ACEC, your gateway to the ACEC Life/Health Trust.
Additional Resources:
www.acec.org
UnitedHealthcare Forms
We’ve put together some frequently used forms to help when you need them.
Composite Rate Contribution Guide
This tool is meant to assist you in calculating your health care contributions
- Download the Microsoft Excel Spreadsheet here.
Medical Forms
- Direct Debit Request (updated 07.15.08)
- Transition of Care Form
Pharmacy
Stand Alone Vision Benefit
Members with UnitedHealthcare Vision® coverage who are also covered by an ACEC Trust medical plan can use their medical ID number to access vision benefits. Members with stand-alone UnitedHealthcare Vision coverage can use their Social Security number to access vision benefits.
- Benefit Summary
- Out of Network Claim Form
- Additional benefit details available at www.myuhcvision.com
Stand Alone Dental
- Consumer MaxMultiplier
- Prenatal Dental
- Additional information can be found at www.myuhcdental.com
Life and Disability
Forms
• Life Claim
• Short Term Disability
• Long Term Disability
Sample Certificates
• Short Term
• Long Term
• Group Life
Additional information can be found at www.unimerica.com
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