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

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 (Short)

List of Eligibility (Long)

Change in Status Matrix -COBRA

HRA Q & A

New Employee HRA/FSA Enrollment

HRA Online Set-Up Info

Met Life Dental

800.275.4638

Dental Claim Form

VSP Vision

VSP Claim Form

Hartford 401K

Grant Caudle

866.629.8906 or 503.421.5541

401K Beneficiary Form

401K Roll Over to Nerland Form

Benefit Payment Request

Participant Change Form

Long Term Disability (Unum)

Nerland Employee Benefits

Nerland Executive Benefits

The Alaska Club