Group Business

Forms & Applications

Starting in 2017 Family Health Statements will no longer be required

Employer Application Master

Employee Application Form

Termination Form

Request for Waiver

Brochure

Drug Formulary

Please check for any of the following abbreviations after the prescription you look up.


PA – Prior Authorization – the doctor will have to give authorization to get the medication approved
ST – Step Therapy - you may have to try a different medicine to treat your condition before your plan will cover the medicine your doctor first prescribed for you
QL – Quantity Limit - the pharmacy may only be allowed to give you exactly enough medicine to cover a certain period of time

FIND A DOCTOR


This Link redirect you to a Quick Search that
allows you to search a doctor or facility by name.