Union Pacific Railroad Employee Health Systems

Some forms and publications are only available to existing UPREHS plan members. Please visit the member login link at the top of the website, or Click Here to visit the login page. Once you have logged in please visit the forms and publications link in that section of our website.

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2010 Open Enrollment

2010 Annual Notice of Change

2010 Open Enrollment Invitation

2010 Preferred Part D Formulary

2010 Non-Preferred Part D Formulary

2010 Prime Medicare Plan Benefit Guide

2010 HCPP Prime Medicare Plan Benefit Guide

2010 Summary of Benefits

2010 Enrollment Packet
   Form 1
   Form 2
   Form 3

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Authorizations & Release Forms

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Benefits Guides & Summaries

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Surviving Spouse Benefit Check List

Company Brochures & Newsletters

UPREHS Company Brochure
Preventing Fraud
Medicare & You 2009

HIPAA

HIPAA Privacy Notice

Health Information & Tips

Traveling with Insulin

Pharmacy

2009 Formularies

Active Member Drug Formulary

Retiree Drug Formulary

Medicare Preferred Drug Formulary

Medicare Non-Preferred Drug Formulary

Earlier Formularies

2008 Medicare Preferred Drug Formulary

2008 Medicare Non-Preferred Drug Formulary

Provider Nomination

Provider Nomination Form

Policies

Privacy Policies
Legal Disclaimers

Plan Coverage, Rules & Regulations

Challenger Plan
60/30 + Plan Summary
60/30 + Plan Rules & Regulations
ERMMB Plan
Medicare HCPP/Supplemental Plan
Prime Medicare Prescription Drug Plan
Pensioner Under 65
Pensioner Under 65 Supplemental Plan
CHC / MMCP Cover Letter 09/07
CHC / MMCP Family Supplemental Plan

Report of Personal Injury

English
Español

Secondary Coverage for Dependents

Open Enrollment Information
Family Supplemental Brochure
Family Sup. Enrollment Application

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