These plans are available to Brevard businesses for their employees, and feature low copayments.

Benefits

For coverage becoming effective 1/1-12/31 2009

• Medical plans for small groups - 2-50 eligible employees
• Medical plans for large groups - 50+ 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

For coverage becoming effective 1/1-12/31 2010

• 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

• Provider directory (search for physicians)
• Provider directory (printable format)
• Ancillary services (labs, hospitals, etc.)
• Participating pharmacies

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

• Member handbook
• Member rights and responsibilities
• Notice of privacy practices
• Member newsletter
• Health education programs
• Agency for Health Care Adminstration

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.