For the convenience of our policyholders, below is a list of forms and other information you may access or download as needed. You may need to download the Adobe Acrobat Reader before you can view some of the forms.
Important Contacts
FSA Customer Service – 1-866-347-3640
Dental. Vision – 1-888-816-3096
Short Term Disability customer service – 1-877-318-4487
FSA Claim Form – Download Here
Dental Claim Form – Download Here
Vision Claim Form – Download Here
Contracted Dental Practices – Click Here
For Dental and Vision Reimbursements, members can mail the itemized statement and proof of payment into the following address.
The Health Plan
1110 Main Street
Wheeling WV 26003
Claim Forms & Products
- Allstate Accident Outpatient Physician’s Treatment Claim Form: Download Form
- Group Accident Claim Form Download Here
- Group Cancer Claim Form: Download Form
- Wellness Claim Form: Download Form
- Policy Service form (ex. address, name and beneficiary changes): Download Form
- SHOP Information: Download Brochure
- SHOP Claim Form: Download Form
- Allstate Cancer Plan for Cumberland County Schools
- Claims Service Number: 1-800-348-4489
- Policyholder Service Number: 1-800-521-3535
Accident
Hospital Stay Pay
Critical Illness
Life Insurance with Long Term Care
Wellness Claim Form
Customer Service – 1-800-918-8877 option 6
Cancer Forms (Policies issues prior to 1/1/14)
Manhattan Life (formerly Humana Policies) – Forms & Policies
- Manhattan Life Cancer Forms (Policies issued prior to 1/1/14)
- Manhattan Life (formerly Humana -Cumberland County School Employees ONLY)
Group Life Insurance
Benefit information and Certificate number for CCS employees
Certificate Number: VF02383A
403(b) Retirement Planning
403(b) Retirement PlanningFor an Application or to speak with a Representative: Local: 1-910-483-6210
(Universal Life and Term)
For assistance, please contact us at 910-483-6120.