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Member Handbook (downloadable PDF)
(updated 9/24/2007)
Complete Member Handbook in PDF format. You may open and print this complete handbook or select a topic below to view specific information contained within the handbook.
Important Telephone Numbers
(updated 9/24/2007)
A Local Health Plan
(updated 9/24/2007)
Choice of Health Care Providers
(updated 9/24/2007)
Do I Have to Designate A Primary Care Practitioner (PCP)?
(updated 9/24/2007)
Importance of Your Primary Care Practitioner (PCP)
(updated 9/24/2007)
Pre-Service Authorizations
(updated 9/24/2007)
When Do I Need A Pre-Service Authorization?
(updated 9/24/2007)
Services That Do Not Require Pre-Service Authorization
(updated 9/24/2007)
Whose Responsibility Is It To Obtain Required Pre-Service Authorizations?
(updated 9/24/2007)
How Will Bills Be Paid If I Receive Care From a Non-Participating Specialist?
(updated 9/24/2007)
Continuity of Care
(updated 9/24/2007)
Utilization Management
(updated 9/24/2007)
Affirmative Statement Regarding Incentives
(updated 9/24/2007)
Emergency Care
(updated 9/24/2007)
Urgent Care
(updated 9/27/2007)
Out of Area Care
(updated 9/24/2007)
Out of Area Medical Care for College Students
(updated 9/24/2007)
Benefits
(updated 9/24/2007)
Wellness Benefits
(updated 9/24/2007)
Office Services
(updated 9/24/2007)
Behavioral Health Care
(updated 9/24/2007)
Chiropractic Services
(updated 9/24/2007)
Exclusions
(updated 9/24/2007)
Coordination of Benefits
(updated 9/24/2007)
Insurance Identification Card
(updated 9/24/2007)
Not Sure If You Should See a Doctor?
(updated 9/24/2007)
How to File a Claim
(updated 9/24/2007)
Claims Denials
(updated 9/24/2007)
How to Voice a Complaint or File a Grievance
(updated 9/24/2007)
Your Right to an Independant Review
(updated 9/24/2007)
Your Right to an Employee Trust Funds (ETF) Review
(updated 9/24/2007)
New and Emerging Medical Technologies
(updated 9/24/2007)
Collection, Use, and Disclosure of Health Information
(updated 9/24/2007)
Your Rights As A Health Plan Member
(updated 9/24/2007)
Your Responsibilities As A Health Plan Member
(updated 9/24/2007)
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