Health Forms

Enhanced-Surest and Standard-Surest Option Claim Forms

Complete a form only if you use out-of-network providers (in-network providers typically submit claims directly to the carrier)

Surest:
Benefits.Surest.com
1-866-683-6440

Health Maintenance Organization (HMO) Plan Forms

Contact your HMO about coverage, procedures and any required forms

Contact information is available:

• On the back of your ID card, if you are currently enrolled in an HMO;
• In the current Benefits At-a-Glance and Resource Contact Information in the annual open enrollment section of this website;
• By visiting the Your Benefits Resources (YBR) website at https://digital.alight.com/nokia; or
• By calling the Nokia Benefits Resource Center at 1-888-232-4111.

Prescription Drug Program Claim Forms
(Enhanced-Surest and Standard-Surest option participants)

Required when you need to use a pharmacy outside of the CVS Caremark network

CVS Caremark:
Caremark.com
1-800-240-9623

Prescription Drug Program Mail-Order Service Forms
(Enhanced-Surest and Standard-Surest option participants)

Required when mailing your initial request for filling up to a 90-day supply of medications through CVS Caremark Mail Service Pharmacy

MetLife Dental Plan Claim Forms

Required only if you use a dentist outside of the MetLife network

MetLife:
www.metlife.com/mybenefits
1-888-262-4876
Company/Group Name: US-Nokia
Group number: Nokia 85848