Merck Benefits: Merck Benefit Forms

Although many benefit communications and processes are paperless, there are still some benefit forms to consider. If you are making benefit changes--or increasing certain coverages--you may need to complete one or more of the forms provided in the links below. Also, links to certain benefit claim forms are included here for your convenience.

• Medco by Mail Mail Order Form
• Merck's Adoption Assistance Program Reimbursement Form
• Employee Life Insurance and Survivor Income Insurance Proof of Good Health—Short Form
• Employee Life Insurance and Survivor Income Insurance Proof of Good Health—Long Form
• Employee Long-Term Disability Proof of Good Health Form
• Employee/Spouse Long-Term Care Proof of Good Health Form
• Aetna Medical Expense Claim Form
• Aetna Dental Expense Claim Form
• Aetna Health Care Account Claim Form
• Aetna Dependent Care Account Claim Form
• Aetna EFT Authorization Form
• AETNA Health Care Account Streamlined Submission Participation Form

This Web site is intended only as a guide to using the employee benefit programs available to eligible salaried, U.S.-based (and U.S. Expatriate) employees of Merck & Co. Inc., its divisions and the following subsidiaries... more >>