PNMG Benefits

Medical Benefits

Benefits Matrix

• High Deductible Health Plan
• PPO Plan

Benefits Guide

• PNMG 2023 Benefit Guide

Summary of Benefits of coverage

• High Deductible Health Plan
• PPO Plan

SPDs

• High Deductible Health Plan
• PPO Plan

Legal

• Omnibus

Pharmacy

• 2023 Pharmacy Plan Formulary
• Prescription Reimbursement Request Form
• Preventative Medications

High Deductible Health Plan

• High Deductible Health Plan pharmacy benefit
• Medications Not Subject to Deductible

PPO Plan

• PPO Plan pharmacy benefit
• Zero Dollar Copay Medication List

Forms

• Unavailable Service Request Form
• Medical Claim Form
• Coordination of Benefits
• General Disclosure Form

Click to view 2022 PNMG Benefit Information

Health Equity Contact Information

Health Savings Account

• Call: (866) 346-5800
• Visit: www.healthequity.com
• 24/7/365 support

Flexible Spending Account

• Call: (877) 924-3967
• Visit: www.healthequity.com
• 24/7/365 support

Metlife Dental Contact Information

• Call: (800) 275-4638
• Visit: www.metlife.com

VSP Vision Contact Information

• Call: (800) 877-7195
• Visit: www.vsp.com

OptumRx Pharmacy/Prescription Contact Information

• Call: (800) 356-3477
• Visit: www.OptumRx.com