Health First Health Plans - group HMO plans

Commercial HMO

These plans are available to Brevard businesses for their employees.

Benefits

Small group plans
(2-50 eligible employees)

For coverage becoming effective
on or after July 1, 2011

Medical plans
State-mandated plans (medical plans for sole proprietors, and also available for small groups)
Prescription drug riders
Vision riders

Large group plans
(50+ eligible employees)

For coverage becoming effective
on or after September 1, 2011

Large and small groups

For coverage becoming effective from January 1, 2010 to June 30, 2011

Medical plans for small groups - 2-50 eligible employees
Medical plans for large groups - 51+ eligible employees
Medical plans for sole proprietors - state-mandated plans (also available for small groups)
Prescription drug riders - for large and small groups
Vision riders - for large and small groups

Prescription drug information

Participating pharmacies
5-tier preferred drug list (formulary)
3-tier preferred drug list (formulary)
Prescription reimbursement form
Order mail order prescriptions online
Prescription mail order form
Pharmacy authorization/exception request form - must be completed and submitted by your physician

Provider information

Authorizations

Medical services that require authorization
Medical authorization request form - must be completed and submitted by your physician
Radiology services that require authorization
Pharmacy authorization/exception request form - must be completed and submitted by your physician

General information

Forms

Prescription mail order form
Prescription reimbursement form
General reimbursement form
Appoint a representative - authorize someone to act on your behalf
Pharmacy authorization/exception request form - must be completed and submitted by your physician
Medical authorization request form - must be completed and submitted by your physician

This information provides a general overview of our commercial HMO plans with answers to important questions. For detailed information, please refer to your Member Handbook or Certificate of Coverage, or contact Customer Service.

Contact customer service