Forms

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• Spirit Dental 

• Delta Dental MN/ND

• Short Term Medical IHC

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Medicare Part B And D Premiums - IRMAA Information For High Wage Earners

• https://www.medicare.gov/your-medicare-costs/part-b-costs

• https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/monthly-premium-for-drug-plans

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Medicare Forms

• Medicare Part B Application Enrollment

• Medicare Employer Proof of Coverage Form

• Medicare Part B Monthly Payment EFT Form

• Waive Part A and Part B

• Scope of Appointment Form

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Blue Cross And Blue Shield Claim Form

• Blue Cross Vision Reimbursement

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Customer Service Phone Numbers

• Aetna: (855) 335-1407

• Blue Cross Blue Shield MN: (800) 382-2000

• Cigna: (866) 459-4272

• Delta Dental MN: (800) 448-3815

• Humana: (800) 281-6918

• Medica: (866) 269-6804

• Mutual Of Omaha:

• Silver Script: (866) 362-6212

• Spirit Dental: (844) 833-8440

• UCare: (855) 307-6978

• United Healthcare: 800-721-0627