海角社区

• Medical Claim Form (WebTPA)
• Prescription Drug Claim Form (MedImpact) 
• First Choice Provider Nomination Form
• 海角社区 First Prior Authorization Form
• WebTPA HIPAA Form
• MedImpact Rx HIPAA Form

• Care Coordination
• MedImpact Choice 90 Program
• MedImpact Direct Mail Flyer 
• Preventative Care Services
• Proration Grid
• The ABC's of Explanation of Benefits (EOBs)
• ES Voucher 2024
• 2024 Abbott Freestyle & Precision Xtra free meter flyer

• HIPAA Privacy Practices 
• Medicare Part D Notice

• 2024 Summary Plan Document (SPD) 
• 2024 Benefits Snapshot 
• 2024 Summary of Benefits and Coverage (SBC)*
• 2024 Premiums for Active Employees 
• 2024 Retiree Premiums 19%
• 2024 Retiree Premiums 38%
• 2024 Retiree Premiums 56%
• 2024 Retiree Premiums 75%

*A good faith effort is made to provide accessible documents. If you require assistance, please contact the 海角社区 Board of Supervisors at lsuboard@lsu.edu. All official Minutes of the 海角社区 Board of Supervisors from 1862 to the present are housed in the University Archives in Hill Memorial Library.