The forms and documents below are provided for your convenience and easy download. All downloads are in PFD form and require Adobe Reader for viewing. Don’t see what you need here? Contact us, we’re ready to help.

Employer Information

Administrative Guide PDF I 1.4 MB

Authorization Release - Standard Appeal Form PDF | 37 KB

Behavioral Health - MHNet PDF I 47 KB

Certificate of Coverage - Arkansas PDF I 614 KB

Certificate of Coverage - Mississippi PDF | 611 KB

Certificate of Coverage - Tennessee PDF | 570 KB

College Students Passport Program PDF | 76 KB

Coventry Difference PDF | 219 KB

Coventry Electronic Eligibility PDF | 200 KB

Coventry Financial Strength - 2009 PDF | 92 KB

Electronic Enrollment Request Form PDF | 19 KB

Enrollment Form - 2-25 PDF | 453 KB

Enrollment Form - 26-50 PDF | 452 KB

Enrollment Form 51+ PDF | 447 KB

How to Read Your EOB PDF | 816 KB

How to Read Your EOB - Addendum PDF | 75 KB

How to Read Your Premium Invoice - Fully Insured PDF | 135KB: The form provides information detailing the different sections of the premium billing invoice.

How to Read Your Premium Invoice - Self-Insured PDF | 90KB: The form provides information detailing the different sections of the premium billing invoice.

Member Handbook PDF | 1.51 MB

Member Information Flyer PDF | 47 KB

Online Cost of Care Tool PDF | 275 KB

Online Provider Comparison Tool PDF | 264 KB

Online Provider Search Tool PDF | 219 KB

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Electronic Enrollment Request

RELATED INFORMATION

CHC Tennessee

Coventry Health Care

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