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.

	2023 Plan Year	2022 Plan Year
Annual Notice of Changes (ANOC)	English \| Spanish	English \| Spanish
Evidence of Coverage (EOC)	English \| Spanish	English \| Spanish
Summary of Benefits	English \| Spanish	English \| Spanish
Formulary (List of Covered Drugs)	English \| Spanish	English \| Spanish
Pharmacy Directory	English \| Spanish	English \| Spanish
Primary Care Provider Directory	English \| Spanish	English \| Spanish
Specialty Care Provider Directory	English \| Spanish	English \| Spanish
Over-the-Counter (OTC) Catalog	English \| Spanish	English \| Spanish
Benefits at a Glance	English \| Spanish	English \| Spanish
Non-Discrimination Notice and Multi-Language Interpreter Services	English \| Spanish	English \| Spanish
Star Ratings	English \| Spanish	English \| Spanish
Authorization to Release PHI (Protected Health Information)	Coming Soon!	English \| Spanish
Disenrollment Form	English \| Spanish	English \| Spanish

	2023 Plan Year	2022 Plan Year
Annual Notice of Changes (ANOC)	English \| Spanish	English \| Spanish
Evidence of Coverage (EOC)	English \| Spanish	English \| Spanish
Summary of Benefits	English \| Spanish	English \| Spanish
Formulary (List of Covered Drugs)	English \| Spanish	English \| Spanish
Pharmacy Directory	English \| Spanish	English \| Spanish
Primary Care Provider Directory	English \| Spanish	English \| Spanish
Specialty Care Provider Directory	English \| Spanish	English \| Spanish
Over-the-Counter (OTC) Catalog	English \| Spanish	English \| Spanish
Benefits at a Glance	English \| Spanish	English \| Spanish
Non-Discrimination Notice and Multi-Language Interpreter Services	English \| Spanish	English \| Spanish
Star Ratings	English \| Spanish	English \| Spanish
Authorization to Release PHI (Protected Health Information)	Coming Soon!	English \| Spanish
Disenrollment Form	English \| Spanish	English \| Spanish

Members

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.

Annual Notice of Changes (ANOC)

Evidence of Coverage (EOC)

Summary of Benefits

Formulary (List of Covered Drugs)

Pharmacy Directory

Primary Care Provider Directory

Specialty Care Provider Directory

Over-the-Counter (OTC) Catalog

Benefits at a Glance

Non-Discrimination Notice and Multi-Language Interpreter Services

Star Ratings

Authorization to Release PHI (Protected Health Information)

Coming Soon!

Disenrollment Form

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