Insurance & Benefits

Public Employees Insurance Agency (PEIA)

CompBenefits Insurance - Vision & Dental Insurance

New Address for submitting Dental & Vision Claim Forms

Humana Dental Claims
P.O. Box 14284
Lexington, KY 40512-4283 

Humana Vision Care Plan
Attn: OON Claims
P.O. Box 14311
Lexington, KY 40512-4311

Follow these instructions for the out-of-network vision provider:

  1. When visiting an out-of-network provider, you are responsible for payment of services and/or materials at the time of service. First American Administrators will reimburse you for authorized services according to your plan design.
  2. Please complete all sections of this form to ensure proper benefit allocation. Plan information may be found on your benefit ID card.
  3. First American Administrators will only accept itemized paid receipts that indicate the services provided and the amount charged for each service. The patient name and date of service must be included on the receipt. The services must be paid in full in order to receive benefits. Handwritten receipts must be on the provider's letterhead. Attach itemized paid receipts from your provider to the claim form. If the paid receipt is not in U.S. dollars, please identify the currency in which the receipt was paid.
  4. Sign the claim form

American Fidelity Assurance (AFA) - Flex Medical, Annuities & Other Insurance

Washington National Insurance

AFLAC - American Family Life Assurance Company

AAA Auto Club Membership

AAA Membership forms are available for those who are interested in AAA Membership, please complete this AAA Membership Form (PDF) and contact Denise Hott by phone at 304-822-3528, ext. 133 or email Denise Hott.

If you are currently a AAA member, you will automatically be renewed unless you indicate that you no longer want to keep it.

It can only be payroll deducted if 25 or more employees participate.

Student Accident Insurance

Information about QBE Student Accident Insurance plus enrollment forms and instructions can be found on the Student Accident Insurance page.