Click on and download the PDF file for Summary of Benefits, Star Ratings, Ancillary Benefits information, and enrollment forms.
Helpful Forms
rx_review_request_form_4.pdf
cms-40b-4-19.pdf
request_for_employment_information_cms-l564e.pdf
generic_scope_of_appointment.pdf
UHG
SCAN
Blue Shield
Other Helpful PDF Forms
rx_review_request_form_4.pdf
cms-40b-4-19.pdf
request_for_employment_information_cms-l564e.pdf
generic_scope_of_appointment.pdf
UHG
- Assure- 2020_uhc_assure.pdf
- Assure San Diego - 2020_uhc_assure_sd.pdf
- Plan 2 Los Angeles - 2020_plan_2_la.pdf
- Essential - 2020_uhc_essential.pdf
- Focus LA - 2020_uhc_focus_la.pdf
- Focus Riv/SB - 2020_uhc_focus_riv-sb.pdf
- Plan 1 Los Angeles - 2020_uhc_plan_1_la.pdf
- Plan 2 Orange County -2020_uhc_plan_2_oc.pdf
- Plan 2 Riv/SB - 2020_uhc_plan_2_riv-sb.pdf
- Premier Los Angeles - 2020_uhc_premier_la.pdf
- Premier Orange County - 2020_uhc_premier_oc.pdf
- Premier Riv/SB - 2020_uhc_premier_riv-sb.pdf
- Premier San Diego - 2020_uhc_premier_sd.pdf
- Value San Diego- 2020_uhc_value_sd.pdf
SCAN
- scan_classic_oc_2020_sob.pdf
- scan_balance_oc_2020_sob.pdf
- scan_enrollment_form_2020.pdf
- scan_formulary.pdf
Blue Shield
- blue_shield_inspire_oc_benefit_highlights_2020.pdf
- blue_shield_mapd_enrollment_forms_2020.pdf
- blue_shield_med_supp_complete_kit_2020.pdf
- blue_shield_med_supp_enrollment_form_2020.pdf
- blue_shield_scope_of_appointment_2020.pdf
Other Helpful PDF Forms