Shared Decision Making
Important Benefit Updates

Benefit Additions for 2018 Group Renewals

Quartz is adding two notable benefits for 2018 group renewals; coverage is effective upon renewal –

  • Bariatric Surgery coverage when prior authorization is obtained and service is provided at UW Health or Gundersen Health System.
    Limited to one (1) per lifetime of the member. Applies to Large Group and Small Group ACA plans with HMO, POS, or PPO network. This coverage does not apply to grandfathered or transitional plans (also known as “keep your plan” or “grandmothered” plans.

  • Updated vision exam coverage.
    First exam is covered without cost-sharing. Subsequent exams apply cost-sharing.

Learning More about Member Pharmacy Benefits

Quartz’s website is a great resource for detailed pharmacy benefit information. Here members can find tips on how to best use their pharmacy benefits.


They can simply go to ​QuartzBenefits.com/pharmacy to learn more.


Members will find information about –

  • Vacation supply, emergency drug supply, step therapy and new member drug supply, generic substitution, as well as prior authorization
  • Programs including Choice 90 Extended Supply Program and Specialty Pharmaceuticals Program
  • Choosing a Pharmacy and the Find a Pharmacy tool

The formulary list is available in a searchable format or PDF and includes quarterly updates.


As programs and policies are updated, ​check back for the most current information.

Changes to Group Certificates for
2018 Renewal

  • Added bariatric surgery coverage when prior authorization is obtained and service is provided at UW Health or Gundersen Health System. Coverage is effective upon renewal. One (1) per lifetime of the member. Applies to Large Group and Small Group ACA plans with HMO, POS, or PPO network. This coverage does not apply to grandfathered or transitional plans (also known as “keep your plan” or “grandmothered” plans.)
  • Updated biofeedback benefit. Coverage requires prior authorization.
  • Clarified electric breast pumps are covered.
  • Clarified foot orthotics are covered for diabetics when prior authorization is obtained.
  • Updated vision exam coverage. First exam is covered without cost-sharing. Subsequent exams apply cost-sharing
  • Added LINX procedure coverage for GERD treatment when prior authorization is obtained.
  • Updated Section 1557-compliant language box and notice paragraph. ​​​​​​