Background Image

Managing Your Account is Easy

Welcome to the downloadable forms resource page for Moose members. Here you will find all of the necessary forms and applications you need to manage your account, process a claim or apply for additional Moose benefits.

Downloads

Welcome to the downloadable forms resource page. Files are available in PDF format to be downloaded, printed and mailed accordingly. Acrobat Reader is a free application that can be downloaded at adobe.com/reader/.

Mail all claim forms to the following address:
AGIA Affiliate Services
Claims Department
P.O. Box 9060
Phoenix, AZ 85068

Form Product Form Type Download
Claim Form Cancer Care CIGNA Cancer Care Insurance Plan Claim Form Download
Claim Form Cancer Care TransAmerica Cancer Care Insurance Plan Claim Form Download
Claim Form Hospital Help CIGNA Hospital Help Plan Claim Form Download
Claim Form Hospital Help TransAmerica Hospital Help Plan Claim Form Download
Claim Form Life Insurance TransAmerica Senior Term Life Claim Form Download
Term Life Application Senior Term Life Enrollment Application Download