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Contact Member Services
 
Please use this web form to:
* Request a new ID card to replace a lost or stolen card.
* Change your address if you have recently moved, or name if it recently changed.
* Ask a specific question about your coverage.
Messages are retrieved every business day between the hours of 8:00 a.m. and 5:00 p.m. Eastern Time.
 
Note: For security reasons, you may not request a replacement ID card and simultaneously change your address. Replacement cards will be sent to the address supplied by your employer. All change of address requests will be verified with your employer; please notify employer first of change. This policy protects you from unauthorized use of your health care plan benefits.
 
Identification: (all fields are required)
Last Name:   First Name:   MI:
Employer:
 
Email Address:
 
Date of Birth: Month:   Day:   Year:   SSN (no hyphens):
 
Replacement ID Cards:
  Provide a replacement ID Card for the subscriber above.
 
  For a family member.  Name:
 
Change of Name or Address:
New Last Name: First Name:   MI:
 
New Address: Street:
City:   State:   Zip:
 
Questions About Coverage:

How would you like us to respond?
Email  Phone  Mail to Home Address
 
   
 
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