Home
Calendar
About CTSI
CTSI Board
CTSI Staff
Loss Prevention
Class List
The Pools
CAPP
CHP
CWCP
Members Only
County
Special Districts

Technical Updates
2008
2007
2006
2005
2004

Health Awareness
2008
2007
2006
2005
2004
Links
Special Programs
Online Claims
Contact Us
CHP Forms & Documents

These documents are mostly in Adobe Acrobat format. If you do not already have Acrobat installed please download the free reader.

County Health Pool - Frequently Asked Questions

Medical Summary Documents

2009 Plan A Benefit Summary
2009 Plan B500 Benefit Summary
2009 Plan B1000 Benefit Summary
2009 Plan HSA HDHP Benefit Summary

2008 Plan A Benefit Summary
2008 Plan B500 Benefit Summary
2008 Plan B1000 Benefit Summary
2008 Plan HSA HDHP Benefit Summary

Medical Plan Documents

2009 Plan A SPD
2009 Plan B500 SPD
2009 Plan B1000 SPD
2009 Plan HSA HDHP 2500

2008 Plan A SPD
2008 Plan B500 SPD
2008 Plan B1000 SPD
2008 Plan HSA HDHP 2500

Medical Documents & Forms

Medical Claim Form
CDL Physical Claim Form
Health Fair Claim Form
Flu Shot Claim Form

Dental &Vision Documents & Forms

2009 Dental Plan A Summary
2009 Dental Plan B Summary
2009 Dental Comparison Summary

2009 Dental Plan A SPD
2009 Dental Plan B SPD

2008 Dental A Summary
2008 Dental B Summary
2008 Dental Comparison Summary

2008 Dental Plan A SPD
2008 Dental Plan B SPD

2009 Vision Benefit Summary
2009 Vision Plan Document

2008 Vision Plan Document

Attending Dentist Statement Form

Dental Claim Form for Medical Procedures

Prescription Forms

Prescription Drug Claim Form
Prescription Drug Mail Order Form

Other Documents

CHP HIPAA Privacy Notice
"Who to Call" Reference Sheet


County Technical Services, Inc.
800 Grant Street, Suite 400 · Denver, Colorado 80203 · ctsi@ctsi.org
phone 303.861.0507 · fax 303.861.2832 · claims line 1.800.544.7868