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Pharmacy Plan

     Medco Claim Form

     Medco Rx Mail Order Form

Claim Forms

     TRS-Active Care Claim Form

     Cigna Choice Fund (HRA) Reimbursement Request Form
     CIGNA HealthCare - Plan terminated 8/31/2011
     
     CIGNA Member Claim Form
     This form is for both the HRA and HMO plans - Plan terminated 8/31/2011

     Hospital Indemnity Claim Form

     Cancer & Specified Disease Plan - Claim Form (Humana)

     Cancer Plan Well Care Benefit - Claim Form (Humana)

     Cancer & Specified Disease Plan Claim Form (Hartford Life Ins. Co.)

     Cancer & Specified Disease Plan Claim Form (National Union Fire Ins. Co.)

     Cancer Plan Well Care Benefit Claim Form (National Union Fire Ins. Co.)

     Assurant Indemnity Dental Claim Form

     Unum Disability Claim Form & Instructions for completion

     Unum Disability Medical Treatment Claim Form

     Colonial Life - Accident Claim Form

     Colonial Life - Universal Claim


Change Forms:

     Mid-Year Plan Changes Instructions and Change Forms



Station & Ayers Insurance Planning Services, L.L.C.

P.O. Box 265
League City, TX 77574

Phone: (281) 333-9792
Fax: (281) 333-9223

E-mail: stationandayers@aol.com

© 2002 All contents are the property of Station & Ayers Insurance Planning Services, L.L.C.
Protected by the copyright laws of the United States of America. All rights reserved