Quartz Align Participants Information & Forms

Quartz Align participants

Congratulations! Your employer has selected Quartz Align to administer its self-funded health plan benefits. Together we’ll ignite a spark for well-being. Here are some quick links to access information about your plan coverage:

(To confirm this is your plan, look for the Quartz Align logo on your member ID card.)

You’ll use the MyCreateHealth portal for secure access to your Quartz Align health coverage details. To log in, you’ll first need to follow the simple prompts to register as a new user. Then, you’ll have 24/7 access to your benefits information.

Mobile access with the MyCreateHealth app

After creating your login on the MyCreateHealth online portal, download the MyCreateHealth mobile app from the Apple App Store or Google Play for on-the-go access to your account information. Log in using the same username and password that you set up in the online portal.

The app includes a growing list of features:

Check coverage | See your eligibility and summary of benefits (SOB), plan details, and more

Access your digital ID card | View, print, or email a digital copy of your ID card online or from the app

View claims | See your claims and Explanation of Benefits (EOB)

Find a provider | Use the search tool to find participating doctors, labs, and other facilities

Track your balances | Instantly access your out-of-pocket maximums, medical costs and other details

Quartz Align Member Forms & Resources

Appeals

To verify if your employer offers Appeals, please refer to your Summary Plan document.

All appeals must be submitted in writing within 180 days following the receipt of notification of an Adverse Benefit Determination. If the appeal qualifies as an Expedited case, then the appeal request can be taken verbally. Appeals Specialists will work with appropriate staff to determine if an appeal qualifies to be expedited.

Appeals Specialists will determine if an appeal is a valid appeal by verifying that Quartz has processed the issue correctly. Valid appeals will be acknowledged within five business days by a mailed letter to the participant. The appeal will be resolved within 30 days for pre-service requests and 60 days for post-service claims. Participants have the right to submit relevant testimony with the appeal.

Providers can file appeals on behalf of participants, with the participants’ permission. In order to obtain proper authorization, the Appointment of Authorized Representative form will need to be signed by the participant.

Once a decision has been reached and if it is unfavorable for the participant, you may have the option to file a request for external review. If this is an option for your appeal, the external review rights will be given to you with the final internal determination.