Health Forms

Surest and UnitedHealthcare (UHC) Medical Plan Claim Forms (Enhanced and Standard Options)

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

UHC:
www.myuhc.com
1-800-577-8539

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 digital.alight.com/nokia; or
• By calling the Nokia Benefits Resource Center at 1-888-232-4111 (TTY 711).

Prescription Drug Program Claim Forms
(Surest Enhanced and Standard option participants, UHC Enhanced and Standard 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
(Surest Enhanced and Standard option participants, UHC Enhanced and Standard 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