Members

Member Materials

Last Updated: January 10, 2023 at 11:07 pm

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. 

 

 

2023 Plan Year

Annual Notice of Changes (ANOC)

English (Updated - 12/23/2022 12:42 AM) | Spanish (Updated - 12/23/2022 12:36 AM)

Evidence of Coverage (EOC)

English (Updated - 01/10/2023 11:24 PM) | Spanish (Updated - 01/10/2023 11:24 PM)

Summary of Benefits

English (Updated - 12/23/2022 12:59 AM) | Spanish (Updated - 12/23/2022 01:00 AM)

Formulary (List of Covered Drugs)

English | Spanish (Updated - 02/28/2023 09:33 PM)

Pharmacy Directory

English  |  Spanish (Updated - 03/03/2023 04:11 PM)

Primary Care Provider Directory

English (Updated - 02/28/2023 09:30 PM) | Spanish (Updated - 02/28/2023 09:31 PM)

Specialty Care Provider Directory

English (Updated - 02/28/2023 09:32 PM) | Spanish (Updated - 02/28/2023 09:32 PM)

Over-the-Counter (OTC) Catalog

English | Spanish (Updated - 02/16/2023 11:05 PM)

Benefits at a Glance

English (Updated - 10/23/2022 10:40 PM) | Spanish (Updated - 10/23/2022 10:40 PM)

Non-Discrimination Notice and Multi-Language Interpreter Services

English  |  Spanish (Updated - 01/18/2023 12:36 PM)

Star Ratings

English (Updated - 10/21/2022 09:36 AM) | Spanish  (Updated - 10/21/2022 09:56 AM)

Authorization to Release PHI (Protected Health Information)

English | Spanish

Disenrollment Form

English (Updated - 10/31/2022 10:39 PM) | Spanish (Updated - 10/31/2022 10:39 PM)


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