Claim Forms
Enrollment Forms
Open the enrollment form below, download it and save it to your computer. Once saved, open that file, fill in all necessary fields, save the completed form again and attach and email it to the IDA Enrollment Department.
OptumRx Forms
Express Scripts Forms
ProAct Forms
Miscellaneous Forms
Regulatory Forms
Cigna Forms & Programs
All Others
- Healthy Rewards - English / Spanish
- Active & Fit Healthy Rewards - English / Spanish
- Active & Fit Q&A - English
- Ask & Save - English / Spanish
- Care & Equipment - English
- Cost & Quality - English / Spanish
- Flu Shots- English
- Vaccine Program Participating Pharmacies - English
- Hearing Aid Program- English
- Know Your Plan- English / Spanish
- Medical Supplies Home Delivery- English
- Save on Labs- English / Spanish
- Save on Radiology- English / Spanish
- Substance Abuse Treatment - English
Aetna Programs
Brightline Behavior Health Program
- Announcing Brightline Behavior Health Program
- Pediatric Behavioral Health
- Get to Know Brightline
- Here's What's Covered
- How to Get Started
- Mobile Registration Instructions
- Brightline Videos
- Video - The Brightline Experience: Build for kids and teens, here for you
- Video - The Brightline Experience: Build for kids and teens, here for you (short)
- Video - The Brightline Experience: What's Different about Brightline's Care Model?
- Video - The Brightline Experience: How is coaching different than therapy?
- Video - The Brightline Experience: What are the benefits of teletherapy?
Transparency In Coverage - Machine Readable Files
In-Network Files
- Aetna
- AmeriHealth
- Anthem/Empire
- CIGNA
- Firsthealth
- MagnaCare
Out-Of-Network Files
- Reliant
- Zelis
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