Additionally, an employer who has elected to provide injured workers access to care through the ZHCN has four basic responsibilities:

1. Communicate to their current employees and all new hires that the company participates in the ZHCN and document the communication and responses. This is done through the distribution of the Notice of Network Requirements (NONR) packet.
2. Collect a signed Network Acknowledgement form from each employee and maintain it in the employee’s personnel file.  Click here for a sample NONR Tracking Form.
3. Post a copy of the NONR at each company location.
4. Provide the Notice to the employee again at the time of injury. (A Zenith claim examiner will confirm with the employer that the NONR was provided to the employee upon injury, and request a copy of the signed Network Acknowledgement form.)

The Notice of Network Requirements (NONR) is a roadmap designed to help employees navigate through the ZHCN. It contains all the information employees should know in order to seek treatment from a Network physician and includes contact information needed to reach Zenith with questions.

Notice of Network Requirements Packet:

Due to the transition to the new ZHCN, two different NONR Packets will be in use until approximately March 2010. The following explains when each packet should be used.

New ZHCN NONR Packet: Use this form to notify employees of the new ZHCN, and for any work-related injuries that occur after Zenith’s implementation of the new ZHCN on 02/16/2010.

Download the NEW NONR Packet.

Old Interplan-ZHCN NONR Packet: Use this form to notify employees of the old Interplan-ZHCN and for any work-related injuries that occur before 02/16/2010.

Download the OLD Interplan-ZHCN Packet.