Resources for Employer Plans
Find more information about benefits, claims, and coverage here.
Benefits
2025-2026 Member Handbook Sample
View PDF2025-2026 Written Plan Description with IVF
View PDF2025-2026 Written Plan Description without IVF
View PDFMedical Claim Form
View PDFPharmacy Claim Form
View PDFReferral Form
View PDFTransparency in Coverage
View PDFLegal Forms & Notices
Appeal Rights
View PDFCoordination of Benefits (COB) Form
View PDFHow to Submit a Pre-Authorization
View PDFMedical Power of Attorney
View PDFMember Complaint Form
View PDFMinor Dependent PHI Access
View PDFPharmacy Pre-Authorization Form
View PDFPre-Authorization Form
View PDFPre-Authorization List of Codes
View PDFSample Evidence of Coverage
View PDFTransition and Continuity of Care Member Guide
View PDFTransition and Continuity of Care Patient Request
View PDFHave more questions?
Speak with a Harbor Health team member
Monday-Friday, 7:00am-8:00pm CT
Saturday, 8:00am-5:00pm CT
(855) 481-0225