Forms & Documents

For Employees

MIT Traditional Health Plan
- MIT Traditional Health Plan – Summary of Benefits
- MIT Traditional Health Plan – Summary of Benefits and Coverage
MIT Choice Plan
- MIT Choice Plan – Summary of Benefits
- MIT Choice Plan – Summary of Benefits and Coverage
MIT High Deductible Health Plan
Other MIT Health Plan resources
- Physician Order Form (for patients who have any MIT-sponsored health plan and who want to have tests ordered by their outside provider done at MIT Medical)
- Express Scripts Drug Claim Form (for prescription drugs)
- Blue Cross Blue Shield forms