Employee Resources, Health & Welfare Benefits

Health & Welfare Benefits

Select a Health & Welfare benefit below for resources:

Health Benefits - Principal (Medical, FSA, GUL)
Prescription Plan - Caremark (RX)
Employee Assistance Plan (EAP) - Business Psychology
Vision Benefits - Davis Vision
Free Outpatient Laboratory Benefit Card - Labcard
Life Insurance Plan
Short Term Disability Plan for Hourly
Short Term Disability Plan for Salaried

Health Benefits - Principal (Medical, FSA, GUL)

Medical Claims: 1-800-894-9576
Flexible Spending Account (FSA) Claims: 1-877-372-4730
Group Universal Life (GUL): 1-800-255-6614
Health Information Line: 1-800-533-5044
Prenatal Care Program: 1-800-248-5447
Spanish Line: 1-800-243-1404

If you have health benefits administered by Principal, you can use this site to view your plan summary information as well as view your explanation of benefits for medical, dental, vision, wellness, prescription and flexible spending accounts, and search for providers.

Health Maintenance Organizations (HMO's) and Point of Service Programs (POS)
Based on your state of residency, your other health benefit options include HMO or POS programs. To verify if your home zip code is offered an HMO or POS program, access your benefits at employee.simplot.com.

The following states offer HMO or POS programs:

California
Kaiser Permanente Member Services
www.kaiserpermanente.org
1-800-464-4000

California - Lathrop Union Employees only
Kaiser Permanente Member Services
www.kaiserpermanente.org
1-800-464-4000

Washington State
Group Health Options
www.ghc.org
1-888-901-4636
This is a POS program.

Oregon
Kaiser Permanente Member Services
www.kaiserpermanente.org
1-800-813-2000

Health & Welfare Benefit Forms:


	Dental Claim/Estimate Complete this form, along with your Dentist to determine cost of procedure and amount that will be covered under the dental plan.

	Medical, Dental, Vision Claim Form Complete this form for reimbursement of claims paid.

Supplemental Documents:


	Student Verification Questionnaire Complete this form along with the school registration form to provide proof of full-time student status.

	Foster & Step-child Questionnaire Complete this form to determine if your foster or step-child qualifies as an eligible dependent.

	Handicap Child Coverage Application Complete this form to apply for continued coverage beyond the maximum age defined for the dependent (other than the spouse). The dependent must be incapable of self-support as the result of a developmental disability or physical handicap and must be dependent on the member for primary support.

	Supporting Documentation Coversheet Submit this coversheet along with your dependent supporting documentation.

	Dependent Administrative Procedure This administrative procedure will explain what supporting documentation is required when adding or removing a dependent.

	Beneficiary Administrative Procedure This administrative procedure will explain the process for designating beneficiaries through the Simplot enrollment system.

Prescription Plan - Caremark (RX)
www.caremark.com or www.principal.com
1-877-683-6838
Specialty Rx 1-866-295-2779

If you have health benefits administered through Principal, you can use this Caremark site to:

Locate pharmacies;
Order mail-order prescription refills;
Track the status of your order;
See what you will pay for a specific drug.

Caremark Forms:


	Caremark Claim Form Complete this form to process a prescription claim.

	Caremark Mail Order Form Complete this form to order your prescription through mail order.

	Rx Foreign Claim Form This form is to provide direct reimbursement for prescriptions that were purchased outside the United States.

Employee Assistance Plan (EAP) - Business Psychology
www.bpahealth.com
1-888-272-0456

Your site to learn more about your EAP benefits.

Vision Benefits - Davis Vision
www.davisvision.com
1-877-923-2847

Your vision plan, access this site to find Davis Vision providers. Use the control code of 7205 for Simplot's vision providers.

Davis Vision Forms:


	Davis Vision Claim Form Complete this claim form to submit out of network claims to Davis Vision.

Free Outpatient Laboratory Benefit Card - Labcard
www.labcard.com
1-800-646-7788

Your site to locate laboratory collection facilities by State, for your routine lab work. If there is no collection site, you can work with your doctor and request they use the Labcard to pick up your lab tests. NOTE: You must be enrolled in the Principal Health Plan to take advantage of this benefit.

Life Insurance Plan
www.regencelife.com
1-800-286-1129

The company provides you with your life insurance plan.

Short Term Disability Plan for Hourly Employees, administered by the Principal Life Insurance Company
www.principal.com
Short Term Disability Claims
1-800-843-1371

Short Term Disability Plan for Salaried Employees
AskHR@simplot.com
1-800-824-6979

EMPLOYEE RESOURCES HOME

Select a topic below to view benefit information and/or associated forms:

Benefit Topics:
Benefit Enrollment
Health & Welfare Benefits
Medical Providers by State
Optional Benefits
Retirement Benefits

Note: Some sites require a user name and password.

Disclaimer: Benefits vary by location, employment status, union status, hours, etc.. Please contact the Employee Service Center if you have questions regarding your benefit eligible plans.