When prompted enter: Group Name: statewy Access code: groupltc
2013 1st Quarter Formulary
Enroll in or make changes to Health, Dental, Vision & Life Insurance
Authorization form to deduct premiums from a bank account.
Information regarding mail order prescription program.
Order presctiptions from the mail order pharmacy. (effective 1/1/2012)
To cliam reimbursement when a prescription has not gone through a retail pharmacy
Instructions for your Explanation of Benefits
2nd option for Mail Order Prescriptions available 11/1/2012
www.mycignaforhealth.com.......1-800-685-1060
www.deltadental.com.......307-632-3313......1-800-735-3379
www.vsp.com.....1-800-877-7195
www.medimpact.com/member.......1-800-788-2949
www.medvantxrx.com.........1-866-744-0621
www.diplomatpharmacy.com.......1-877-319-6337
www.ppsrx.com.........800-552-6694