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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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