Document Library
Category:
HRA - FSA - HSA
Member Spending Accounts Mobile App Quickstart Guide
Form #LH-1545-PHP
Audience: Members
Format: Flyer
Share with members as an introduction to the FSA/HRA mobile app; walks them through using the app for the first time.
Updated: 4/24
Benefits Spending Account Enrollment Guide Brochure
Form #LH-203
Audience: Members
Format: Brochure
Share with members as a guide to help them enroll in their flexible spending account benefits.
Updated: 4/24
Members FSA-HRA FAQ (with FSA/HRA benefit card) Flyer
Form #LH-1677-PHP
Audience: Members
Format: Flyer
Share with members to answer common questions that come up about their FSA and how to use their card.
Updated: 4/24
Claim Form: Health Reimbursement Account Reimbursement Form
Form #LH-2056-PHP
Audience: Members
Format: Form
Share with members requesting reimbursement from health reimbursement accounts.
Updated: 4/24
Claim Form: FSA Reimbursement Form
Form #LH-2059-PHP
Audience: Members
Format: Form
Share with members requesting reimbursement from FSAs.
Updated: 4/24
Benefit Spending Accounts Consumer Portal QuickStart Guide
Form #LH-1269-PHP
Audience: Members
Format: Brochure
Share with members as a guide to accessing their online Portal to submit claims, view account balances, download plan information, upload receipts, track expenses and more.
Updated: 3/24
Eligible/Ineligible Expenses
Form #LH-389
Audience: Members
Format: Brochure
Share with members to give members a broad overview of what they can and cannot pay for using funds in their FSA.
Updated: 3/24
Employer Portal Quickstart Guide
Form #LH-1268
Audience: Brokers
Format: Brochure
Share with employers and brokers as an overview of the portal.
Updated: 3/24
Commuter Benefits (FSA/HRA benefit card)
Form #LH-1672
Audience: Members
Format: Flyer
Share with members to show how to use FSA/HRA benefit card to pay for commuter expenses.
Updated: 3/24
Commuter Benefits FSA Reimbursement Form
Form #LH-2057-PHP
Audience: Employers/Clients
Format: Form
Share with clients for employees requesting reimbursement from commuter benefits FSAs.
Updated: 3/24
FSA Direct Deposit Form
Form #LH-2058-PHP
Audience: Employers/Clients
Format: Form
Share with clients for employees requesting direct deposit to FSAs.
Updated: 3/24
Annualized Dependent Care Reimbursement Form
Form #LH-2055-PHP
Audience: Employers/Clients
Format: Form
Share with clients for employees requesting reimbursement from dependent care accounts.
Updated: 3/24
Members
Knowing Where to go for Care Member Flyer
Form #R450-1495_PHP
Audience: Members
Format: Flyer
Provide members with this flyer to help educate them about the appropriate location to receive care–their doctor's office, an urgent care facility, or the ER.
Updated: 9/25
Shop for Care and Save Money (Healthcare Bluebook Member Flyer)
Form #LH-3151-PHP
Audience: Members
Format: Flyer
Share with members to show them how to shop for care and save money with Healthcare Bluebook.
Updated: 9/24
Individual Case Management Member Flyer
Form #R006-32_PHP
Audience: Members
Format: Flyer
Share with members to educate them on how case management can help them.
Updated: 7/24

Promise Health Plan Medical Claims Form
Form #N/A
Audience: Employers/Clients
Format: Form
Share with clients who need to complete a medical claim.
Updated: 4/24
ID Card Carrier
Form #LH-1129-PHP
Audience: Members
Format: Flyer
Sent to members with their ID cards attached.
Updated: 4/24

myPromiseHealthPlan.com Member User Guide
Form #LH-2200-PHP
Audience: Members
Format: Brochure
Step-by-step overview of the myPromiseHealthPlan.com member portal.
Updated: 4/24

Promise Health Paper Enrollment Form
Form #N/A
Audience: Members
Format: Form
Share with members to initiate the enrollment process.
Updated: 4/24
Access Your ID Card Online Member Flyer
Form #LH-2455-PHP
Audience: Members
Format: Flyer
Share with members to promote accessing their ID card digitally via the portal or mobile app.
Updated: 4/24
Member Mobile App Flyer
Form #LH-1162-PHP
Audience: Members
Format: Flyer
Share with members to inform them about the capabilities of Promise Health Plan's mobile app and encourage them to download.
Updated: 4/24
A Member's Guide To Registering on myPromiseHealthPlan.com
Form #LH-714-PHP
Audience: Members
Format: Brochure
Share with members to walk them through how to register for the portal.
Updated: 4/24
New Member Welcome Letter (CVS)
Form #LH-1191-PHP
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the CVS ID card + contact info.
Updated: 4/24
New Member Welcome Letter (ESI + PHCS)
Form #LH-1191-PHP-ESI-PHCS
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the ESI/PHCS ID card + contact info.
Updated: 4/24
New Member Welcome Letter (ESI)
Form #LH-1191-PHP-ESI
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the ESI ID card + contact info.
Updated: 4/24
New Member Welcome Letter (CVS + PHCS)
Form #LH-1191-PHP-CVS-PHCS
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the CVS/PHCS ID card + contact info.
Updated: 4/24
New Member Welcome Letter (Optum)
Form #LH-1191-PHP-OPTUM
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the Optum ID card + contact info.
Updated: 4/24
New Member Welcome Letter (Liviniti + PHCS)
Form #LH-1191-PHP-Liviniti-PHCS
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the Liviniti/PHCS ID card + contact info.
Updated: 4/24
New Member Welcome Letter (Liviniti)
Form #LH-1191-PHP-Liviniti
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the Liviniti ID card + contact info.
Updated: 4/24
New Member Welcome Letter (Optum + PHCS)
Form #LH-1191-PHP-OPTUM-PHCS
Audience: Members
Format: Flyer
Provide members with this welcome letter to introduce them to Promise Health Plan and provide answers on key FAQs. This version includes the Optum/PHCS ID card + contact info.
Updated: 4/24

Member Welcome Journey
Form #N/A
Audience: Members
Format: Excel/PowerPoint/Word
Visual walk through of the member welcome journey experience and logic.
Updated: 4/24
Transition of Care/Continuity of Care Member Flyer
Form #LH-2942-PHP
Audience: Members
Format: Flyer
Gives employers and members an overview of transition of care process; to be paired with transition of care form.
Updated: 3/24
Sample EOB
Form #N/A
Audience: Members
Format: Flyer
Sent to members to show their claims and what their benefits paid.
Updated: 1/24
Pre-certification Member Flyer
Form #R450-2498_PHP
Audience: Members
Format: Flyer
Provide members with this flyer to answer FAQs about pre-certification, including what it is and why it's important.
Updated: 12/23
Member Portal Overview Flyer
Form #LH-1218_PHP
Audience: Members
Format: Flyer
Share with members to give them an overview of the portal, including opting in for electronic communications.
Updated: 12/23
Frequently Asked Questions - Members
Form #LH-3089-PHP
Audience: Members
Format: Flyer
Share with members to answer frequently asked questions.
Updated: 12/23
Case Management Member Flyer
Form #R450-2974_PHP
Audience: Members
Format: Flyer
Share with members to educate them on how case management can help them.
Updated: 10/23
Three Reasons to Schedule Your Annual Exam Member Flyer
Form #R450-2645_PHP
Audience: Members
Format: Flyer
Provide members with this flyer to stress the importance of regularly visiting their primary care provider.
Updated: 10/23
Member EOB Flyer
Form #R006-178_PHP
Audience: Members
Format: Flyer
Provide to members to help them understand their EOBs.
Updated: 10/23
Is it in-network? Member Flyer
Form #R450-1883_PHP
Audience: Members
Format: Flyer
Provide members with this flyer to help empower them to work with their doctor to find in-network care for lab work and planned surgeries.
Updated: 10/23
Sales Materials
Portal Eligibility Submission Tutorial Flyer
Form #LH-3227-PHP
Audience: Brokers
Format: Flyer
Share with brokers and clients to walk them through how to submit eligibility updates via the portal.
Updated: 5/24

Client / Broker Portal User Guide
Form #LH-2199-PHP
Audience: Brokers, Employers/Clients
Format: Brochure
Clients and Brokers can refer to this tutorial guide to learn about the capabilities of Promise Health Plan's portal and how to navigate it.
Updated: 1/24
New Client Finance Document (ASO)
Form #N/A
Audience: Internal, Brokers
Format: Flyer
This form outlines the workflow and information needed to set up financial interactions between Promise Health Plan and its clients.
Updated: 1/24
New Client Finance Document (Level-Funded)
Form #N/A
Audience: Internal, Brokers
Format: Flyer
This form outlines the workflow and information needed to set up financial interactions between Promise Health Plan and its clients.
Updated: 1/24
A Broker's Guide To Registering on mypromisehealthplan.com
Form #LH-2647-PHP
Audience: Brokers
Format: Brochure
Share with brokers to walk them through how to register for the portal.
Updated: 1/24
A Client's Guide To Registering on mypromisehealthplan.com
Form #LH-2138-PHP
Audience: Employers/Clients
Format: Brochure
Share with clients to walk them through how to register for the portal.
Updated: 1/24

Provider Portal User Guide
Form #LH-2113-PHP
Audience: Providers
Format: Brochure
Providers can refer to this tutorial guide to learn about the capabilities of Promise Health Plan's portal and how to navigate it.
Updated: 1/24
Promise Health Plan Implementation Checklist
Form #R450-2410_PHP
Audience: Brokers
Format: Flyer
Share with new partners to help them navigate the implementation process.
Updated: 12/23
Promise Health Plan Design & Solution Overview Brochure
Form #B680-MK122_PHP
Audience: Brokers
Format: Brochure
Get a look at Promise Health Plan's flexible plan designs, capabilities, and locations requirements.
Updated: 12/23
RFP Form
Form #R450-3057_PHP
Audience: Brokers
Format: Form
Brokers complete this form when requesting info from Promise; also includes a list of RFP submission requirements.
Updated: 12/23

Promise Health Plan Utilization Management Process Flow
Form #R450-2938_PHP
Audience: Brokers, Employers/Clients
Format: Flyer
Review how the Promise Health Plan utilization management process works, from intake to appeals.
Updated: 12/23
Promise Health Plan Case Management Process Flow
Form #R450-2909_PHP
Audience: Brokers
Format: Brochure
Review how the Promise Health Plan case management process works, including affected diagnosis codes.
Updated: 12/23
Frequently Asked Questions - Employers
Form #LH-3085-PHP
Audience: Employers/Clients
Format: Brochure
Share with employers to answer frequently asked questions.
Updated: 12/23