| MEDICAL
PLAN ADMINISTRATOR (7/1/04-Current) |
| Company Name |
Fiserv Health (formerly
Wausau Benefits) |
| Group Number |
76-070072 |
| PH Number |
800-826-9781 Member
Services
877-233-1800 Providers use this number to verify
benefits |
| Internet Site |
www.fiservhealthservices.com
|
| Correspondence Address (not for claims) |
Fiserv Health
PO Box 8013
Wausau, WI 55402-8013 |
| Plan Year |
Runs January through
December |
| PRESCRIPTIONS
Plan Administrator (7/1/04- Current) |
| Company Name |
Fiserv Health Pharmacy
Benefits
Also knows an Innoviant |
| Group Number |
RXGRP 01960241 |
| PH Number |
877-559-2955 |
| Internet Site |
www.innoviant.com |
| Send paper claims to: |
Innoviant
PO Box 8082
Wausau, WI 54402-8082 |
| Plan Year |
Runs January 1 through
December 31 |
| Medical
Services Network (Doctor's Network) for COLORADO
Medical Plan Participants (7/1/05-Current) |
| Company Name |
Sloans Lake Preferred |
| Phone Numbers |
800-850-2249 (toll
free)
303-504-5615 |
| Internet Site |
www.sloanslake.com |
| Send claims to: |
Sloans Lake Preferred
Health Networks
PO Box 241322
Denver, CO 80224 |
Medical
Services Network (Doctor's Network) for NEVADA and
WYOMING Medical Plan Participants
(7/1/04-Current) |
| Company Name |
PHCS |
| Phone Numbers |
800-944-5184 |
| Internet Site |
www.phcs.com |
| Send claims to: |
Fiserv Health
PO Box 8013
Wausau, WI 54402 |
Medical
Services Network (Doctor's Network) for UTAH Medical
Plan Participants
(1/1/07-Current) |
| Company Name |
Beech Street |
| Phone Numbers |
866-811-9094 |
| Internet Site |
www.beechstreet.com |
| Send claims to: |
Fiserv Health
PO Box 8013
Wausau, WI 54402 |
| DENTAL
PLAN PROVIDER (effective 7/1/05) |
| Company Name |
United
Concordia (through Mutual of Omaha) |
| Group Number |
A00409000 |
| Plan Type |
DentaBenefits |
| PH Number |
866-454-3190 |
| Internet
Site |
www.dentabenefits.com |
| Address |
United
Concordia Companies, Inc.
Dental Claims
PO Box 69416
Harrisburg, PA 17106-9416 |
| Plan Year |
Runs January
1 through December 31 |
| VISION
PROVIDER (connected to Medical, effective 9/1/05) |
| Company Name |
EyeMed |
| Group Number |
9231499 |
| Plan Name |
Access Plan C |
| PH Number |
866-723-0513 |
| Internet Site |
www.eyemedvisioncare.com |
| Note: |
Participation matches
Medical Plan Participation |
| Plan Year |
Runs January 1 through
December 31 |
| FLEXIBLE
SPENDING ACCOUNT (effective 7/1/05) |
| Company Name |
PayFlex (formerly Denver
Reserve) |
| Group Number |
Use SSN |
| PH Number |
800-736-4611 Toll Free
303-798-4611 (Denver Local) |
| Email Addresses |
drcmail@denverreserve.com
|
| FAX Numbers |
800-450-0016 Toll Free
303-795-5105 (Denver Local) |
| Internet Site |
www.payflex.com
|
| Plan Year |
Runs January 1 through
December 31 |
| 401(k)
PLAN PROVIDER |
| Company Name |
MFS
|
| Group Number |
110514308 |
| PH Number |
800-854-0647
|
|
FAX Number
|
800-452-6416
|
| Internet Site |
www.mfs.com
|
| Address |
Qualified Plans, MFS
PO Box 55274
Boston, MA 02205-5274
|
| 401(k)
ADMINISTRATION |
| Company Name |
CBIZ Acturial |
| PH Number |
303-790-0825 |
| FREE
FINANCIAL ADVISOR |
| Contact |
Tom Alley |
| Company |
UBS |
| PH Number |
303-488-0888 |
| SUPPLEMENTAL
CANCER & SHORT TERM DISABILITY INSURANCE |
| Company Name |
Colonial |
| PH Number |
800-325-4368 |
| FAX Number |
800-880-8325 |
|
