Broker Downloads

SALES COLLATERAL

Benefit Comparisons: 2024

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

Benefit Comparisons: 2023

• Large Group Benefit Comparison (2023)
• Small Group Benefit Comparison (2023)
• Individual Benefit Comparison (2023)

Other Sales Materials

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

Medicare Resources

Looking for sales flyers, enrollment forms or plan documents? See our Medicare Advantage website for Tools & Resources to help you support your Medicare-eligible clients during this AEP.

PLAN DOCUMENTS

Large Group

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

Small Group

• Traditional Plans
• Deductible Plans
• HSA-Compatible High-Deductible Plans
• Optional Riders
• 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
• Hearing Aid Optional Rider from TruHearing
• 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 Health Virtual Physical Therapy
• Livongo for Hypertension Flyer
• Nutritional Counseling for Weight Management
• Open Enrollment Booklet for Employees
• Parent Support
• Pediatric Dental
• Pediatric Vision
• Preferred Drug List (large group plans)
• Preferred Drug List (individuals and small group plans)
• Prescription Benefits
• Rate Filing Disclosure
• Rate Change Justification-Individual-Covered CA (English)
• Small Group Underwriting Guidelines
• Virta Type 2 Diabetes Reversal
• Wellness Brochure

Frequently Asked Questions

• Group FAQs
• Group Medicare

FORMS

Applications

• Individual Application + Supplement (2024)
• Individual Application + Supplement Spanish (coming soon)
• Individual Application + Supplement (2023)
• Individual Application + Supplement Spanish (2023)
• Large Employer Group Application (2024)
• Small Employer Group Application (2024)

Enrollment

• 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
• Electronic Funds Transfer (EFT)
• HIPAA Authorization for Use or Disclosure
• Individual Termination Form
• Member Termination Form for Groups
• Non-Registered Domestic Partner Form
• One-Time eCheck Payment Authorization Form
• Owner Statement