Better Health Benefits Start with Allegiance
Since 1981, the Allegiance Companies have earned a reputation for quality,
service, and efficiency unmatched throughout the country. Since its earliest days, our company has
been a leader in providing health benefit plans to employer groups and plan participants throughout
the United States.
We have always remained dedicated to one thing: outstanding customer service. That commitment continues today as strong as ever. Our corporate spirit has always been one of allegiance to the companies we serve. Our people are deeply committed to our clients and to plan participants.
Resources for Members
Health Forms
Health Enrollment Forms
- Dependent Disability Form
- Domestic Partner Affidavit
- Provider Nomination Form
- Authorization to Appeal
- Request an ID Card
Health Claim Forms
- Accident Questionnaire
- Authorization to Release Confidential Health Claim
- Alternate Payee Request Form
- Coordination of Benefits Questionnaire
- Continuity of Care
- Disability Application
- Verification of Dependent Eligibility
Claim Forms for Medical and Vision
Reimbursement Account Forms
Reimbursement Account Information (Flexible Spending And Dependent Care)
- Debit Card Information
- Flex Advantage Grace Period
- Medical Expenses
- Appeal Rights
- Medical Information Release Authorization
- Mobile App and Website Login Instructions
Claim Forms (Flexible Spending and Dependent Care)
Videos
Please Note: The walkthrough video reflects general login instructions. Please continue to log in using the login link on this custom site.
Take Allegiance On the Go
Our website offers personalized services at the click of a mouse. By registering, you will have 24
hour access to information regarding your health plan. You can check the status of a claim, review coverage
and benefits, and verify who is covered under your plan.
These services are also available through the Allegiance Mobile App available in Google Play and Apple App
stores.
Contact Us
2806 S. Garfield St.
P.O. Box 3018
Missoula, MT 59806
6:00 am - 6:00 pm PST
Customer Service 855-999-2261
Allegiance Holiday Closures
| New Year's Day | January 1st |
| Martin Luther King Jr. Day | Third Monday in January |
| President's Day | Third Monday in February |
| Memorial Day | Last Monday in May |
| Independence Day | July 4th |
| Labor Day | First Monday in September |
| Thanksgiving Day | Fourth Thursday in November |
| Friday after Thanksgiving | Fourth Friday in November |
| Christmas Eve | (1/2 day) December 24th |
| Christmas Day | December 25th |
Notice
For assistance regarding a claim or to pre-notify for medical services,
please call the customer service number at 855-999-2261.
CAA Customer Balance Billing Disclosure Out-of-Network