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> Forms & Brochures
Forms & Brochures
All files below are in Adobe PDF format
Applications
Student Application
Dependent Application
Informational Brochures
Insurance Plan Brochure
Global Assist Brochure
Claims Materials
NIU Claim Form
Authorization of Release of Confidential Health Insurance Claims Information
Pre-existing Conditions Form
Accident Information Form
Coordination of Benefits (COB) Form
Designation of Authorized Representative (DAR) Form
