Administration Manual

Administration Manual

Your Quick Reference Guide to CDPHP

We strive to make our programs simple to administer. This informative manual will help make CDPHP health benefits management as easy as possible. You’ll find general guidelines on the policies and procedures of our plans as well as links to more detailed information and commonly used forms.

• Administration Manual
• View the entire CDPHP Administration Manual
• Table of Contents
• Welcome: Who to call.
• Product Guide: Highlights of our diverse plan offerings.
• Service Area: Online provider search, worldwide emergency care, and national networks.
• Wellness: Education, disease management, and online resources.
• Healthy Savings: Special CVS discount and other savings tools.
• Prescription Drug Coverage: Online access to detailed pharmacy benefits.
• Underwriting Participation Guidelines: Group requirements and necessary forms to join a CDPHP plan.
• Group Procedures: How to enroll, renew, or make changes to a plan.
• Group Medicare Eligibility and enrollment basics for our Medicare plans.
• Member Procedures: Member eligibility, enrollment requirements, and qualifying events.
• Pre-existing Condition Clause: Qualifications and exceptions for a pre-existing condition.
• Billing: The CDPHP billing process and checklist for paying invoices.
• Corporate Compliance: Privacy rights and protecting the confidentiality of personal health information.
• Complaints, Grievances, and Appeals: Brief procedural guides to manage discrepancies.