Members

Member Materials

Here is where you will find our most up-to-date information on health plan benefits, provider directories, a list of covered drugs, and more.

If you are a member and would like any of the following documents mailed to you, please call Member Services at 1-800-656-8991, TTY: 711, 8 a.m. to 8 p.m., 7 days a week. 

We are here to help. If you have questions, please call Member Services at 1-800-656-8991, TTY: 711, 8 a.m. to 8 p.m., 7 days a week. 

 

2022 Plan Year

Annual Notice of Changes (ANOC)

English  |  Spanish

Evidence of Coverage (EOC)

English  |  Spanish 

Summary of Benefits

English Spanish

Formulary (List of Covered Drugs)

English  |  Spanish

Pharmacy Directory

English  |  Spanish

Primary Care Provider Directory

English  |  Spanish

Specialty Care Provider Directory

English  |  Spanish

Over-the-Counter (OTC) Catalog

English  |  Spanish 

Benefits at a Glance

English Spanish

Non-Discrimination Notice and Multi-Language Interpreter Services

English  |  Spanish

Star Ratings

English | Spanish 

Authorization to Release PHI (Protected Health Information)

English | Spanish

Disenrollment Form

English | Spanish


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