Insurance

Notices:

Instructions for the Medical Health Plan Changes:

_________________________________________________________________________________________

Health Plan Rates Schedule:

Health Plan Provider and Facility Lookup:
Independent Medical Systems (IMS)
Call 1-800-853-7003 or go online at http://www.imsppo.com

90 Day Retail Pharmacy Network:
SISD Retail 90 Day Pharmacy Network List

RX Mail Order Form:
Prescription Mail Order Form

Imaging Centers:

PCI - Preventative Care Institute:

PCI Brochure

Mission Regional Medical Center:

Mission Regional Medical Center

Plan Claim Forms:

Medical Plan Claim Form

Preferred Lab Facility Information: LabCorp

Flexible Spending Account Information & Claim Forms:

Health Benefit
Health Screening Claim MyBenefits Instructions
Health Screening Claim Form

Cancer
Cancer Plan Claim Form

Hospital Indemnity
Hospital Indemnity Claim Form

Critical Illness
Critical Illness Claim Form

Accident

*********************************************************************************************

COBRA Premium Rate Schedule - Need to contact the TPA Frates at 1-800-850-7166 for Rates.

***********************************************************************************************

Student Accident Insurance:

Student Voluntary Accident Enrollment Form

************************************************************************************************

Alternate to Social Security Information:

457b FICA Alternative Plan

Annuity TPA (Third Party Administrator) Website:
www.tcgservices.com
403b Savings Plan
457b Savings Plan

SHARYLAND