Provider

Contact

 Forms

Aetna Medical

Member Services (8a-5p) 888.802.3862

Pharmacy Management (24-hours) 800.238.6279

Informed Health Line (24-hours) 800.556.1555

Claim Fax # 866.474.4040

Medical Claim Form

RX Claim Form

RX Home Delivery Form

$10,000 Family Plan

$5,000 Single Plan

Alaska Preventative Care Sheet

Alaska Medical Travel Benefit

HRA (Benefit Solutions)

HRA & FSA Member Services 888.398.8057

Mail or Fax Claims to:

PO Box 67230

Portland, OR 97268-1230

Fax: 888.249.5058

HRA Claim Form

Letter of Necessity Form

List of Eligibility

Change in Status Matrix -COBRA

HRA Visual

New Employee HRA/FSA Enrollment

HRA Online Set-Up Info

Met Life Dental

800.275.4638

Dental Claim Form

Dental Benefit Summary 8 2011

VSP Vision

VSP Claim Form

VSP Summary

Northwest Plan Services 401K

Tim Wulfekuhle/Jacqueline Eaton

206-933-1500

Northwest Plan Services - Seattle

Enrollment & Change Form

Termination Participant Form

Rollover Into Our Plan Form

Beneficiary Form

Special Tax Notice

Long Term Disability (Unum)

Nerland Employee Benefits

Nerland Executive Benefits

The Alaska Club