Benefits
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Insurance Information
Group insurance is open to public
libraries. Library must join group for employees to participate. Insurance
benefits include: major medical, dental, long term disability, short
term disability, and life insurance. Choose from Bronze, Silver, or Gold
plans.
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Resource
Allied Benefit Systems, Inc.
Check status of your claims and deductibles or research medical conditions and procedures in the knowledge base.
Plans
Several plans are available.
Choose the one that works best for you.
Gold
Plan: Effective July 1, 2007
Silver
Plan: Effective July 1, 2007
Bronze
Plan: Effective July 1, 2007
Preferred Provider Network (PPO)
Choose a physician or hospital in the selected network. Benefits are paid at a higher level.
Aetna Signature Adminstrators PPO
Forms
Medical
Allied Medical Claim
Allied Enrollment Application - Medical
Additions
Changes
Termination,
Certification and Cobra Initiation
Authorization
To Release Medical Information
Dental
Dental
Care Claim
Allied Enrollment Application - Dental
Prescription
Caremark / CVS (formerly AdvancePCS)
Refill a prescription online or check out the health resource section for drug interactions
Mail
Order Prescription Form
Mail Form to:
Caremark
P.O. Box 3223
Wilkes-Bare, PA 18773-3223
Prescription
Drug Claim Form
2006
Caremark Performance Drug List (formerly AdvancePCS Performance
Drug List)
Jefferson Pilot Financial
Insurance Co. / Lincoln Financial Group
New Enrollment Form
Request for
Change Form
