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Retirees Benefit Information

Online Retiree Insurance Payment: Pay your retiree insurance premium online 

Montgomery College Retiree Group Insurance Enrollment Form: This form is used to notify the Office of Human Resources and Strategic Talent Management of any changes a retiree wishes to make to his/her benefits. 

Retiree Group Insurance Rates: Rates for retirees with 10 or more years of service 

Health Insurance Information, Forms and Links

CIGNA PPO (Preferred Provider Organization)
PPO Claim Form
Summary of Benefits
CIGNA Health Care Website

CIGNA POS (Point of Service)
POS Claim Form
Summary of Benefits
CIGNA Health Care Website 

Caremark Prescription Drug Plan

Effective January 1, 2008 for those insured with either of the CIGNA plans, prescription coverage is through CVS Caremark. All members were mailed new ID cards with the CVS Caremark and Montgomery College logo printed on it. 

Effective January 1, 2015 for those insured in the CIGNA/Medicare plan, prescription coverage is through Silver Script. All members will be mailed new ID cards. 

PPO Prescription Benefits-at-a- Glance
POS Prescription Benefits-at-a-Glance
Caremark Website
Mail Service Order Form
Prescription Drug Claim Form
Silver Script Website
Customer Care: 1-888-790-4266

Dental Insurance Information, Forms and Links

CIGNA (PPO Preferred Provider Organization) Dental
Summary of Benefits
CIGNA PPO Dental Claim Form
CIGNA Website

Cigna DentalCare Plan

This plan provides dental coverage under an HMO-like structure. This plan provides coverage based on a predetermined fee schedule with many basic services being covered at NO CHARGE. There are no patient charges for most preventative procedures, no claim forms, no deductibles and no annual dollar maximums. Complex procedures are available at low, pre-set patient charges.

Fee Schedule
CIGNA Website


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