Employers

At Saint Mary’s Health Plans, our goal is to make our health plans easy to understand and our coverage easy to access. We are committed to helping both you and your employees get all you need from your health plan by providing all our tools and resources is an efficient and convenient manner. Below are links to a variety of downloadable forms needed to manage both your health care management needs and the needs of your employees.

• Health Choice PPO Master Application (PDF)
• Health Choice PPO Enrollment Change/Termination Form (PDF)
• Health Choice PPO Group Waiver Form (PDF)
  
• HealthFirst HMO/POS Master Application (PDF)
• HealthFirst HMO/POS Enrollment Change/Termination Form (PDF)
• PCP Selection Instructions for Southern HMO (PDF)
• HealthFirst HMO/POS Group Waiver Form (PDF)
  
• Small Group Health Questionnaire (2-50 Eligible Employees) (PDF)
• Large Group Health Questionnaire (51+ Eligible Employees) (PDF)
• Sole Proprietor, Partner, or Corporate Officer Statement (PDF)
• Health Information Authorization Release Form (Underwriting) (PDF)
  
• Member Claim Form (PDF)
• Catalyst Rx Member Reimbursement Form (PDF)
• Disclosure of Health Information Form (English) (PDF)
• Disclosure of Health Information Form (Spanish) (PDF)
• Catalyst Mail Mail-Order Form (PDF)
• Catalyst Mail Health, Allergy & Medication Questionnaire (PDF)
  
  
• How to Read an Invoice (PDF)
• Enrollment & Premium Billing Administrative Manual (PDF)

If you have any questions, please call our Sales Department Monday through Friday, 8 a.m. to 5 p.m. at

Northern Nevada
1510 Meadow Wood Lane
Reno, NV 89502
775.770.6065 

Southern Nevada
2475 Village View Drive, Ste. 100
Henderson, NV 89074
702.260.3012