Midwest Public Risk: Download Forms

Download Forms

All of the forms listed below are in PDF format which allows you to view them electronically on most computers. The Adobe Acrobat reader is required to view and print PDF files. Follow this link to download Adobe free of charge.

All Members

Guide to Your Health Care Benefits

Schools - Updated for 2011-2012
Municipalities - Updated for 2011-2012

Humana HMO Members:

Humana Plan Summary Option 1
Humana Plan Summary Option 2
Humana Plan Document
Humana Website - Check claim status, change Primary Care Physicians, Look up specialists and other providers;
Mail Order Prescription Program

PPO Benefit Info:

PPO Plan Document - Missouri
PPO Plan Document - Kansas
Medtrak Services - Useful pharmacy benefit and service information 1-800-771-4648 or 913-262-2187

Missouri Entities

Kansas Entities

PPO Network Info
Preferred Health Professionals -- Consult your identification card for your Network PPO choices. Locate Physicians and Hospitals in our Network of preferred providers. Please see the explanations below if you need assistance in determining a network area or call 1-800-544-3014.

PHP (Preferred Health Professionals) www.phpkc.com

Freedom Network Select - Network choice for services in 48 counties around the Kansas City area including a 5-county service area in Kansas

HealthLink or Healthlink Open Access III PPO - Network choice for services outside Freedom Network Select in Missouri

HPK (Health Partners of Kansas) - Network choice for services outside Freedom Network Select in Kansas

PHCS - Network choice for services outside Missouri and Kansas

Midlands Choice - Network choice for specific groups (Nebraska and Iowa only)



	19400 East Valley View Parkway Independence, Missouri 64055 • 1-877-627-2481