Check here for important information and forms to help direct your care as a CHP member.
If you are a Medicare member, click here for Medicare forms.
Fitness Center Reimbursement
(For more information on the reimbursement program or to see a list of facilities offering discounts to CHP members, check our Health & Fitness Section)
Protecting your privacy:
Assign someone to represent you in accordance with HIPAA regulations:
Provide verification of eligibility for dependents who attain or exceed age 19. For more information on dependent eligibility determination, click here (pdf 30.38 kB) .
Important: These forms are for Capital Health Plan members and enrolled employer groups only. Electronic submission will not be accepted. Members must submit signed forms to their Personnel Office for processing:
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