Documents & Forms Center

Members

2017 Essential Selection No Rx

PDF icon SBC - 2017 Essential Selection No Rx.pdf

Agents, Employers

2018 3101 - Platinum 153050 - Religious Exemption

PDF icon SBC - 2018 3101 - Platinum 153050 - Religious Exemption.pdf

Agents, Employers

2018 3104 - Gold 1550100

PDF icon SBC 2018 3104 - Gold 1550100.pdf

Agents

2018 3104 - Gold 1550100

PDF icon SBC 2018 3104 - Gold 1550100.pdf

Medicare

2018 Advantage Plus Annual Notice of Changes

PDF icon 2018 Advantage Plus Annual Notice of Changes.pdf

Medicare

2018 Advantage Plus Evidence of Coverage

PDF icon 2018 Advantage Plus Evidence of Coverage.pdf

Medicare

2018 Advantage Plus Preferred Advantage Enrollment Application

PDF icon 2018 Advantage Plus Preferred Advantage Enrollment Application.pdf

Medicare

2018 APPA Enrollment Checklist 012618

PDF icon 2018 APPA Enrollment Checklist 012618.pdf

Medicare

2018 APPA Summary of Benefits

PDF icon 2018 APPA Summary of Benefits.pdf

Medicare

2018 Big Bend Choice Retiree Advantage (HMO) Schedule of Copayments

PDF icon 2018 Big Bend Choice Retiree Advantage (HMO) Schedule of Copayments.pdf

Medicare

2018 Capital Health Plan Advantage Plus Preferred Advantage Summary of Benefits

PDF icon 2018 Capital Health Plan Advantage Plus Preferred Advantage Summary of Benefits.pdf

Members

2018 Capital Health Plan Summary of Benefits

PDF icon 2018 Capital Health Plan Summary of Benefits.pdf

Medicare

2018 Capital Selection 15 30 50 Retiree Advantage (HMO) Schedule of Copayments

PDF icon 2018 Capital Selection 15 30 50 Retiree Advantage (HMO) Schedule of Copayments.pdf

Medicare

2018 Capital Selection 15 50 100 Retiree Advantage (HMO) Schedule of Copayments

PDF icon 2018 Capital Selection 15 50 100 Retiree Advantage (HMO) Schedule of Copayments.pdf

Medicare

2018 Enrollment Checklist

PDF icon 2018 Enrollment Checklist.pdf

2018 FEHB Benefits Brochure

PDF icon 2018 FEHB Benefits Brochure.pdf

2018 FEHB Summary of Benefits

PDF icon 2018 FEHB Summary of Benefits.PDF

Members, Providers

2018 Guidelines - Assessment and Treatment of Children with ADHD

PDF icon ADHD GUIDELINES 5.8.18_Final.pdf

Members, Providers

2018 Guidelines - Diabetes Care

PDF icon 2018 Diabetes Clinical Practice Guideline 3.6.18.pdf

Members, Providers

2018 Guidelines - Management of High Blood Pressure in Adults

PDF icon Management of High Blood Pressure in Adults 5 8 18 Final.pdf

Members, Providers

2018 Guidelines - Management of Major Depression in Primary Care

PDF icon Depression Clinical Practice Guidelines 2017 FINAL.PDF

Members, Providers

2018 Guidelines - Pediatric Health Assessment

PDF icon Ped Health Assessment 5-8-2018_Final.pdf

Members, Providers

2018 Guidelines - Perinatal Care

PDF icon Perinatal Care QIC approved 5-8-2018_Final.pdf

Members, Providers

2018 Guidelines - Secondary Prevention for Patients with Atherosclerotic Vascular Disease

PDF icon Secondary Prevention for Patients with Atherosclerotic Vascular Disease.pdf