2021 Documents and Forms
Medical benefits
California Medical Benefits
- Side by side benefit comparison
- Summary of Benefits and Coverage (SBC)
- Summary of Benefits and Coverage (SBC) – AHRO and AHMC associates
- Summary of Benefits and Coverage (SBC) – Delano associates
- Summary Plan Description (SPD)
- Summary Plan Description (SPD) - AHRO and AHMC associates
- Summary Plan Description (SPD) - Delano associates
Oregon Medical Benefits
- Side by side benefit comparison
- Summary of Benefits and Coverage (SBC)
- Summary Plan Description (SPD)
Legal and Privacy notices
Pharmacy benefits
- Pharmacy Benefit
- Zero Dollar Copay Medication List
- Community Partner Pharmacy List
- OptumRx Formulary
- OptumRx Claim Form
- How to create an OptumRx account
- Preventive Care Medications
- Free glucose monitor