Dental Claim Form

Optical Claim Form

Medical Claim Form    part 1    part 2

Yearly Mandatory Information Update Form 2006

 

United Association's National Prescription Drug Program (NMHC RX) this replaces SavRX Card which in no longer accepted. Please make sure your pharmacy has NMHC card and address for summiting. Visit web site at www.nmhcrx.com

NMHC RX Member Services page.

NMHC RX Direct Reimbursement Claim Form page. Online Claim Form

NMHC RX Enroll in NMHC Mail page

 

Community Health Alliance Network (CHA) is the Preferred Provider Organization Network Provider, when using a member provider belonging to this group you receive greater discounts for medical services.

CBA