For Specific Coverage - Corporate Solutions 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Policyholder's name and specific deductible in the designated fields.
3. Fill in the Contract and Policy Year details, followed by the Employee's information including their name, date of birth, and ID number.
4. Complete the Claimant section with relevant details such as their relationship to the employee and date of birth.
5. Indicate if the claimant is active, a COBRA participant, or a retiree by selecting 'Yes' or 'No' where applicable.
6. Provide diagnosis codes using the ICD-10 format for both primary and secondary diagnoses.
7. Review all entered information for accuracy before submitting your form via email to RS_notifications@swissre.com.

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