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Colonial life health wellness screening claim form

Health wellness claim form 2026

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The document provides instructions for filing a health/wellness screening claim with Colonial Life, including options for submitting claims via fax or online. It outlines the necessary information required from the claimant and policy owner, details on optional service agreements, and includes fraud warning statements mandated by various states. Additionally, it emphasizes the importance of completing the form accurately to avoid delays in processing claims.

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Click ‘Get Form’ to open the health wellness claim form in the editor.
Begin by filling out the Claimant Statement section. Enter your name, date of birth, and Social Security number. Indicate your relationship to the policy owner.
Complete the Policy Owner Information section if it differs from the claimant. Provide their name, date of birth, address, email, and contact number.
In the Type of Screening Test Performed section, list each test you underwent by filling in the corresponding dates in MM/DD/YYYY format.
Attach copies of bills for each test performed that include the facility or physician’s name and contact information.
Review all sections for completeness. Ensure you have signed and dated where required before submitting your claim.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (181 Votes)
2019	4.4 Satisfied (119 Votes)
2018	4.3 Satisfied (127 Votes)
2017	4.3 Satisfied (61 Votes)
2013	4.3 Satisfied (41 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I file a claim with Colonial Wellness?

If you dont want to file online, download the form you need by visiting the Claims Center page on ColonialLife.com and clicking on claim and service forms. You may fax your claim to 1-800-880-9325. Follow the instructions, tips and videos to complete and submit your claim.

How do I file a wellness claim with Cigna?

HOW TO FILE A. CLAIM FOR WELLNESS. INCENTIVE BENEFITS. Fax documents to our fax line at 1.866.304.3001. Email scanned documents to SuppHealthClaims@Cigna.com. Mail documents to. Cigna Supplemental Health Solutions. P.O. Box 188028. Chattanooga, TN 37422.

What are wellness claims?

Page 1. Aflac wellness claims pay you money for staying on top of your health by getting yearly checkups and medical screenings such as physicals, dental exams and eye exams. Most accident, hospital indemnity and cancer insurance policies have wellness benefits.

What does wellness mean in insurance?

Wellness plans may include products and services like* Dental and vision care, prescriptions, alternative health care and wellness screenings. Health coaching, fitness program planning and tracking, diet and nutrition planning, gym memberships, vitamins/supplements and immunizations.

What is an example of a wellness claim?

Some examples of wellness claims from non-traditional healthcare providers are: Receipt for a flu shot received at a drug store. Invoice for a smoking cessation program. Invoice from a weight-loss program.

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What is a health insurance claim Form 1500?

The Health Insurance Claim Form (CMS-1500) is used by Allied Health professionals, physicians, laboratories and pharmacies to bill supplies and services to the Medi-Cal program. Providers are required to purchase CMS-1500 claim forms from a vendor. Claim forms ordered through vendors must include red drop-out ink.

What is the wellness credit on my pay stub?

Some Aflac policies pay you money for staying on top of your health by getting routine checkups and medical screenings such as physicals, dental exams, eye exams and more. Most Aflac Accident, Hospital Indemnity and Cancer Insurance policies have wellness or health screening benefits. Accident Policies: Annual physical.

Health wellness claim form 2026

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