Claims Status and Forms

Stay on top of your medical claims

It’s important to keep track of your medical claims. To check the status, just visit your plan’s site and start reviewing claims that have been submitted. It’s that easy.

Medical claim forms

Need to file a new medical claim? It’s quick. If you’re enrolled in the Premier Plan, the Contribution Plan, the Saver Plan, the Select Local Plan, or the other Local Plans, look for the name of your administrator on your plan ID card and follow these instructions to find the right form.

Pharmacy

  • OptumRx link

Were you unable to use your plan ID card at a network pharmacy? Did you disagree with the amount you were charged? Then file a pharmacy claim. It’s simple and quick. For questions or help, contact OptumRx at 844-705-7493

Dental

With Delta, the good news is that you can ask your network dentist to file a claim for you. If you need to file a claim yourself, use this claim form. For questions or help, contact Delta Dental at 800-462-5410.

Disability

  • Short-term disability claim
    To start a claim for either short-term disability basic or enhanced, contact Sedgwick at 800-492-5678 or go to viaOne express.
  • Long-term disability (LTD) claim
    To start a claim for either long-term disability basic or enhanced, contact Lincoln at 800-492-5678 or visit the Lincoln website.

Other insurance programs

  • Life insurance claims
    For information, help, to file a claim, or to request an accelerated benefit, call Prudential at 877-740-2116

  • Accident insurance brochure (PDF)
    Learn about accident policies that can help supplement your existing medical insurance.

For disability benefits:

Associates working in... ...need to contact:
All states except as listed below Sedgwick at: 800-492-5678
California The state of California at: 800-480-3287
Hawaii Lincoln at: 800-492-5678
New Jersey Lincoln at: 800-492-5678
New York Lincoln at: 800-492-5678
Rhode Island The State Disability Carrier at: 401-462-8420


Long-term disability claims

For information or support with an existing long-term disability claim, call Lincoln at 800-492-5678 or visit the Lincoln website.

Contact Number

People Services: 800-421-1362

Prudential: 877-740-2116