Common Forms
This page includes only standard versions of our most-used forms. Many forms are specific to your policy or plan and aren't listed here. If you don't see what you need, please contact us or your benefits administrator.
Former Anthem Life customers should log in to get their claim forms.
| Title | Purpose | Action |
|---|---|---|
| New Jersey State Disability Claim Packet | Use this packet to file a claim through a New Jersey State Disability plan. |
Download |
| New York Paid Family Leave Bonding Leave Packet | Use this packet for file a claim for bonding leave under Paid Family Leave in New York. |
Download |
| New York Paid Family Leave Care of Family Member Packet | Use this packet for file a claim for care of family member leave under Paid Family Leave in New York. |
Download |
| New York Paid Family Leave Military Leave Packet | Use this packet for file a claim for military exigency leave under Paid Family Leave in New York. |
Download |
| New York State Disability Claim Packet | Use this packet to file a claim through a New York State Disability plan. |
Download |