Forms & Resources
Weekly Cost Sheet
Enrollment Forms
Adoption Assistance Program
Beneficiary Forms
- PR 2022 Summary of Benefits and Coverage
- PR 2021 Certificate of Major Medical
- PR Medicare Part D
- PR 2022 Benefits at Separation
- Long-Term Cash Retirement Provision
- Transparency in Coverage – Machine Readable Files
- Triple S creates and publishes the MRFs for the medical plan offered in Puerto Rico. To link to the Machine-Readable Files, please click on the URL provided: https://salud.grupotriples.com/en/transparency-in-coverage-machine-readable-files/