Common Questions

Below are common questions about the forms and documents page.

I don't have Adobe Acrobat Reader. How can I get it?
Adobe Acrobat Reader is available as a free download from http://get.adobe.com/reader/.

How do I save a copy of the document to my computer?
To save any of the documents, right click on the link and choose "Save Target As." You can then save the document to the appropriate directory on your computer.

How do I submit an out-of-network claim form?
Please note that some plans have specific out-of-network claim forms, and that not all plans have out-of-network benefits.

As long as the plan uses the standard form and offers allowances for services obtained outside the network, you can use the form to follow the below process for obtaining out-of-network benefits:

  • Before obtaining services, the member should call the Customer Care Center to verify benefits available.
  • The member can then have vision care services at a provider not part of the network.
  • The doctor and/or dispensary should sign the form, and the member should make sure to get receipts for all services and materials.
  • The member should then mail the completed form with receipts according to the instructions on the form. We will reimburse the member directly based on out-of-network benefits available.
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