance Claim Form

Prescription Forms                                                          Prescription Mail Order
Prescription Claim Form                                               Prescription Fax Form                                                           www.myprimemail.com

Colonial Forms
Colonial Claim Forms