Notices/Forms

COVID-19 Information

UHC Montoring Coronavirus 2-6-2020

Covid-19 Update 4-21-2020

Enrollment and Change Form

To enroll an employee or to make employee changes please complete the attached enrollment/change form and send it to your current Mercer contact.

Email it to CBS.HBP.Billing&Eligibility@mmc.comor fax it to 1-515-365-1310.

Alicia Schossow is the contact for housing authorities in Alabama, Arkansas, Florida, Georgia, Kansas, Louisiana, and Missouri.

Raymund Boltron is the contact for housing authorities in Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas.

Plan Information for Newly Enrolled Employees

Claim Forms

Medical Out of Network

Pharmacy Reimbursement

Dental

VSP Vision

UHC Vision (Out of Network)

International

Life Insurance Information

Portability and Conversion at a glance

Conversion Application

Portability Application

The Standard’s Death Claim Packet

Instructions for completing the Death Claim Packet

Waiver of Group Health Benefits

Wellness Bonus Program shared by the Housing Authority of St. Louis County, MO

HBP Plan and Trust Document

Privacy Notice