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Express Scripts COB Form

Complete this form to submit a claim to for pharmacy purchases.

Express Scripts COB and Reimbursement Form

Do you have an employment related question? Contact AskHR. Did you find what you were looking for? Provide feedback about this website. This information was last updated on June 29, 2020
Categories: Forms, Health and Wellness Forms.

Division of Human Resource Management

For inquiries or to schedule an appointment, contact us.

4315 S 2700 W
Suite 2100
Salt Lake City, Utah
84184

Phone: (801) 957-9380
Fax: (385) 465-6054
Dial 711 or TTY: 800-346-4128

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