PO Box 1095 Kirksville, MO 63501 cva@charitonvalley.org Phone: 660-665-1111 Fax: 660-665-1409 HR Fax: 660-665-3417

Plan Documents & Summary of Benefits

CVA FT Employee Benefits Packet ,Summaries, Costs

CVA PT Employee Benefits Packet, Summaries, Costs

PPO 1500 with FSA Health Plan Summary of Benefits

PPO 2500 with FSA Health Plan Summary of Benefits

PPO 2500 High Deductible Plan with HSA Summary of Benefits

Consociate Health Online Portal Registration

Consociate Health Contact Info

EmpiRX Total Care Formulary List 2022

EmpiRX Preventive Drug List 2022

EmpiRX Diabetes Management Program

EmpiRX Online Portal Registration

MeMD Telehealth

Delta Dental Summary of Benefits

Deltal Dental Claim Form

Delta Dental List of Providers within 15 miles 7-9-21

Delta Dental Summary Plan Description

Delta Vision Summary of Benefits

Delta Vision Claim Form

Delta Vision Flyer

EyeMed Schedule of Benefits eff 1-11-22

Delta Vision Policy Amendment to EyeMed and Certificate

Delta Vision Notice of Privacy Practices 1-1-2022

Delta 24/7 Online Access

Aflac Group Accident Insurance

Aflac Group Short-Term Disability Insurance

Aflac Group Hospital Indemnity Insurance

Aflac Critical Illness Insurance

FSA (Flexible Spending Account) Brochure

FSA Contribution Form

HSA Contribution Direct Deposit Form

HSA Payroll Deduction Hourly Employees

HSA Payroll Deduction Exempt Employees

Self-Funded Plan Notice of Privacy Practices