Available Documents

The following PDF documents are available for download. Please make sure your computer has Adobe Reader® installed. You may download it here if it is not installed.

  
 
 
Benicorp Customer Info guide
APC Authorization Form
Drug Claim Form
Prescription Mail Order Service
Prescription Medication Prior Authorization Drug List
Prescription Medication Prior Authorization Drug Guide
Customer Information Guide
Member Web Site Navigation Instructions (Iowa Members ONLY)
Disability Claim Form
Benicorp Financial Brochure
LabOne and Lab Card Letter to Clients
Late Enrollee Policy
Protected Health Information Authorization for Release Form
Claims Benefits Online Flyer
Eligibility Flyer
Doing Well by Doing Good
Envision Preferred Drug List Pocket Reference
 
 
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All text and images contained herein are the property of Benicorp.