Broker Downloads

SALES COLLATERAL

Benefit Comparisons: 2025

• Large Group Benefit Comparison (2025)
• Small Group Benefit Comparison (2025)
• Individual Benefit Comparison (2025)

Benefit Comparisons: 2024

• Large Group Benefit Comparison (2024)
• Small Group Benefit Comparison (2024)
• Individual Benefit Comparison (2024)

Other Sales Materials

• Provider Network Brochure
• 10 Reasons We Are Good For Your Business
• The Flexible HMO Brochure
• Small Group Brochure

PLAN DOCUMENTS

Large Group

• Premier (traditional copay plans)
• Advantage (traditional copay plans)
• Western (deductible plans)
• Prescription Plans (2024)
• Western HDHP (HSA-compatible plans)
• Optional Riders

Small Group

• Traditional Plans
• Deductible Plans
• HSA-Compatible High-Deductible Plans
• CalChoice Plans

Individual

• Traditional Plans
• Deductible Plans
• High-Deductible HSA-Compatible Plans
• Individual SBC

Medicare Advantage

• Summary of Benefits
• Evidence of Coverage

Member Benefit Information

• Advantage Referral
• Behavioral Health
• Complementary and Alternative Medicine (CAM)
• Convenient Care Options
• Digital Resources: Apps and Mobile
• Emergency Travel Assistance
• Family & Diversity Support Flyer
• Health Plan Basics: WHA FAQs
• HDHP: Considering an HSA-Compatible Plan
• HDHP: Managing Your HDHP + HSA
• HDHP: Considering an HSA-Compatible Plan (HealthEquity)
• HDHP: Managing Your HDHP + HSA (HealthEquity)
• Kaia Digital Pain Management
• Livongo for Hypertension Flyer
• Nutritional Counseling for Weight Management
• Parent Support (Small Group)
• Preferred Drug List (large group plans)
• Preferred Drug List (individuals and small group plans)
• Prescription Benefits
• Virta Type 2 Diabetes Reversal
• Wellness Brochure (Large Group)
• Wellness Brochure (Small Group)
• Wellness Brochure (Individual)

Frequently Asked Questions

• Group FAQs
• Group Medicare

FORMS

Applications

• Individual Application + Supplement (2025)
• Individual Application + Supplement Spanish (2025)
• Individual Application + Supplement (2024)
• Large Employer Group Application (2025)
• Small Employer Group Application (2025)

Enrollment

• Open Enrollment Guide for Small Group (2025)
• Open Enrollment Guide for Large Group (2025)
• Group Enrollment/Change
• Group HSA Authorization
• Individual HSA Authorization

Broker-Agent Materials/Forms

• Opportunities Brochure
• Broker/Agent Kit and Forms
• Agent Agreement
• Business Associate Amendment
• Direct Deposit Form
• IRS Form W-9

Other

• Continuity of Care Request Form
• Declination of Coverage
• eCheck Payment Authorization Form
• EFT Authorization Form
• HIPAA Authorization for Use or Disclosure
• Individual Termination Form
• Member Termination Form for Groups
• Non-Registered Domestic Partner Form
• Owner Statement
• Rate Filing Disclosure
• Rate Change Justification-Individual-Covered CA (English)
• Small Group Underwriting Guidelines