Ancillary Products

WELCOME to the new interactive BSG website. For your convenience, you can access employer account information, employer reports, and forms for your Flexible Spending Account(s), Max105 health insurance, HSA(s) and/or COBRA administered by BSG.
ADDRESS CHANGES: Address changes for the Flexible Spending Accounts, MAX105 health insurance , COBRA or Direct Dental may be E-MAILED to: barb@benefitservicesgroup.netFor your convenience, we have also provided links to a number of outside carriers. Our clients can now easily access forms, provider networks, order ID cards, etc. To use this feature, click on the web address for the insurance company.

Phone Number – 1-800-992-3522
Visit their home page – Welcome to Aflac.

 

Cancer Claim Form- -http://www.aflacny.com/us/en/docs/policyholders/claimforms/NY-S-00220.pdf
Injury/Accident Claim Form - http://www.aflacny.com/us/en/docs/policyholders/claimforms/NY-S-00198.pdf
Short Term Disability due to Accident/Injury - http://www.aflacny.com/us/en/docs/policyholders/claimforms/NY-S-00198.pdf
Short Term Disability due to Illness/Pregnancy – http://www.aflacny.com/us/en/docs/policyholders/claimforms/NY-S-2029.pdf


Phone Number – 1-800-365-4999
Visit their home page – Welcome to First Rehab Life.

 

Life/LTD Enrollment/Change Form – http://firstrehab.com/downloaddocument/forms/GDSNYF2.pdf
Vision Enrollment/Change Form – http://firstrehab.com/downloaddocument/forms/GVCNYF1.pdf
First Rehab Vision Claim Form - http://firstrehab.com/downloaddocument/forms/GVCNYF2.pdf
100% Solution Claim Form - http://firstrehab.com/downloaddocument/forms/GMRNYF2.pdf
Disability Claim Form - http://firstrehab.com/downloaddocument/forms/DBLNYF2.pdf


Phone Number – 1-800-858-6843
For Employees 1-800-421-0344
Visit their home page – Welcome to Unum.

 

Claim Instructions for Disability, Life etc. – disability insurance, life insurance, supplemental insurance, cancer insurance, accident insurance, long term disability, LTD, long term care, short term disability, group disability, benefits administration, income protection, individual coverage, group cove


Phone Number – 1-800-275-4638
Visit their home page – Welcome to Met Life.

 

Online Change Of Address – Forms Library – MetLife
Dental Claim Form – https://eforms.metlife.com/wcm8/cmsclient/eForms_PROD_Deployment/3400/3226.pdf


Phone Number – 1-716-652-4604
Visit their home page – Welcome to National Benefit Life.

 

 


Phone Number – 1-860-547-5000
Visit their home page – Welcome to the Hartford Group

 

Life and disability claims - The Hartford Group Benefits – Claim Questions