Claims and Enrollment

For your convenience we provide downloadable forms for claims and enrollment.
If you need assistance, please call us at 302-654-2590 or email to Benefits@hudsoninsurancegroup.com.


 
FORMS
Hudson Forms:
(H1)
Hudson Quotation Form
(H2)
Hudson Claim Form
(H3)
Hudson Census Form
   
Blue Cross Forms:
(BC1)
BlueAdvantage Application
(BC2)
BlueAdvantage Individual Application
(BC3)
Blue HSA Addendum and Authorization Form
(BC4)
Blue Easy Pay Plan
(BC5)
HIPPA Authorization Form
(BC6)
Blue Cross Medical History
 
Coventry Forms:
(COV1)
Enrollment / Change Form - Delaware Small Group
 
   
Hudson Insurance Group is a transparent extension of your employer’s HR Department.
HIG is here to assist you with the resolution of any claim issues you may have.

HIG needs the following items to assist you in the claim process
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NAIFA Website
    300 Martin Luther King Jr. Blvd. | Suite 100 | Wilmington, DE 19801 | Phone: 302.654.2590 | Fax: 302.654.2591 | Email


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