Below are official plan documents you may need to properly understand or receive benefits under your plan.
Title | Description | Download |
---|---|---|
OFFICIAL PLAN BROCHURE | 2019 FSBP Plan Brochure | |
SUMMARY OF BENEFITS & COVERAGE CHART | 2019 Summary of Benefits & Coverage Chart | |
OFFICIAL PLAN BROCHURE | 2018 FSBP Plan Brochure | |
SUMMARY OF BENEFITS & PROGRAMS | 2018 Summary of Benefits & Programs | |
SUMMARY OF BENEFITS & COVERAGE CHART | 2018 Summary of Benefits & Coverage Chart (SBC) | |
MEMBER FORMS | Provider Nomination Form | |
MEMBER FORMS | Medical Claim Form | |
MEMBER FORMS | Urine Drug Testing Coverage Guidelines | |
MEMBER FORMS | EFT/Direct Deposit Authorization form | |
MEMBER FORMS | Authorization for Release of Protected Health Information (PHI) form | |
MEMBER FORMS | 2018 Deemed Exhaustion Notice | |
MEMBER FORMS | Wellness Incentive Claim Form |
Title | Description | Download |
---|---|---|
Member Document | CAHPS Member Satisfaction Scores | |
Member Document | HEDIS Clinical Performance Scores | |
Member Document | Program Description - Quality Management FEHBP | |
Member Document | Provider Satisfaction Post-Call Survey Scores - San Antonio, TX | |
Member Document | Provider Satisfaction Post-Call Survey Scores - Scottsdale, AZ |