Plan Documents
| Title | Date Sort ascending | |
|---|---|---|
| 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 | |
| Blue Shield of CA Medical Claim Form - USA Only 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 CA PPO - Out of Area, 2024, 2023, 2022, 2021 |
Download | |
| 2022 Blue Shield of CA PPO-Out of Area 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, Blue Shield of CA PPO - Out of Area, 2022 |
Download | |
| Blue Shield of CA PPO-Out of Area 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, Blue Shield of CA PPO - Out of Area, 2022 |
Download |