Documents & Forms
Access plan documents and forms that support enrollment, claims and benefits administration.
How to use this page
Search by benefit, plan or company (like “dental” or “Hartford”) and the list narrows as you type. Or jump to a section with the links below the search box.
- Plan summaries & guides: start here. Plain-language overviews and how-tos.
- Summary Plan Descriptions: the full official rules for a plan.
- Summaries of Benefits & Coverage: a standard summary of each medical plan’s costs and coverage, in the same format for every plan.
- Coverage certificates: the insurance company’s contract for your coverage.
- Legal notices: notices Lumexa Imaging must give you each year, including your privacy rights. You can also read them on the Annual Notices page.
Documents open as a PDF in a new tab. Can’t find what you need? Call the Alliant Benefit Advocates at 877-531-8820 (Monday–Friday, 8 a.m.–8 p.m. ET) or email lumexaimagingbenefits@alliant.com.
Plan summaries & guides
Enrollment & eligibility
Dental
Medicare
Supplemental health coverage
Employee Assistance Program
Summaries of Benefits & Coverage
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HIPAA Authorization Form
You may need to complete a HIPAA Authorization Form to grant your Benefit Advocate permission to work with your insurer and/or healthcare provider(s) to resolve your claims issues. Permission is granted on a limited time basis to only the individuals listed on the form. The form is revocable at any time.
Your Benefit Advocate will provide the form to you when needed.
Your Contacts
Alliant Benefit Advocates
Help finding a document or understanding your benefits
877-531-8820
Monday–Friday, 8 a.m.–8 p.m. ET