Quick Forms

Membership

• BRS Membership Form (pdf)

Health Insurance

• Health Insurance-New Group Sign Up Forms

Health Savings Account Enrollment Forms

• BRS First Horizon Msaver Application (pdf)
• BRS Chittenden Bank Application (pdf)

COBRA and HIPAA Administration

• Workflow and Procedures (pdf)
• Cobra Member Sign-Up Checklist (pdf)
• Cobra Services Agreement Sign-Up (pdf)

Prescription Drug Plan

• Prescription Transfer Form (pdf)
• One-time Registration Form (pdf)

Download BRS forms as PDF files. PDF requires the free Adobe Acrobat Reader [Download Now]