10/1/2009
Member Travel Reimbursement Request

Benefit changes made to the Self Transport Reimbursement Program effective November 1, 2009. 

Changes include:

A Request for Taxpayer Identification Number and Certification (W-9) is included with the new Travel Reimbursement Form .  The W-9 must be completed and submitted before any checks can be issued.

Please be sure to download the new form and start using it immediately or contact Member Services for a copy of this revised form.  Call 800-336-3874 with any questions.  

Travel Reimbursement Request

Capstone Health Plan