Group & Employer Plan Members Forms and Resources

Access the forms you need

Get secure and convenient access to member forms and resources through MyChart.

Printed materials

If you would like printed materials, complete the Request Materials form in Quartz MyChart, or send a message.

You can also contact Quartz Customer Success at (800) 362-3310.

Printed materials you can request include:

  • Provider Directory
  • Member Guide
  • Certificate of Coverage
  • Prescription Drug Benefit brochure
  • Preventive services covered under the Affordable Care Act
  • Prescription Drug Formulary
  • Notice of Privacy Practices

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Essential information and resources
Protected Health Information (PHI) Authorization
  • You have the right to allow someone else to access your Protected Health Information (PHI). To do so, please complete and submit the Authorization for Disclosure of Protected Health Information form at or in Quartz MyChart.
  • You may also print and mail the Authorization to Disclosure of Protected Health Information form and send it to Quartz.

Appeals & Grievances

You or your authorized representative may request an initial decision or appeal. Your prescriber or treating provider may also request it for you.

Contact us

Quartz is committed to providing superior customer service. That's one reason we offer so many ways to reach us.