Pre-65 Benefit Information

Resources

Below are links to forms to help you manage your benefit plan. Don't see what you're looking for or have a question?

Contact us at 1.800.542.6373

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Medical Plan Highlight Sheet

Rx plan Highlight Sheet

Summary of Benefits

You can review all your plan benefits in one document.

Evidence of Coverage

This document gives you the details about your Medicare healthcare and prescription drug coverage from January 1 – December.

Formulary Drug listing

Your employer group uses a specific Drug List. On our website, please refer to the Advantage Formulary. The formulary may change at any time. You will receive notice if necessary. To request a printed copy, contact us at

800.779.6962.