Documents & Forms Center

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2019-FEHB-Brochure-10-4-2018.pdf

PDF icon 2019-FEHB-Brochure-10-4-2018.pdf

Members

2020 SOF High Deductible Health HMO Plan SBC

PDF icon SOF High Deductible Health HMO Plan SBC.pdf

Members

2022 HMO Individual Contract

PDF icon 2021.18.HMO_.IndQHP-COC.pdf

Members

2022 HMO Individual Contract

PDF icon 2021.18.HMO_.IndQHP-COC.pdf

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2023 Capital Selection 15/30/50

PDF icon Capital Selection 15.30.50 1-1-23.pdf

Members

2023 Capital Selection 15/30/50

PDF icon Capital Selection 15.30.50 1-1-23.pdf

Members

2023 HMO Individual Contract

PDF icon 2022.07.HMO_.IndQHP-COC.pdf

Members

2024 HMI Individual Contract

PDF icon 2023.01.HMO_.IndQHP-COC.pdf

Members

2024 HMO Individual Contract - Handbook

PDF icon 2024 HMO Individual Contract (Handbook).pdf

Members

2024 Individual Plan Flyer

PDF icon CHP - 20420 - Individual Plan Flyer_v3.pdf

Members

2025 HMO Individual Contract

PDF icon 2024.21.HMO_.IndQHP-COC.pdf

Members

2025 Principal Choice - Medicus

PDF icon PrincipalChoice-15.50.100-Medicus-Bariatric_1-1-25.pdf

Members

2025 Principal Choice - TMH

PDF icon PrincipalChoice-15.50.100-TMH-Bariatric_1-1-25.pdf

Medicare, Members

2025 Retiree Advantage Annual Notice of Change

PDF icon H5938-802-EGWP-HMO-ANOC-2025-FINAL.pdf

Members

2025 SBC - TMH & Medicus

PDF icon PrincipalChoice-15.50.100-Medicus-TMH-Bariatric_1-1-25.pdf

Members

24-CHP-021 Healthline Newsletter Fall Winter 2024

PDF icon 24-chp-021-healthline-newsletter-fall-winter-2024.pdf

Members

3102 - Platinum 2021

PDF icon 3102 Platinum 2021.pdf

Agents, Employers, Members

Amwell Frequently Asked Questions

PDF icon Amwell FAQ General.pdf

Agents, Employers, Members

Amwell Quick Start Guide

PDF icon Amwell Quick Start Guide.pdf

Medicare, Members

Authorization to Use or Disclose Protected Health Information

PDF icon Authorization to Disclose Protected Health Information Form - Revision 1....pdf

Agents, Employers, Members

Away From Home Care FAQ

PDF icon Away From Home Care FAQ.pdf

Members

Basic Option I

PDF icon BasicOption-I.pdf

Members

Basic Option II

PDF icon Basic Option II.pdf

Agents, Employers, Members

Blue Card Program Information

PDF icon Blue Card Program Information.pdf