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    Tel: (866) 991-4900

    © 2020 by Baker Benefits Administrators, Inc.

    Forms Library

    Termination Form
    Termination Form
    Medical Release Form
    Medical Release Form
    Health Questionnaire
    Health Questionnaire
    Enrollment/Change Form
    Enrollment/Change Form
    2015 Data Request Letter
    2015 Data Request Letter

    To open the forms below, you must have a PDF document reader. We recommend Adobe Reader, which can be downloaded for free here: https://get.adobe.com/reader/

    Links & Resources

    Cigna Providers
    Cigna Providers
    To search for participating providers and facilities in the Cigna PPO Network, click here and select "PPO, Choice Fund PPO" as your plan type.
    PHCS Providers
    PHCS Providers
    To search for participating providers and facilities in the PHCS PPO Network, click here and select the logo that is shown on the front of your ID card.
    Christus Spohn Network
    Christus Spohn Network
    To view participating providers and facilities in the Christus Spohn PPO Network, click here.
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    To search for providers and facilities in your Network, please select the PPO Network identified on your member ID card and follow the on screen instructions.

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