State managed care

If you are enrolled in the ZSC Select MPN or the ZSC Primary MPN or Zurich’s CA MPN; First Health Comp America Select HCO or First Health Comp America Primary HCO – the following is important information you will need:

MPN website: www.zurichna.com

MPN address: 1299 Zurich Way, Schaumburg, IL 60196-1056

Medical Access Assistant: 866-732-5342 available Monday through Saturday 7:00 am to 8:00 pm Pacific time to provide employee assistance with access to medical care under the MPN

MPN Contact: Sheree Barros, MPN Contact and Grievance Coordinator 800-835-7169

MPN Materials: If you need to obtain a copy of The Complete Written Employee MPN Notification, Transfer of Care Policy Process , Continuity of Care Policy Process or a copy of the Second or Third Opinion Policy Process, you can request by contacting our MPN Contact at 800-835-7169.

MPN ID number: If you do not know or recall your MPN ID number from the original documents provided, please contact your employer or call us at 800-835-7169

OR

If your employer is Anthem, please click here for MPN information.

The following are the necessary documents for implementing the California Medical Provider Network (MPN). The Time of Hire pamphlet must be given to all newly hired employees in the state of California, regardless of enrollment in the MPN.

Employer Instructions

• Enrollment Instructions for CA MPN

CA Complete Employee Notice

• English
• Spanish

Time of Hire Pamphlet

• English
• Spanish

Template - MPN Coverage Termination Notice to Employee

The employer should use their own letterhead for the template.

• English
• Spanish

Additional Forms

Continuity of Care Plan Overview for Employees

• English
• Spanish

Second and Third Opinion Plan Overview for Employees

• English
• Spanish

Transfer of Care Plan Overview for Employees

• English
• Spanish

If you would like to enroll or obtain education materials for this state, please send an email to mcaenrollment@zurichna.com.

Florida Handbook (English)

Florida Handbook (Spanish)

For your convenience, Zurich is pleased to offer electronic funds transfer (EFT) payments. Learn more.

Utilization Review Plan Information Materials

• Overview

Enrollment Information

• Complete Enrollment Kit

Enrollment Letter to Employer

• Employer Instructions for Enrollment

Notice of Network Requirements

• Notice of Network Requirements (English)
• Notice of Network Requirements (Spanish)

Employee Acknowledgement Form

• Employee Acknowledgement Form (English)
• Employee Acknowledgement Form (Spanish)

Additional Information

• Employer FAQ
• Predesignation of Personal Physician (English)
• Predesignation of Personal Physician (Spanish)
• Provider Instruction Form
• Employee Acceptance Log

Vermont Utilization Review Pre-certification List

If you would like to enroll or obtain education materials for this state, please send an email to mcaenrollment@zurichna.com.