Employee Insurance

Please review the following insurance forms.  Click a title to review and print.

Employee Insurance

#	Name
1	Change Form (Rev. 10/2010) (Details)
2	Deposit Affidavit (Details)
3	Enrollment Form (Details)
4	Express Scripts Mailorder (Details)
5	Eligibility Bulletin (Details)
6	Express Clinic Brochure (Details)
7	Insurance Premiums (Details)
8	Provider Directory Instructions (Details)
9	South Central - Dental Blue w/o Signature (Details)
10	South Central - SOB#1 w/o Signature (Details)
11	South Central - SOB#2 - w/o Signature (Details)
12	South Central - SOB#3 w/o Signature (Details)

Anthem Contact Information
Member Services
1-800-295-4119

Precertification
1-877-814-4803

Provider Services
1-800-345-4344

Dental Services
1-866-589-0578

Rx Provider Services
1-800-662-0210

WHO CAN HELP YOU FOR CLAIMS INCURRED BEFORE 11/01/09?
For questions on benefits or claims:
Claim's Administrator: WEBTPA
1-800-953-2023

South Central Indiana School Trust
Julie Burton - Administrator
500 Earlywood Drive
Franklin, IN 46131
Phone 1-317-738-5972
Fax 1-317-738-5972