New Mexico Public Schools Insurance Authority

Carrier Contacts

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Benefits
New Mexico Public Schools Insurance Authority
Customer Service for Administrative issues Issues \| Claim Issues \| Appeals		1.800.548.3724	nmpsia.com
NMPSIA Eligibility Administrative Office
Erisa Administrative Services, Inc. Eligibility \| Enrollment \| Premium Billing \| COBRA Administrator		1.800.233.3164	nmpsiaonline.nmpsia.com
MEDICAL
Carrier	Group Number	Customer Service	Website Address
	N05501 – High N05502 – Low 213895 – EPO	1.888.966.7742	www.bcbsnm.com/nmpsia
Video Visits: mdlive.com!NMPSIA (or visit bcbsnm.com; log in as a member to locate the link)
	3343552	1.800.244.6224	connections.cigna.com/newmexico/
Video Visits: visit myCigna.com for appointment via MDLIVE
	A0000035	1.888.275.7737	www.phs.org/health-plans/employer-plans/Pages/new-mexico-public-schools-insurance-authority.aspx
Video Visits: visit phs.org and click on "Login to MyPres" to locate link
PRESCRIPTION DRUGS
	RxBIN 004336 RxPCN ADV RxGRP RX22AS	1.877.787.0652	www.caremark.com
DENTAL
	8564 – Low 8565 – High	1.877.395.9420	www.deltadentalnm.com/
	812022 (refer to ID card or subgroup #)	1.888.898.0370	www.unitedconcordia.com/benefits/clients-corner/New-Mexico-Public-School-Client-Corner-Dental-Benefits
VISION
	7129	1.800.999.5431	www.davisvision.com/member
LIFE AND DISABILITY
	645549	1.888.609.9763 Ext. 0957	nmpsia.com/TheStandard.html

Applying for Life and LTD Coverage

For Additional Life or Long Term Disability that is declined or if the employee chooses to enroll AFTER the 31 day enrollment deadline, to add these coverages the emlpoyee needs:

1. A Change Card
2. Evidence of Insurability (Medical History Statement)
3. Approval by The Standard

What is evidence of insurability?

EOI is a statement or proof of a person's physical condition that is required to obtain certain types of insurance.

This applies to requests for LTD coverage or Additional Life for the employee and Dependent Life coverage for spouse.

Step 1
Complete the attached NMPSIA Employee Change Card

Step 2
Complete the attached Standard Medical History Statement

Step 3
Submit both forms to your employer's Benefits Office. They will send to the NMPSIA administrator who will expedite to The Standard for review.

If you do not want to send the Medical History Statement to your employer's Benefits Office, you may mail it to the address on the form. You MUST submit the NMPSIA Employee Change Card to your employer's Benefits Office before you mail the Medical History Statement to The Standard.

Note: The late enrollment process is available anytime, but for faster decision turnaround, apply between January and August. The annual Fall Open/Switch Enrollment is not the ideal time to apply.