Plan Documents
| Title | Date Sort ascending | |
|---|---|---|
| 2022 UHC PPO Companion Plan OOA SBC City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, UHC PPO - Companion Plan, 2022 |
Download | |
| 2022 UHC PPO Companion Plan (CA) MedRx SOB City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, UHC PPO - Companion Plan, 2022 |
Download | |
| 2022 UHC PPO Companion Plan (CA) SBC City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, UHC PPO - Companion Plan, 2022 |
Download | |
| 2022 Health Net Canopy Care Disclosure Form and SBC City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, Health Net CanopyCare HMO, 2022 |
Download | |
| 2022 Health Net CanopyCare HMO SOB Rx City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, Health Net CanopyCare HMO, 2022 |
Download | |
| 2022 Health Net CanopyCare HMO EOC City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, Health Net CanopyCare HMO, 2022 |
Download | |
| BSC RX Claim Form US and International City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, Blue Shield of California PPO, Blue Shield of California PPO 20, Blue Shield of CA PPO - Out of Area, 2024, 2023, 2022, 2021 |
Download | |
| BSC International Medical Claim Form City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, Blue Shield of California HMO, Blue Shield of California PPO, Blue Shield of California PPO 20, Blue Shield of CA PPO - Out of Area, 2024, 2023, 2022, 2021 |
Download |