Adventist Health Employee Health Plan benefits
Medical benefits
California Medical Benefits
- Side by side benefit comparison
- Summary of Benefits and Coverage (SBC)
- Summary of Benefits and Coverage (SBC) – AHRO and AHMC associates
- Summary of Benefits and Coverage (SBC) – Delano associates
- Summary Plan Description (SPD)
- Summary Plan Description (SPD) - AHRO and AHMC associates
- Summary Plan Description (SPD) - Delano associates
Oregon Medical Benefits
- Side by side benefit comparison
- Summary of Benefits and Coverage (SBC)
- Summary Plan Description (SPD)
Legal and Privacy notices
Pharmacy benefits:
- Pharmacy Benefit
- Zero Dollar Copay Medication List
- Community Partner Pharmacy List
- OptumRx Formulary
- OptumRx Formulary Exclusion List
- OptumRx Claim Form
- How to create an OptumRx account
- OptumRx Step Therapy Medication List
- OptumRx Prior Authorization Medication List
- OptumRx Quantity Limit Medication List
- Free glucose monitor
Forms:
- Unavailable Service Request form
- Medical Claim form
- Pharmacy Claim form
- Coordination of Benefits/Other Insurance form
- General Authorization Designation of Personal Representation and Email Consent form
Flexible Spending Account:
For claims and additional information:
- Visit EBCFlex.com
- Call 800-346-2126
Dental:
For claims and additional information:
- Visit DeltaDentalins.com/AH
- Call 888-335-8227
Vision:
For claims and additional information:
- Visit Adventist.VSPForMe.com
- Call 800-877-7195