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Forms

Optum Rx Downloads

  • Paper claim reimbursement form (pdf)

Benefit Information

  • Jan 1, 2023 Prescription Drug List (WW Choice, WW Non-Medicare Retiree, SW Choice & SW Retiree) (pdf)
  • Jan 1, 2023 Prescription Drug List (WW Medicare Retiree) (com/)
  • Sharewell Choice 2023 SBC (pdf)
  • Wellwise Medicare Retiree 2023 Summary (pdf)
  • Wellwise Choice 2023 SBC (pdf)
  • Sharewell Retiree 2023 Summary (pdf)
  • Wellwise Non-Medicare Retiree 2023 Summary (pdf)
  • Jan 1, 2023 EOC (WW Medicare Retiree) (pdf)
  • Vaccine Program Flyer (pdf)
  • Flu Shot Flyer (pdf)
  • Home Delivery Flyer (pdf)
  • Online Tools Flyer (pdf)
  • Health Care Reform Preventative Drug List (WW Choice, WW Non-Medicare Retiree, SW Choice & SW Retiree) (pdf)
  • Free Meter Flyer (WW Choice, WW Non-Medicare Retiree, SW Choice & SW Retiree) (pdf)
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