General Board of Pension and Health Benefits Information

Health Insurance Benefit Information and Claim Forms

2009 Active Participant Rates
HealthFlex Rates and Impact on Local Churches

Benefit Summaries and Forms

Medical and Pharmacy - Active

• United Health Care (UHC)
  • EPO Benefits Summary
  • PPO Benefits Summary
  • OOA Benefits Summary
  • EPO Plan Booklet
  • PPO Plan Booklet
  • OOA Plan Booklet
• Medco Pharmacy
  • EPO Benefits Summary
  • PPO & OOA Benefits Summary
  • Prescription Drug Information
• Vision
  • VSP Benefit Summary

United Behavioral Health (UBH)

• EPO Benefits Summary
• PPO & OOA Benefits Summary
• EPO Benefit Booklet
• PPO & OOA Benefit Booklet

Dental - Active and Retiree

• Cigna HMO Dental
• Cigna Traditional Dental
• Cigna Dental Benefit Booklet
• Cigna Dental Claim Form

Medical and Pharmacy - Retirees

• Secure Horizons HMO Benefit Summary
• UHC Medicare Companion 2 Summary Sheet
• Medicare Companion 2 Pharmacy Plan
• Vision Care Plan

Reimbursements

• Ceridian MRA Claim Form
• Ceridian DCA Claim Form
• MRA - DCA Information
• MRA Over the Counter Drug List
• MRA Grace Period

Other Information

• Personal Health Screening Guidelines
• Wellness and You--Wellness Exam Benefits
• Wellness Guidelines
  • Age 10 and under
  • Age 11-24
  • Age 25-64
  • Age 65 and over

Some Abbreviations:

• EPO = Exclusive Provider Organization
• HMO = Health Maintenance Organization
• MRA = Medical Reimbursement Account
• OOA = Out of Area
• OTC = Over the Counter
• PCP = Primary Care Physician
• PPO = Preferred Provider Organization
• UBH = United Behavioral Health
• UHC = United Health Care
• VSP = Vision Service Plan

If a form that you need is not here, please contact Donna Hite at 303-733-3736 or 800-536-3736, ext. 150.

General Board of Pensions and Health Benefits web site

Web-based Health Assessment (GBOPHB)

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