Foreign Service Benefit Plan (FSBP)

Click here for frequently asked questions about our recovery services.

Click here for the online Reimbursement Questionnaire. You must have your Username and Password to access.

Click here for the online Settlement Survey. You must have your Username and Password to access.

FSBP Brochures
The FSBP member’s obligations concerning liability insurance and third party actions (subrogation) are described in the annual plan brochures. Below you will find links to recent editions of the FSBP brochures, with the relevant on-line page referenced for convenience:

			Year 2010 FSBP brochure (see pages 78-79)
			Year 2009 FSBP brochure (see pages 79 and 80)
			Year 2008 FSBP brochure (see page 77)
			Year 2007 FSBP brochure (see pages 75 and 76)
			Year 2006 FSBP brochure (see page 76)
			Year 2005 FSBP brochure (see page 75)
			Year 2004 FSBP brochure (see page 64)
			Year 2003 FSBP brochure (see page 61)
			Year 2002 FSBP brochure (see page 61)
			Year 2001 FSBP brochure (see page 65)
			Year 2000 FSBP brochure (see page 33)

FSBP Individual’s Authorization for Release of Information Form
Below is a link to the FSBP Individual’s Authorization for Release of Information Form used to confirm the direction of an individual that we use or disclose Protected Health Information (PHI) for a particular purpose.

		Individual’s Authorization for Release of Information (FSBP)
		Assignment of Proceeds of Recovery/Reimbursement Agreement (Attorney)
		Assignment of Proceeds of Recovery/Reimbursement Agreement (Enrollee)