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

1. Assure- 2020_uhc_assure.pdf
2. Assure San Diego - 2020_uhc_assure_sd.pdf
3. Plan 2 Los Angeles - 2020_plan_2_la.pdf
4. Essential - 2020_uhc_essential.pdf
5. Focus LA - 2020_uhc_focus_la.pdf
6. Focus Riv/SB - 2020_uhc_focus_riv-sb.pdf
7. Plan 1 Los Angeles - 2020_uhc_plan_1_la.pdf
8. Plan 2 Orange County -2020_uhc_plan_2_oc.pdf
9. Plan 2 Riv/SB - 2020_uhc_plan_2_riv-sb.pdf
10. Premier Los Angeles - 2020_uhc_premier_la.pdf
11. Premier Orange County - 2020_uhc_premier_oc.pdf
12. Premier Riv/SB - 2020_uhc_premier_riv-sb.pdf
13. Premier San Diego - 2020_uhc_premier_sd.pdf
14. Value San Diego- 2020_uhc_value_sd.pdf

SCAN

1. scan_classic_oc_2020_sob.pdf
2. scan_balance_oc_2020_sob.pdf
3. scan_enrollment_form_2020.pdf
4. scan_formulary.pdf

Blue Shield

1. blue_shield_inspire_oc_benefit_highlights_2020.pdf
2. blue_shield_mapd_enrollment_forms_2020.pdf
3. ​blue_shield_med_supp_complete_kit_2020.pdf
4. ​blue_shield_med_supp_enrollment_form_2020.pdf
5. blue_shield_scope_of_appointment_2020.pdf

Other Helpful PDF Forms

1. 2020_medicare_cost_and_charts.pdf