Plan Documents – Haraden Motor Car Corp

Plan Documents

Everything you need in one place.

Below you’ll find links to information and forms, which you can view or download and print.

If you prefer talking with a HealthEZ representative, call 844-475-2805

2026 Medical Benefit Information

Benefit Overview	Provides a high level overview of your HealthEZ medical benefits.
Bronze Plan SBC	Provides an easy-to-understand summary about a health plan’s benefits and coverage.
Gold Plan SBC	Provides an easy-to-understand summary about a health plan’s benefits and coverage.
Silver Plan SBC	Provides an easy-to-understand summary about a health plan’s benefits and coverage.
2026 Summary Plan Description (SPD)	The Summary Plan Description for the plan year effective 6/1/2026 has yet to be finalized and will be posted once available. In the meantime, if you have questions on your plan's benefits, please contact the number at the top of this page.

HealthEZ Resources

Member App Instructions	Provides instructions on downloading the MyHealthEZ app and creating an online account.
Member Portal Overview	A brief video overview of your MyHealthEZ portal where you be able to find EOBs, statements, accumulator data, ID cards, and so much more.
Boost Your Baby	HealthEZ offers maternity support by providing education and resources to promote a healthy pregnancy through postpartum.
HealthEZ EZPay	Manage all your medical expenses in one simple spot with EZpay. Everything you need is at your fingertips in the free HealthEZ app.
Understanding Your ID Card	Provides an easy-to-understand summary about how to read your HealthEZ ID card.

HealthEZ Care Advocacy

Care Advocacy	Helping you when you need it the most.
Care Advocacy Enrollment Form	HealthEZ wants to make sure that your medical care during your health insurance transition is as seamless as possible

Teladoc Benefits

Teladoc Overview	You’ve got Teladoc virtual health!
Teladoc Mobile Enrollment	How to set up your Teladoc Health account through the app
Teladoc Online Enrollment	How to set up your Teladoc Health account through your preferred browser

Ancillary Benefits

Balance Bill Flyer	Provides steps on comparing medical bills to an Explanation of Benefits (EOB), what to do if there is a balance bill, and steps for resolution.
Surgical & Imaging Flyer	Provides an overview of the Surgical and Imaging benefit offered through Vālenz.

Coordination of Benefits

Coordination of Benefits Form	Fill out the Coordination of Benefits form and submit to HealthEZ to document any secondary insurance coverage

Member Appeal Form

Member Appeal Form	Member Appeal Form

Preventive Care Guidelines

Preventive Care Guidelines	An ounce of prevention is worth a pound of cure. That’s why your health plan fully covers preventive care services. These services are defined by the U.S. Preventive Services Task Force and vary depending on age, sex, and pregnancy. All services classified as Grade A or B are covered at no cost to you.

Precertification List

Precertification List	Common services that require precertification. For services not listed, contact the number at the top of this page for more information.

Important Notices

Paper Employee Benefit Notices	Acknowledgement of Paper Employee Benefit Notices
Notice of Electronic Disclosure	Notice of Electronic Disclosure of Employee Benefit Notices, Summary Plan Description, and Plan Amendments
CHIP Model Notice	Premium Assistance under Medicaid and the Children’s Health Insurance Program
COBRA Notice	General COBRA Notice
GINA Booklet	The Genetic Information Nondiscrimination Act
HIPAA Notice	HIPAA Privacy Notice
Newborns Act	Newborns’ and Mothers’ Health Protection Act
Special Enrollment Rights Notice	Special Enrollment Rights Notice
WHCRA	Women’s Health and Cancer Rights Ac