You can fill in all these forms directly on
the web by typing in the appropriate spaces. Then just print
the form, sign where necessary, and send to the Plan
Administrator.
You need Adobe Reader for these forms to work.
If you do not have Adobe Reader you can download it by
clicking on the link below.
Download:
Adobe Reader 
Extended Health Benefits Claim Form (223 KB)
Weekly Income Benefits Claim Form (104 KB)
