Benefits

Statement of Benefits

2019-2020 SOB Classic Gold


2019-2020 SOB - HDHP $1350                                                                                                                                                                                                                   
Health Savings Account (HSA)                  


2019-2020 SOB Copay Gold


Dental Benefits

Delta Dental Benefits 2019-2020                     Delta Dental Claim Form

Delta Dental Enrollment Form

Vision Benefits 


Vision Benefits 2019-2020                      


Summary of Benefits and Coverage 

SBC - 2019-2020 CoPay Gold

SBC - 2019-2020 CoPay Gold (Spanish)

SBC - 2019-2020 Classic Gold

SBC - 2019-2020 Classic Gold (Spanish)

SBC - 2019-2020 HDHP $1350

SBC - 2019-2020 HDHP $1350 (Spanish)

General Information 

ASBA Insurance Trust 2019-2020  

ASBAIT Plan Document 2019-2020

ASBA 2019-2020 Enrollment Form 

SY 2019-2020 Insurance Rates 


ASBAIT Open Enrollment Meeting PowerPoint Presentation 19-20

My Meritain Claims Web Access

Aetna Doc Find Flyer 

Nurse Health Coaching/Disease Management Flyer

Lab Work and Costs Flyer

ASBAIT Preventive Care List

Prescription Benefits

Mail Order Rx Form

Rx Reimbursement Form                               Generic Rx

Rx Mobile App                                              Home Delivery Rx