Here are the SOA Benefit Forms for:

Davis Vision - Out of Network

Healthplex Dental - please note new mailing address on form

Hearing Aid Benefit

Prescription Drug Reimbursement - Prescriptions from 2018 NOW AVAILABLE

Participating Dentist List Revised 11/6/18

Attachments:

File	File size
Healthplex Dental Claim Form	3278 kB
Davis Vision Out of Network Claim	43 kB
Hearing Aid Claim Form	52 kB
Dentist List Nov 6 2018	126 kB
Prescription Drug Reimbursement 2018	140 kB