Forms
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Forms

Member Forms

Click to download III-A Forms:

III-A Employee Enrollment Form

III-A Claims Form

III-A Employee Change Form

BCI Member Claim Form

Coordination of Benefits Form

Disabled Member Form

When submitting a form to the III-A that has personal information, please request a secure email from III-A staff or fax to 208-575-6423

Member Benefit Information

III-A Member Benefit Videos 2020-21:

Standard Plans

First Responder Plans