Resources for Employer Plans

Find more information about benefits, claims, and coverage here.

Benefits

Legal Forms & Notices

Appeal Rights

View PDF

How to Submit a Pre-Authorization

View PDF

Medical Power of Attorney

View PDF

Member Complaint Form

View PDF

Minor Dependent PHI Access

View PDF

Pharmacy Pre-Authorization Form

View PDF

Pre-Authorization Form

View PDF

Transition of Care Form

View PDF

Hours of operation

Monday - Friday, 8am - 5pm CT

Have more questions?

Talk with a Harbor Health human at (855) 481 0225

Call us

Resources for Employer Plans

Find more information about benefits, claims, and coverage here.

Benefits

Cost Share Reduction Explanation

Medical Claim Form

Member Handbook Sample

Pharmacy Claim Form

Referral Form

Transparency in Coverage

Written Plan Description with IVF

Written Plan Description without IVF

Legal Forms & Notices

Member Complaint Overview

Pre-Authorization List

Appeal Rights

How to Submit a Pre-Authorization

Medical Power of Attorney

Member Complaint Form

Minor Dependent PHI Access

Pharmacy Pre-Authorization Form

Pre-Authorization Form

Transition of Care Form

Hours of operation

Monday - Friday, 8am - 5pm CT

Have more questions?

Talk with a Harbor Health human at (855) 481 0225