Forms, Numbers, & Compliance Notifications
CONTACT NUMBERS
AFLAC CANCER CARE
1-800-99-AFLAC
ANTHEM MEDICAL
1-888-641-5224
ANTHEM DENTAL
1-888-641-5224
BOSTON MUTUAL WHOLE LIFE
1-800-669-2668
CHARD SYNDER
1-800-982-7715
HRI DENTAL
1-800-727-1444
Anthem.com Resources
Member Services 1-844-720-0798
Dental Services 1-866-641-7762
24/7 Nurseline 1-888-279-5449
Pre Certification 1-866-643-7087
Provider Services 1-800-676-2583
Pharmacist Questions 1-800-824-0898
Coverage While Traveling 1-800-810-2583
FORMS AND RESOURCES
REMOTE HYBRID POLICY AND APPLICATION
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YMCA
Files:
2025 MEDICAL SUMMARY PPO 50
2025 MEDICAL SUMMARY PPO 75
2025 DENTAL SUMMARY
2025 DENTAL INSURANCE RATES
2025 MEDICAL INSURANCE RATES (UNDER 43K)
2025 MEDICAL INSURANCE RATES (OVER 43K)
ANTHEM HEALTH BENEFIT BOOK - ACTIVE WITH CLINIC ACCESS
ANTHEM HEALTH BENEFIT BOOK - ACTIVE WITHOUT CLINIC ACCESS
ANTHEM HEALTH BENEFIT BOOK - RETIREES
EMPLOYEE CHANGE FORM APPLICATION
INJURY/ILLNESS REPORT
PRESCRIPTION DRUG LIST
MXP RETAIL MAIL ORDER FORM
UNIFORM GLOSSARY
SUMMARY OF BENEFITS AND COVERAGE (SBC) 50
SUMMARY OF BENEFITS AND COVERAGE (SBC) 75
SUMMARY OF BENEFITS AND COVERAGE (SBC) RETIREE