Forms - The Florida Bar Member Benefits Insurance & Retirement Programs

Misc./Payments/Billing

Monthly Auto Pay Form »
Coverage Cancellation Form »
Coverage Documents Delivery Receipt Form »

Dental/Vision

PPO Dental/Vision eApplication »
ID Cards & Policy Documents »
Vision Claim Form (.pdf) »

Long Term Disability

LTD eApplication »

Term Life/AD&D

Term Life eApplication »
Term Life Enrollment Kit (.pdf) »
AD&D eApplication »
Beneficiary Change Form for Term Life/AD&D (.pdf) »