Brokers: Individual Plans

2020 plans

• Comparison of benefits
• Commercial Metal 5T formulary Online Search | PDF | Prior Authorization | Step Therapy
• Commercial 5T formulary Online Search | PDF | Prior Authorization | Step Therapy
• 3 Tier Commercial Formulary Online Search | PDF | Prior Authorization | Step Therapy
• How to pay premiums
• Search for Providers
• Complete provider directory (PDF)
• Fitness center membership (Active&Fit) - Fitness center membership does not apply to all plans. Please reference your plan documents to confirm this benefit.
• Pediatric dental benefit
• Application (PDF)
• Change/termination form (PDF)

2019 plans

• Comparison of benefits
• 5 Tier Commercial Metal Formulary PDF | Online Search | Annual Notice of Change | Prior Authorization & Step Therapy
• 5 TIer Commercial Formulary PDF | Online Search | Annual Notice of Change | Prior Authorization & Step Therapy
• SBCs
• How to pay premiums
• Complete provider directory (PDF)
• Fitness center membership (Active&Fit) - Fitness center membership does not apply to all plans. Please reference your plan documents to confirm this benefit.
• Pediatric dental flyer
• Pediatric vision flyer
• Application (PDF)
• Change/termination form (PDF)

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Complete an electronic application and upload the required documents