Medical Benefits

Medical Provider:  MagnaCare
Dental Provider:  Self Insured Dental Services
Pharmacy Manager:  Optum
Optical:  Davis Vision | Download Information
Members’ Assistance: LECSA | Download Information
COBRA Notice: HIPPA Special Enrollement, COBRA and Filing of Claims and Appeals

To access machine-readable files (MRF) go to:
  • The MagnaCare home page
  • The machine-readable files will be under the “Resources” tab.
  • The Table of contents for MRF are searchable and downloadable by Employer Name, EIN, Plan or Network Name.
  • Under the Resources tab, your Rights and Protections Against Surprise Medical Bills notice can be found.

Medical/Dental Forms
Dental Benefit Claim Form
Optum Reimbursement Form
Davis Vision Claims Form
Summary of Material Modifications