FOR EMERGENCY MEDICAL TREATMENT, CALL 911 OR SEEK CARE AT AN APPROPRIATE FACILITY.
Name of Insured:__________________________________
Your Insurance Plan participates in the NHBC
Member Id #:_____________________________________
network of providers. To find and in-network
Mail Claims to:
Effective Dates: 08-01-11 to 07-31-12 Policy Number: SPR 270326 11 provider, log on to http://providers.nhbc.com
and use access code AMA311 MCA Administrators
Name of Policyholder: Calvin Seminary or call 1-888-621-7900. PO Box 6540
Harrisburg, PA 17112
For access to healthcare outside the
Bin# 603286 PCN: 01410000 Group # 516254 United States contact On Call International (800) 427-9308
The Person whose at (800) 850-4556 or collect/local
name appears on call to (603) 898-9159.
this card is insured Pharmacy benefits are administered through
for a claim form, log on to
Prescription Drug Benefits: Walgreens under a policy issued
Walgreens Health Initiative. For locations
by Starr Indemnity
Pharmacy Contact Health Desk: (800) 207-2568 and questions, visit www.walgreens.com
& Liability Company
or call (800) 207-2568.