Fringe Benefits Plans for Government Contractors

Members: Claim Forms

How to submit a claim

At our FCE office in Texas, we provide a wide variety of Claims Administration services, including:

1. Approving, processing and paying medical, prescription, dental, vision and short term disability
2. Coordinating benefits between FCE plans and other benefit plans
3. Identifying and describing benefits to providers
4. Explaining benefits to participants and their advocates
5. Processing and paying Medicaid, Medicare, Champus and Tricare reimbursement
6. Administering and collecting subrogation and other third party obligations
7. Monitoring, identifying, preparing, filing and recovering stop loss obligations

The following claims forms are available for download for FCE administered benefits (Note: these forms can be completed online. Simply place your cursor in the space provided and start typing. Press the Tab Key to the progress through the document. Then, print out the form, sign, and return to us using one of the means below):

• Medical
• Dental
• Vision
• Disability

Claims Mailing Address:
Hard copies of claims may be mailed to the following address for processing:

FCE Benefit Administrators, Inc.
4615 Walzem Road, Suite 300
San Antonio, TX 78218-1610