Member Service
Formulary Drug Listing:
Prior Authorization Drug Listing:
- Prior Authorization and Specialty RX Guidelines - 2022 2nd Quarter
- Prior Authorization and Specialty RX Guidelines - 2022 3rd Quarter
Specific Drug Listings for California group contracts:
Specific Drug Listings for Illinois group contracts:
Specific Drug Listings for New Jersey group contracts:
Specific Drug Listings for New York group contracts:
Specific Drug Listings for Texas group contracts:
- 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.