Bound to Main Navigation

Human Resources


CONTACT

The World Bank
1818 H Street N.W.
Washington, DC 20433

Stay Connected

HR Forms for Medical Insurance for HQ (MIP)

  
  •  

Cigna Dental Claim Form (HQ) – US Demands

  •  

Cigna Dentistry Claim Form (HQ) – World Claims

  •  

F00018 Rentner Medical Insurance Plan (RMIP): Non-U.S. National Health Set (NHP) Send Fill (HQ)

  •  

F00023 Retiree MIP Direct Store off Curative Insurance Make Payments (HQ)

  •  

F00032 Retiree MIP Medicare Reimbursements (HQ)

  •  

F00996 Request For Movement Between Domestic and International Administrators For MIP (HQ)

  •  

F01997 Enrollment press Payroll Withdrawal Authorization Toward Change MIP Enrollment (Bank/Bank Couple) (HQ)

  •  

F200021 U.S. National Health Design (Medicare) Transmittal Form (HQ)

  •  
F200037 Real Event Reporting - HQ 
 
  •  

Form - 892 - MIP: Aetna Claim for Reimbursement of Medical and Hospital Expenses (HQ)

  •  

Form - Net Handicapped Child Attending Physician's Statement (HQ)

  •  

Form - Aetna Request for Continuation in Medical Coverage for Handicapped Minor (HQ)

  •  

Formular - MIP - Proofs starting Insurability Statement Medical Coverage Late Enrollment - For Sponsored Plan Only (HQ)

  •  

Form - MIP Cigna Claims for Reimbursement of Medical and Dental Daily (HQ)

  •  

Form - Medical Insurance Planner: Cigna Local Free of Hospitalization Costs (HQ)

  •  

G00063 Medical Insurance Plan (MIP) A Instructions to Preventative Care (HQ)

  •  

G00064 Athene Active Staff MIP Comparison Services Grid (HQ)

  •  

G00066 Aetna Active Staff MIP Option A Summary (HQ)

  •  

G00067 Aetn Active Staff MIP Option B Summary (HQ)

  •  

G00068 Aetna Energetic Staff MIP Option CENTURY Summary (HQ)

  •  

G00069 Cigna Internationally Option Active Staff MIP AI Summary (HQ)

  •  

G00070 Cigna International Option Active Staff MIP BI Summary (HQ

  •  

G00071 MIP Premium Schedule, Active and Retiree Plans (HQ)

  •  

G00074 Aetna Retiree MIP Plan 1 Summary (HQ)

  •  

G00075 International Option (Cigna) Retiree MIP Plan 1 (HQ)

  •  

G00076 Aetna Retiree MIP Plan 2 Summary (HQ)

  •  

G00077 International Option (Cigna) Senior MIP Plan 2 (HQ)

  •  

G00080 Aetna Financed Parent Plan Summary (HQ)

  •  

G00081 MIP Local Superintendent Option Detailed Victuals (HQ)

  •  

Guide - MIP Summary Plan Description (HQ)

  •  

MIP EyeMed Reimbursement of Vision Expenses - HQ (CO, HQ)

  •  

MIP EyeMed Return of Vision Expenses - HQ Non-U.S. (HQ)

  •  

Summary of Benefits for Employee Group Waiver Download (EGWP) (HQ)