Employers/Brokers
Members
Request Customized Quote
- Application for Rate Proposal
- Census Form
- Employer Application & Certification
- Employee Medical Questionnaire - groups with 10 or fewer employees, and groups applying for UHA's Small Business Plan. Must complete one for each eligible employee.
Providers
- Provider Handbook
- Change Existing Provider Information
- W-9
- Request for Prior Authorization
- Request for Prior Authorization for Psychological Testing
- Request for Prior Authorization for In Vitro Fertilization
- Request for Prior Authorization for Injectible and Prescription Drug
- Guidelines for Outpatient Psychological Testing
- Pediatric Health Screening Checklist
Benefit Information
- UHA 600 Medical Benefits Guide
- UHA 2000 Medical Benefits Guide (MBG) — for groups with effective dates on or after 10/1/07
- UHA 2000 Medical Benefits Guide (MBG) — for groups with effective dates prior to 10/1/07
- UHA 3000 Medical Benefits Guide
- UHA Standard Dental and DentalPlus
- Better Health, Better Life Booklet
Directories & Listings
Additional Forms
HIPAA
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