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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 www.cirstudenthealth.com/calvinsem by Starr Indemnity Pharmacy Contact Health Desk: (800) 207-2568 and questions, visit www.walgreens.com & Liability Company or call (800) 207-2568.
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