Savannah River Site
06/07/2018
 

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Retiree Benefits
Forms

Medical Forms Return completed forms to:
5-200 Health Care Programs Enrollment Change Benefits Solutions Service Center
Bldg 703-47A, Aiken, SC 29808
5-340 Medical Claim Form

Claims Processing Center
P.O. Box 100300, Columbia, SC 29202

-- Pharmacy Claim Form Caremark Prescription Drug Claim Processing Center
P.O. Box 52059, Phoenix, AZ 85072-2059
-- Mail Service Order Form Caremark
P.O. Box 94467, Palatine, IL 60094-4467

Dental Forms
Return completed forms to:
5-200 Health Care Programs Enrollment Change Benefits Solutions Service Center
Bldg 703-47A, Aiken, SC 29808
5-342 Dental Claim Form Claims Processing Center
P.O. Box 100300, Columbia, SC 29202

Life Insurance

Return completed forms to:
5-262A Life Insurance Beneficiary Designation Form Benefits Solutions Service Center
Bldg 703-47A, Aiken, SC 29808
Any Benefits content questions contact the Benefits Solutions Service Center at 803-725-7772 or 800-368-7333
or via email at service-center@srs.gov

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SRS Operator: 803-725-6211
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