Forms and Resources

Forms - Enrollment & Updates

NOTE: If you receive a new Wyoming Driver's license, change insurance, or move to a new address please complete and submit a Renewal Form.

Forms can be submitted in one of the following ways:

 -Postal Service: 511 Running W Dr Suite 304 Gillette, WY  82718 - Email: - In-person: at either our Gillette Office    

Claim Forms


Hearing Aid Benefit information:

Please call the Gillette office (307-685-6827) or the Rock Springs office (307-352-2925) to confirm eligibility for hearing aid benefits prior to purchase.

-Members are eligible for a new set of hearing aids every 5 years.

- The benefit pays up to $3,000 for a new set of aids when eligible.

- Hearing aid repairs pay up to $250/aid twice for the life of the aid.

-NO over-the-counter hearing aids are covered through the Miner's benefits

Other Resources

Flowcharts to assist in understanding the process