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American Medical Access Plan (AMA Plan) Forms
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| Click on the form name for a printable PDF version. |
| • Employee Application (over 500 employees) |
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| • Employee Application (under 500 employees) |
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| • Employer Participation Agreement |
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| • Claim Form |
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(These forms require Adobe Acrobat Reader to view and print.)
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American Benefit Administrative Services, Inc. / Third Party Administrators, Inc. |
1733 Park Street, Suite 300
Naperville, Illinois 60563
630-416-1111 • 800-736-7872 • Fax: 630-416-9310
© 2010 American Benefit Administrative Services, Inc. / Third Party Administrators, Inc.
Naperville, Illinois 60563
630-416-1111 • 800-736-7872 • Fax: 630-416-9310
© 2010 American Benefit Administrative Services, Inc. / Third Party Administrators, Inc.