Forms & Material Downloads
Below you will find our current plan year forms for medical benefits, ancillary benefits and worksite benefits. Please contact us at (800) 622-9124 if you have any questions.
Forms & Resources
Medical Benefits
click link to download PDF
- MCMS Insurance Trust
Enrollment Form - MCMS Insurance
Trust Change Form - — PHYSICIAN OWNER PLANS —
- Physician Owner Plans MCMST 2024
Benefit Highlights (E, F, K) - PLAN E
BlueOptions PLAN 03769 (3-1-24) - PLAN F (Individual)
BlueOptions PLAN 05192 (3-1-24) - PLAN F (Family)
BlueOptions PLAN 05193 (3-1-24) - PLAN K (Individual)
BlueOptions 05180 (3-1-24) - PLAN K (Family)
BlueOptions 05181 (3-1-24) - — EMPLOYEE PLANS —
- Employee Plans MCMST 2024
Benefit Highlights (C, I, P, H, L, M) - PLAN C
BlueOptions PLAN 03559 (3-1-24) - PLAN H (Individual)
BlueOptions PLAN 05190 (3-1-24) - PLAN H (Family)
BlueOptions PLAN 05191 (3-1-24) - PLAN I
BlueOptions PLAN 05302 (3-1-24) - PLAN L
BlueCare PLAN 54 (3-1-24) - PLAN M (Individual)
BlueCare PLAN 134 (3-1-24) - PLAN M (Family)
BlueCare PLAN 135 (3-1-24) - PLAN P
BlueOptions PLAN 05789 (3-1-24)
Ancillary Benefits
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- Additional Life and AD&D
Coverage Highlights - Dental Summary
(High and Low) - Vision Summary
- Employee Assistance Program Flyer (English)
- Travel Assistance Program Flyer (English)
- Life and AD&D Benefit Summary
(Class 1) - Life and AD&D Benefit Summary
(Class 2) - Life Services Toolkit
(English) - LTD (Class 1)
- LTD (Class 2)
- LTD (Class 3)
- LTD (Class 4)
- LTD Definitions
- STD (Class 1)
- STD (Class 2)
- STD (Class 3)
- STD (Class 4)
- STD Definitions
- The Standard Disability Packet
- The Standard Insurance
Evidence of Insurability Link - The Standard Life Claim Form
Worksite Benefits
click link to download PDF