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Rural Carrier Benefit Plan
Providing superior service to rural letter carriers nationwide
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Official Plan Documents

Below are official plan documents you may need to properly understand or receive benefits under your plan.

Member Forms & Documents
Title Download
Official Plan Brochure - 2019 PDF
Summary of Benefits - 2019 PDF
Prescription Drug Guide/Formulary PDF
Prescription Drug Guide - Specialty Drugs PDF
Prescription Drug Guide - All Other Drugs PDF
Claim Form - Medical PDF
Claim Form - Mail Order Prescription PDF
Claim Form - Prescription, Retail Pharmacy PDF
Claim Form – Wellness Incentive PDF
Provider Nomination Form PDF
Authorization for Release of Protected Health Information (PHI) PDF
Public Notice of Health Plan Accreditation Survey PDF

Quality Management Documents
Title Download
CAHPS Member Satisfaction Scores PDF
HEDIS Clinical Performance Scores PDF
Program Description – Quality Management FEHBP PDF
Provider Satisfaction Post-Call Survey Scores – San Antonio, TX PDF
Provider Satisfaction Post-Call Survey Scores – Scottsdale, AZ PDF