Member Service
Formulary Drug Listing:
Prior Authorization Drug Listing:
Specific Drug Listings for California group contracts:
Specific Drug Listings for Illinois group contracts:
- Drug List/Formulary 2024 IL
- Prior Authorization and Specialty RX Guidelines – 2024 IL
- Notice of Changes – 2024 IL
Specific Drug Listings for New Jersey group contracts:
Specific Drug Listings for New York group contracts:
- Drug List/Formulary – Q4 2023 NY – For all renewals prior to 4/1/2024
- Drug List/Formulary – Q2 2024 NY – For groups with renewal dates of 4/1/2024, 5/1/2024 and 6/1/2024
- Drug List/Formulary – Q3 2024 NY – For groups with renewal dates of 7/1/2024, 8/1/2024 and 9/1/2024
Specific Drug Listings for Texas group contracts:
2024
Available upon each group’s 2024 renewal- Drug List/Formulary – 2024 TX
- Prior Authorization and Specialty RX Guidelines – 2024 TX
- Notice of Changes – 2024 TX
- Prior Authorization Request Form for Prescription Drug Benefits - TX
2023
Available prior to group’s 2024 renewal- Precertification
- Claim forms: Looking for a claim form? You may print or download one of the following forms to use.
Standard Claim Forms
Medical
Dental
Vision
Life
Disability
Want to look up the status of a claim? Or review your benefits? Register and log in to our member portal to have immediate access to all of the information you need about your insurance coverages.