Updated Applications

Our employee applications are newly revised. Download the current versions by state and group size. Please remember, if an employee checks that they are married and the spouse isn’t listed as a dependent on the application, then the waiver on the application needs to be signed for the spouse.

Note: Old applications will only be accepted until November 30, 2019.

Primary Care Providers vs. Primary Care Clinics

In the past, Quartz has required our members to select a primary care provider (PCP), which would show on their ID card. Now we are asking members to name a primary care clinic (PCC). Members who don’t make a selection will be assigned to a clinic near their home, and the clinic name will appear on their ID card as their PCC.

Retroactive Changes

Employers must notify Quartz of terminations within 60 days of the event for policy / premium adjustments. Please reconcile your invoice monthly and report any changes to Quartz immediately.

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