American Fidelity Forms/Information - Pearl Public School District

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American Fidelity Assurance Disability Information

American Fidelity Assurance Company

Toll Free: 1-800-662-1113

Fax: 1-800-818-3453

Resource

Routine Pregnancy Claim Form

AFRoutinePregnancyClaimForm (PDF)

Hospital and GAP policy reimbursement form

AFHospitalandGAPpolicyreimbursementform (PDF)

Physician Expense Claim

AFPhysicianExpenseClaim (PDF)

Disability Claim Form

AFDisabilityClaimForm (PDF)

Extension of Disability Benefits Form

AFExtensionofDisabilityBenefitsForm (PDF)

FSA HSA Claim Reimbursement Claim Form

AFFSAHSAClaimReimbursementClaimForm (PDF)

Daycare reimbursement form

AFDaycarereimbursementform (PDF)