Medical Claim Form
NO LONGER REQUIRED! I would include a copy/scan of your insurance card for the first page however.
(CAN ONLY SWITCH PLANS STARTING FALL TERM)
(you’ll also need enrollment application filled out)
NOTE: if a NEW GE who has not been on plan before, you NEED to fill out APPLICATION first.
If you have questions, you can contact Glenn Morris, our health care administrator, at (541) 344-0832 or via email at firstname.lastname@example.org.
Forms and more can also be found on the Pacific Source Website: http://www.pacificsource.com/member/oregon/forms-and-materials.aspx
VARIABLE PREMIUM PAYMENT OPTION–check in with Glenn before using! (If paying just for summer, use the Summer Premium Payment option in the Health Care Menu drop down!)