Member materials
- Integrative health services member handbook ― English (PDF)
- Integrative health services member handbook ― Spanish (PDF)
- Mental health and substance use treatment services handbook ― English (PDF)
- Mental health and substance use treatment services handbook ― Spanish (PDF)
- Provider and pharmacy directory (PDF)
- Clinical Practice Guidelines (PDF)
- 2026 Value Added Benefits — English (PDF)
- 2026 Value Added Benefits — Spanish (PDF)
Forms
- Submit a Grievance (PDF)
- Member Appeal Form (PDF)
- Authorization to release protected health information (PHI) (PDF)
- Authorization to release psychotherapy notes (PDF)
- Fraud, waste and abuse form
- Grievance and appeal form
- Member advisory committee application ― English (PDF)
- Member advisory committee application ― Spanish (PDF)
- Notification of pregnancy (PDF)
- Transition of care form ― English (PDF)
- Transition of care form ― Spanish (PDF)
- Notice of Privacy Practices — English (PDF)
- Notice of Privacy Practices — Spanish (PDF)
- Protected health information (PHI) access request form GR-69238-1 — English (PDF)
- Protected health information (PHI) access request form GR-69238-1 — Spanish (PDF)
- Request for an Accounting of Disclosures of Protected Health Information (PHI) GR-69239-1 — English (PDF)
- Request for an Accounting of Disclosures of Protected Health Information (PHI) GR-69239-1 — Spanish (PDF)
- Protected health information (PHI) release form GR-69126-1 — English (PDF)
- Protected health information (PHI) release form GR-69126-1 — Spanish (PDF)
- Authorization to release psychotherapy notes GR-69127-1 — English (PDF)
- Authorization to release psychotherapy notes GR-69127-1 — Spanish (PDF)
- Removal of Authorization Previously Given to Aetna GR-69240-1 —English (PDF)
- Removal of Authorization Previously Given to Aetna GR-69240-1 —Spanish (PDF)
- 2026 Member Passport -- English (PDF)
- 2026 Member Passport – Spanish (PDF)
- 2025 Auth and Appeals Metrics
EAC Meeting Minutes
Coming soon