Medical, Prescription and Dental

* 2019 MEA Enrollment/Change Form

* 2019 NA Enrollment/Change Form

* 2019 MAA Enrollment/Change Form

* 2019 Bus Enrollment/Change Form

Aetna

Aetna Medical Claim Form

Aetna Coverage for Handicapped Dependents

• Handicapped Dependent Request Form
• Handicapped Dependent Physician Statement 

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Express Scripts Rx Mail Order

Express Scripts handles millions of prescriptions each year through home delivery from the Express Scripts Pharmacy.  The Express Scripts Home Delivery allows you to receive up to a 90 day supply of your long term medications, delivered to your home, for one copayment.  To get started, sign in at Express-Scripts.com or call the toll-free number on your ID card.

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Dental Claim Form:

• Delta Dental Claim Form

How do I file a claim for dental charges and when must I file the claim? There are several easy ways to submit a claim. Click here for details.

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Vision Coverage:

VSP Enrollment Form

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Flexible Spending Account (FSA):

Flex Facts is the FSA Administrator

Flex Facts FSA 2017 Enrollment Form

Flex Facts FSA Claim Form

Flex Facts Claims Department, 7 Grant Avenue, Lakewood, NJ 08701, Fax 877-747-8564

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Health Reimbursement Account (HRA):

Flex Facts is HRA Administrator

Flex Facts HRA Enrollment Form

Flex Facts HRA Claim Form

Click Here for a copy of the HRA 2017-2018 Employee Guide.