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Document Center

Click on a link below to access forms to help administer your benefit program. If you do not see he form you are looking for, please contact us.


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Capital Blue Cross

Independence Blue Cross

Highmark

Highmark Northern

Western Highmark

UPMC

Aetna

Health America

PVMA Dental

IMPORTANT NUMBERS AND WEBSITE
  • Member Services: 800.332.0366
  • Billing/Enrollment: 888.32.3316
  • www.ucci.com

FORMS


Enrollment/Change Form

Pug Option

Labrador Option

Great Dane Option

PVMA Highmark Vision

General Census Forms