Insurance



Instructions for the Medical Health Plan Changes:
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Health Plan Rates Schedule:
Benefit Schedule Rates
Alternate Plan Schedule

Temporary Health ID Card
ABA Temporary ID Card

Fast Track Medical Services - $10 CoPay
PCI Clinic
 Primary Care and Wellness Dr. Stinson

Urgent Care/Night Clinic
Urgent Care and Night Clinic Brochure

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: 

Optimum Imaging:
Optimum Imaging
 
Medical Plan Claim Forms:
Preferred Lab Facility Information: LabCorp
 
Flexible Spending Account Information & Claim Forms:
FSA Brochure What is FSA
FSA Medical Claim Form 
FSA Dependent Care Claim Form 
 
Voluntary Life Insurance:
Term Life and AD and D Brochure.

MetLife:
Accident Brochure - Spanish
Formless Claims Submission Flyer
Formless Claims Submission Flyer - Spanish

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COBRA Premium Rate Schedule - Need to contact the TPA ABA at 1-800-850-7166 for Rates.
 
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Worker's Compensation Insurance:
Workers Compensation Packet
Workers Compensation Packet (Spanish)
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Student Accident Insurance:
 
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Alternate to Social Security Information:
Annuity TPA (Third Party Administrator) Website:
www.tcgservices.com
403b Savings Plan
457b Savings Plan