If you have your explanation of benefits requesting COB information (i.e. your COB letter), please complete this form.
Is Spouse Employed?
Does your spouse have the ability to elect health insurance through their employer?
Does your spouse or any of your dependents have coverage through any other MEDICAL benefit plan?
Does your spouse or any of your dependents have coverage through any other DENTAL benefit plan?
Access your account
Access healthcare data
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Schaumburg, IL 60173
Phone: (847) 519-1880
Toll-Free: (800) 323-1683
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