Healthcare Providers

Provider Resources
& Plan Information

At the NALC Health Benefit Plan, we recognize that your dedication is the foundation of our members' well-being. We are committed to standing by you with the clear information, clinical resources, and responsive support you need to provide seamless care.

To ensure you access the correct provider networks, claim filing instructions, and eligibility tools, please select the specific plan option listed on your patient’s Member ID card.

Identify Your Patient's Plan

High Option Plan

This plan is designed for members seeking traditional coverage. It features the Cigna Healthcare OAP network for medical care and Optum for Mental Health & Substance Use support.

Explore High Option Resources

Consumer Driven Health Plan (CDHP)

This plan empowers members with a Personal Care Account (PCA). It utilizes the Cigna Healthcare OAP Network for medical services, and the Cigna Behavioral Health for mental health & substance use support.

Explore CDHP Resources

Provider Administrative & Clinical Guidance

We have gathered these essential tools to help you navigate our general policies, billing requirements, and clinical criteria with ease.

Provider Administrative & Clinical Guidance

Review our streamlined filing requirements, timely filing limits, and reimbursement policies to ensure efficient claim processing.

Explore Claims & Billing Information

Download the complete brochures for an in-depth look at covered benefits, exclusions, and plan limitations. Click here if you would like to review the Plan Brochure for 2025.

Get Official Plan Brochure 2026

Help us maintain the integrity of our healthcare community by reviewing our guidelines on identifying and reporting potential fraud.

Learn More

We're Here to Help

Our team is ready to assist you.

If you have questions about our plans or need additional guidance navigating these resources.

Go to Contact Page