2010 Client Appreciation     site map    faq    contact info
Employee Benefit Management Services, Inc - EBMS

"EBMS has the uncanny ability to predict future trends in healthcare and provide valuable solutions through expertly designed services and technology."

---Doug, Regional Sales Director, Stop-loss carrier

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Downloadable Forms and Information
    Automatic Orthodontia Flex Reimbursement
   Auto Flex Election Form (PDF)  

    EBMS Accident Letter (PDF)

    EBMS Claim Form (PDF)
    EBMS Provider Authorization (PDF) 
    Enrollment Form (Printable)
    FLEX Brochure (PDF)
    FLEX Direct Deposit Authorization Form (PDF)
    FLEX Eiligible Expense Reference List (PDF)
   FLEX Enrollment Form (Downloadable) 
    FLEX Reimbursement Form (Downloadable)
    FLEX Reimbursement Form Including Parking/Transportation (Downloadable)
    Request For HRA Reimbursement (PDF)

    Cobra Brochure (PDF) 
    Cobra Brochure- Spanish (PDF) 
    Wyoming Miners Benefit Registration Form (PDF) 
    Wyoming Miners Health & Rx Assisst Form (PDF)
    Wyoming Miners Hearing Aid Form (PDF)
    Wyoming Miners Hearing Aid Assist Form (PDF)
 

 
 

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