{"id":3720,"date":"2025-07-07T18:26:40","date_gmt":"2025-07-07T18:26:40","guid":{"rendered":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/?page_id=3720"},"modified":"2025-07-23T14:12:39","modified_gmt":"2025-07-23T14:12:39","slug":"claim-forms","status":"publish","type":"page","link":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/claim-forms\/","title":{"rendered":"Claim Forms"},"content":{"rendered":"<div class='flex_column av-2v3aou0-7bc1472b89957380b5b721fb3f233008 av_one_full  avia-builder-el-0  avia-builder-el-no-sibling  first flex_column_div '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mctflonr-acf9b1214a17769c6168837e2c5c482f\">\n#top .av-special-heading.av-mctflonr-acf9b1214a17769c6168837e2c5c482f{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-mctflonr-acf9b1214a17769c6168837e2c5c482f .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-mctflonr-acf9b1214a17769c6168837e2c5c482f .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-mctflonr-acf9b1214a17769c6168837e2c5c482f av-special-heading-h3  avia-builder-el-1  el_before_av_table  avia-builder-el-first '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Claim Forms<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<div class='avia-data-table-wrap av-2ud4oso-dc5b4d660e6197462928785641136b40 avia_responsive_table avia-table-1'><table  class='avia-table avia-data-table avia_pricing_default  avia-builder-el-2  el_after_av_heading  avia-builder-el-last '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/Table\" ><tbody><tr class='avia-heading-row'><th class=''>Benefit<\/th><th class=''>Provider<\/th><th class=''>Claim Form<\/th><\/tr><tr class=''><td class=''>Vision<\/td><td class=''>Superior Vision<\/td><td class=''><a href=\"https:\/\/ffbenefits.ffga.com\/wp-content\/uploads\/sites\/2392\/2025\/07\/Member-Reimbursement-Claim-Form-Superior-Vision.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Claim Form<\/a><\/td><\/tr><tr class=''><td class=''>Disability<\/td><td class=''>One America<\/td><td class=''><a href=\"https:\/\/ffbenefits.ffga.com\/wp-content\/uploads\/sites\/2392\/2025\/07\/G-28203Employee_FILLABLE.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Claim Form<\/a><\/td><\/tr><tr class=''><td class=''>Accident<\/td><td class=''>The Hartford<\/td><td class=''><a href=\"https:\/\/www.thehartford.com\/benefits\/myclaims\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Claim Form<\/a><\/td><\/tr><tr class=''><td class=''>Cancer<\/td><td class=''>American Public Life<\/td><td class=''><a href=\"https:\/\/ffbenefits.ffga.com\/wp-content\/uploads\/sites\/2392\/2025\/06\/CLFORM-Cancer-Fillable-Midlothian-ISD-EN.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Cancer Claim Form<\/a><\/p>\n<p><a href=\"https:\/\/ffbenefits.ffga.com\/wp-content\/uploads\/sites\/2392\/2025\/06\/clform-wellness-Midlothian-ISD-EN.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Wellness Claim Form<\/a><\/td><\/tr><tr class=''><td class=''>Critical Illness<\/td><td class=''>Wellfleet<\/td><td class=''><a href=\"https:\/\/lighthouse.wellfleetinsurance.com\/Employee\/account\/create\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Claim Form<\/a><\/td><\/tr><tr class=''><td class=''>Hospital Indemnity<\/td><td class=''>Wellfleet<\/td><td class=''><a href=\"https:\/\/wellfleetworkplace.com\/wp-content\/uploads\/2023\/01\/Wellfleet-Hospital-Indemnity-Claim-Form-1.1.23.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Claim Form<\/a><br \/>\n<a href=\"https:\/\/wellfleetworkplace.com\/wp-content\/uploads\/2023\/01\/Health-Screening-Claim-Form-1.1.23.pdf\" target=\"\u201d_blank\u201d\" rel=\"noopener\">Health Screening Claim Form<\/a><\/td><\/tr><\/tbody><\/table><\/div><style type='text\/css'>.avia-table-1 td:nth-of-type(1):before { content: 'Benefit'; } .avia-table-1 td:nth-of-type(2):before { content: 'Provider'; } .avia-table-1 td:nth-of-type(3):before { content: 'Claim Form'; } <\/style><\/p><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3720","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/pages\/3720","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/comments?post=3720"}],"version-history":[{"count":16,"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/pages\/3720\/revisions"}],"predecessor-version":[{"id":3986,"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/pages\/3720\/revisions\/3986"}],"wp:attachment":[{"href":"https:\/\/ffbenefits.ffga.com\/midlothianisd\/wp-json\/wp\/v2\/media?parent=3720"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}