This section contains the forms and documents currently in use at Alliant.
For your convenience, we have made the forms below fillable. To enable your computer to edit the forms, follow these instructions.
For a complete list of online Member forms and documents please go to the Members Forms and Documents page.
Broker Forms and Documents
Alliant Health Plans – Medical
Alliant Network Provider Search Instructions
PHCS Network Provider Search Instructions
PHCS Dual Network Carve Out List
Member Direct Reimbursement Rx Claim form
Alliant ID Card Mobile App Instruction Guide
Procedures Requiring Prior Authorization
Alliant Health Plans Covers Certain Preventive Care Services
SimpleCare Forms and Documents
Group Employer Enrollment Application
SimpleCare Employee Enrollment Form
SimpleCare Employee Enrollment Form with Medical
Group and Individual Auto Pay form (Spanish)
SimpleCare Certificates of Coverage