Publications

• BlueCross BlueShield Network S - 2021
• Cigna LocalPlus Network - 2021
• Cigna Open Access Plus Network - 2021
• NOTE: The information in the PDF directory is only 100% accurate on the day it is printed. It is not uncommon for this information to change as providers and facilities join and leave the carrier's networks. You can find the most up to date information by calling member services or doing an online search.
  

• 2021 Eligibility and Enrollment Guide — State and Higher Education  - REV 1/21
• 2021 Eligibility and Enrollment Guide — Local Education - REV 1/21
• 2021 Eligibility and Enrollment Guide — Local Government REV 1-21

• 2021 Guide to Continuing Insurance at Retirement — State and Higher Education
• 2021 Guide to Continuing Insurance at Retirement — Local Education
• 2021 Guide to Continuing Insurance at Retirement — Local Government

• 2021 BlueCross Member Handbook
• 2021 Cigna Member Handbook

• CVS Caremark Handbook
• Preferred Drug List
• Medications Requiring Prior Authorization
• Maintenance Tier Drug List
• Pull out Guide — Premier PPO
• Pull out Guide — Standard PPO
• Pull out Guide — Limited PPO
• Pull out Guide — CDHP/HSA
• Pull out Guide — Local CDHP/HSA
• Pharmacy Benefits as a Result of Health Reform

• 2021 DPPO — MetLife
• 2021 MetLife DPPO Benefit Summary
• DPPO Dentist Nomination Form
  
• DPPO Dental Claim Form
• DPPO Certificate of Coverage
• DPPO Certificate of Coverage - AK
• DPPO Certificate of Coverage - LA
• DPPO Certificate of Coverage - MS
• DPPO Certificate of Coverage - MT
• DPPO Certificate of Coverage - TX
• DPPO MetLife Teledentistry
• MetLife Mobile App Overview Flier

• 2021 Prepaid Plan — Cigna
• Prepaid Plan Flier (2021)
• Prepaid Plan -- Local Education and Local Government (2021)
• Prepaid Plan -- Retirees (2021)
• Prepaid Plan -- State and Higher Education (2021)
• Prepaid Plan Dental Lab Fees Flier
• Prepaid (DHMO) Dentist Nomination Form
• Prepaid Dental Certificate of Coverage - 2021
• Prepaid Dental Patient Charge Schedule - 2021
• Prepaid Dental Patient Charge Schedule, AZ Members - 2021
  
• Prepaid Dental Patient Charge Schedule, CA Members - 2021
• Prepaid Dental Patient Charge Schedule, IL Members - 2021
• Prepaid Dental Patient Charge Schedule, TX Members - 2021
• Prepaid Dental Patient Charge Schedule, WA Members - 2021

• Prepaid Dental Cigna DHMO Identity Theft Program
• Cigna Dental Virtual Care Flier

• Higher Education Short Term Disability Handbook (2021) - REV 03/01/2021
• State Short Term Disability and Long Term Disability Handbook (2021) - REV 03/01/2021
• STD Disability Insurance FAQ - Pregnancy
  
• State and Higher Education: Short Term Disability Insurance Certificate
• State Only: Long Term Disability Insurance Certificate
• State and Higher Education: Short Term Disability Insurance Certificate for Terminated Employees
• Disability Claims Process Overview for State
• Disability Claims Process Overview for Higher Education
• MetLife Mobile App Overview Flier

• Group Basic Term Life/Basic AD&D Certificate (sample)  — effective 3-1-2021
• Group Voluntary Term Life Certificate (sample) — effective 3-1-2021
• Group Voluntary AD&D Certificate (sample) — effective 3-1-2021
• Term Life and AD&D Highlights
• Term Life and AD&D Summary
• Securian Financial (MN Life) Member Handbook & FAQ
• Securian Financial (MN Life) Legacy Planning and Travel Assistance
  
• Securian Financial (MN Life) Travel Assistance
• Voluntary Universal Life FAQ
• Securian Financial Benefit Scout Flier

• Brochure - 2021
• Member Handbook - 2021

• Part D Pharmacy Information
• Plan Document (rev 6/2020)

• Davis Vision Handbook -- 2021
• E-commerce Flier and FAQs
• Sample Expanded Vision Certificate of Coverage
• Sample Basic Vision Certificate of Coverage
• Your Hearing Network Flier
• Expanded Vision Enrollment Flier (2021)
• Basic Vision Enrollment Flier (2021)
• Davis Vision Glossary of Terms

• Overview
• Brochure

For information on copays, coinsurance, deductibles and out-of-pocket maximums, please reference the Insurance Comparison Charts below.

• 2021 Health Options — State and Higher Education
• 2021 Health Options — Local Education and Local Government
• 2021 Dental Options — All Members
• 2021 Vision Options — All Members

• State Plan - 2020
  
• State Plan - 2021
• Local Education - 2020
  
• Local Education - 2021
• Local Government - 2020
• Local Government - 2021

• Comparing Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)

• COBRA Brochure
• HIPAA Privacy Notice
• Telehealth Flier