Core Benefits Links & Forms

Accident Information

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BenefitInformation/Form (s)Carrier Information
DentalDental Highlights


Delta Dental of PA
Policy # 7054
Phone: 1-800-932-0783
Web: www.deltadentalins.com
Employee Assistance Program (EAP)Six confidential counseling sessions will be paid for by FMH.Business Health Services
Phone: 1-800-327-2251
Web: www.bhsonline.com
Flex Spending Accounts
My Benny Card

AD1113 HCA Claim Form
AD1112 DCA Claim Form

UMR
Phone: 1-800-826-9781
Web: www.umr.com
Life Insurance
Aetna Life Insurance
Policy #: 473215
Phone: 1-800-5232-5065
Web: www.aetna.com/group/atena_life_essentials
Health Plan

Claim Form


Plan Administrator UMR
Policy # 76430110
Phone: 1-800-826-9781
Web: www.umr.com
Other Insurance Update

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Prescription Drug

2018 OptumRx Premium Formulary Exclusions

2018 Premium Formulary PDL

OptumRx
Policy # 01961250
Phone: 1-877-559-2955
Web: www.optumrx.com
Retirement 403(b)You can enroll, make changes, complete forms and obtain other information for your Transamerica Retirement Solutions 403(b) plan by going online or calling Transamerica.Transamerica Retirement Solutions
Phone: 1-800-755-5801
Web: http://mytrsretire.com
VisionAetna Vision
Policy # 473215
Phone: 1-877-973-3238
Web: www.aetnavision.com
Voluntary BenefitsSelect Benefits
Phone: 1-888-711-4478, ext. 2