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Frequently Asked Questions

Answers to common questions you may be asked by employers are provided below.

Where can I find copies of the benefit summaries or summaries of benefit coverage (SBC) for quotes or groups?

Copies of group-specific benefits summaries, or SBCs, as well as pharmacy summaries can be found on the Member Reference Desk. You will be prompted to enter your group’s number in order to view this information.

Can employers make enrollment and eligibility changes online?

Through PHP’s online management tool, MyPHP, employers can enroll or terminate an employee or dependent, view a roster of their group’s current enrollees, and make address changes online.

How do employers enroll in MyPHP?

Employers can contact PHP Sales at 517.364.8484 to enroll in MyPHP. They will need their company’s group number and contact e-mail address available to provide to a PHP representative. Their MyPHP password will be e-mailed a few days after we set up the new account.

How can I find participating providers?

To find a participating doctor, visit the Provider Directory page.

Does PHP sell an individual plan?

PHP has individual plans available both on and off the Healthcare Exchange.  For more information about healthcare reform and individual plans, visit the PHP Healthcare Exchange microsite.

Can employer groups pay their premiums online?

Employer groups can send checks to the following address. At this time, groups cannot pay their premiums online.

PHP
PO Box 673723
Detroit, MI  48267-3723

Can employer groups have their premiums automatically deducted from their bank account each month?

At the present time, PHP is not offering automatic payments to its employer groups.

Do the out-of-pocket (OOP) maximum amounts shown on quotes include the deductible?

For PHP’s qualified high-deductible health plans (HDHP), the OOP maximum includes the deductible. For all other quoted products, the OOP maximum does not include the deductible. 

What if I have employees residing outside of the PHP service area?

In order for your group to take part in PHP’s HMO plan, your employees must live within the PHP service area. PHP HMO members who live outside of the PHP service area must agree to receive services from participating providers in the service area.

If your group has the PHP Plus plan (or POS product) or PHP’s PPO product, and you have a new enrollee who lives outside of PHP’s service area, please notify PHP’s Enrollment Department so that the new enrollee can be placed in the appropriate network class to receive in-network benefits.

What if a PHP member needs to seek services while traveling out of the area?

A member who has an emergency situation when traveling outside PHP’s service area, should visit the nearest urgent care center or emergency department, regardless of whether it is in the PHP network.  

Emergency services are always covered under your in-network benefit. If you are traveling and require urgent services and are not familiar with providers in the area, call GlobalCare CustomerCare Center at 866.807.6193 or 770.667.0247 at any time of the day or night, and they will direct you to the nearest GlobalCare provider.

What is the PHP formulary?

A formulary is a list of prescription drugs covered by a particular PHP drug benefit plan.  PHP, in conjunction with its pharmacy benefit manager, ExpressScript, reviews its formularies (otherwise known as Prescription Drug Lists – PDL – on a regular basis to ensure that they are up-to-date. 

Are there pre-existing condition clauses in your policies?

There are no pre-existing clauses under any PHP policies.

How do I enroll a member, make a change or check the status of an enrollment or change?

Call PHP’s Enrollment Department at 517.364.8320 or fax your request to 517.364.8416.

What dental plans are offered – and what are the rates?

PHP offers a number of dental plans through 2016 Delta Dental Rates.

Can a producer receive commissions for referring someone to HIP Michigan?

Commissions are not available for referrals to HIP Michigan.

How do I get appointed with PHP?

Please send back this packet with all the necessary documents to the name listed on the checklist.  After our Administrative Assistant receives your information you will be contacted with further information - Producer Appointment Form.     If you would like to receive PHP agent mailings and haven’t yet sold a group, contact the PHP Sales Department at 517.364.8484.