SRNS Active Employee Benefits

SRNS Active Employee Benefits
Planning for you and your loved ones, too

Open Enrollment & Benefits Overview


Medical Benefits


Dental Benefits


Vision Benefits


Additional Benefits


Reports & Summaries

Summary Annual Reports

SIP Summary Annual Reports

Health and Life Plans Summary Annual Reports

Pension Annual Funding Notices

Summary of Material Modification

Forms

(if PDF doesn’t open in browser,
right click and choose “save link as”)

Medical Forms

Download Form
5-200Health Care Programs Enrollment Change
5-340Medical Claim Form
Prescription Drug Claim Form
Mail Service Order Form

Dental Forms

Download Form
5-200Health Care Programs Enrollment Change
5-342Dental Claim Form

Vision Forms

Download Form
5-200Health Care Programs Enrollment Change
5-352EyeMed Vision Care Out Of Network Claim Form

Flexible Spending Account Forms

Download Form
5-343Health Care Flexible Spending Account Reimbursement Form
5-344Dependent Care Flexible Spending Account Reimbursement Form

Life Insurance

Return completed forms to:
To obtain a Life Insurance Beneficiary Form call:
Prudential Life Insurance
(844) 494-4778

Time Bank

Return completed forms to:
5-346Donor’s Timebank Transfer Request

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

Contacts

Benefits Solutions Service Center

Health Insurance including: Medical, Dental, Life Insurance, Retirement Services and Pension Plan, Savings and Investment Plan (SIP).

Benefits Solutions Service Center (803) 725-7772 (locally) or (800) 368-7333

Download Form
Transamerica SIP 401(k)(866) 288-3257
Website: www.transamerica.com/portal/srsretire/
Representatives M-F 8:00 a.m. – 9:00 p.m. ET
BC/BS of South Carolina(800) 325-6596
(Prime, Standard, Basic, Dental and Flexible Spending Accounts: Option 5 for COBRA and 3161 Benefits) M-F 8:30 – 4:30
Pharmacy Benefits ManagerOptumRX: (855) 811-2218
Specialty Pharmacy: BriovaRx (877) 259-9428
Companion Benefit Alternatives(800) 868-1032 (Mental Health and Substance Abuse Assistance)
EyeMed Vision Care(866) 800-5457 (Vision Plan), website: www.eyemed.com
BAC(800) 581-4222, Westinghouse Corporate Pension
Citistreet(800) 581-3366, Westinghouse Corporate Savings Plan
Prudential Life Insurance(844) 494-4778
Website: www.prudential.com/mybenefits
Social Security Administration(800) 772-1213