Forms & Documents
General Information
Enrollment and Network Information
Ancillary and Additional Products and Services
- Guardian Managed DentalGuard DHMO - Effective Prior to 3 Q 2020
- Guardian Managed DentalGuard DHMO - 3 Q 2020
- Guardian Managed DentalGuard DHMO Plus - Effective Prior to 3 Q 2020
- Guardian Managed DentalGuard DHMO Plus - 3 Q 2020
- Guardian DentalGuard Preferred PPO MAC
- Guardian DentalGuard Preferred PPO Plus MAC
- Solstice Dental EPO S800B - Effective Prior to 3 Q 2020
- Solstice Dental EPO S800B - 3 Q 2020
- Solstice Dental EPO S700B - Effective Prior to 3 Q 2020
- Solstice Dental EPO S700B - 3 Q 2020
- Solstice Dental PPO
- Solstice Dental Value PPO MAC
- UnitedHealthcare Select Managed Care - Effective Prior to 3 Q 2020
- UnitedHealthcare Select Managed Care - 3 Q 2020
- UnitedHealthcare INO 100/50/50 - Effective Prior to 3 Q 2020
- UnitedHealthcare INO 100/50/50 - 3 Q 2020
- UnitedHealthcare Low PPO MAC
- UnitedHealthcare High PPO MAC
- Guardian VisionGuard - Effective Prior to 3 Q 2020
- Guardian VisionGuard - 3 Q 2020
- Solstice Vision - Effective Prior to 3 Q 2020
- Solstice Vision - 3 Q 2020
- UnitedHealthcare Vision PPO - Effective Prior to 3 Q 2020
- UnitedHealthcare Vision PPO - 3 Q 2020
- EverGuard (Term Life, AD&D & Long Term Disability)
- EverGuard Plus (Term Life, AD&D & Long Term Disability)
- Guardian AccidentGuard Adv
- InfoArmor - PrivacyArmor & PrivacyArmor Plus
- LifeLock - Benefit Elite & Ultimate Plus™
- COBRA
- Health Advocate
- POP Kit Section 125
HealthPass Renewals
HealthPass Appointment Paperwork
Insurance Carrier Prescription Lists
2020 Insurance Carrier Summary of Benefits and Coverage (SBC)
- EmblemHealth Prime Platinum POS
- EmblemHealth Prime Platinum Premier
- EmblemHealth Select Care Platinum Premier
- Healthfirst Platinum Pro EPO
- Oscar Circle Platinum 2
- Oscar Circle Plus Platinum 2
- Oscar Circle Platinum 1
- Oscar Circle Plus Platinum 1
- Oxford Liberty Platinum EPO 40/80 411
- EmblemHealth Prime Gold POS
- EmblemHealth Prime Gold Premier
- EmblemHealth Select Care Gold Premier
- Healthfirst Gold Pro EPO
- Healthfirst Gold 25/50/0 Pro EPO
- Oscar Circle Gold
- Oscar Circle Plus Gold
- Oscar Circle Gold 1000
- Oscar Circle Plus Gold 1000
- Oscar Circle Gold 1250
- Oscar Circle Plus Gold 1250
- Oscar Circle Gold 2000
- Oscar Circle Plus Gold 2000
- Oxford Liberty Gold EPO 25/50 ZD
- Oxford Liberty Gold EPO 30/60 G
- Oxford Liberty Gold EPO 30/60
- Oxford Metro Gold EPO 25/40
- Oxford Metro Gold EPO 25/40 G
- EmblemHealth Prime Silver Premier
- EmblemHealth Select Care Silver Premier
- EmblemHealth Select Care Silver Value
- EmblemHealth Millennium Silver Value G
- EmblemHealth Prime Silver HSA
- Healthfirst Silver Pro EPO
- Healthfirst Silver 40/75/4700 Pro EPO
- Oscar Circle Silver
- Oscar Circle Plus Silver
- Oscar Circle Silver 3000
- Oscar Circle Plus Silver 3000
- Oscar Circle Silver 4500
- Oscar Circle Plus Silver 4500
- Oscar Circle Silver HSA 3000
- Oscar Circle Plus Silver HSA 3000
- Oxford Metro Silver EPO 30/80 G
- Oxford Metro Silver EPO 50/100 ZD
- Oxford Liberty Silver EPO 40/70
- Oxford Liberty Silver EPO 25/50 G
- EmblemHealth Prime Bronze HSA
- EmblemHealth Select Care Bronze Premier
- EmblemHealth Select Care Bronze Value
- EmblemHealth Millennium Bronze Pemier G
- EmblemHealth Millennium Bronze Value G
- Healthfirst Bronze Pro EPO HSA
- Healthfirst Bronze 6650 Pro EPO HSA
- Healthfirst Bronze 8150 Pro EPO
- Oscar Circle Bronze 4500
- Oscar Circle Plus Bronze 4500
- Oscar Circle Bronze 8150
- Oscar Circle Plus Bronze 8150
- Oscar Circle Bronze HSA 6750
- Oscar Circle Plus Bronze HSA 6750
- Oxford Liberty Bronze EPO HSA 4000
- Oxford Metro Bronze EPO HSA 6750 G
2020 Resumen De La Cobertura De Beneficio (SBC)
- EmblemHealth Prime Platinum POS
- EmblemHealth Prime Platinum Premier
- EmblemHealth Select Care Platinum Premier
- Healthfirst Platinum Pro EPO
- Oscar Circle Platinum 2
- Oscar Circle Plus Platinum 2
- Oscar Circle Platinum 1
- Oscar Circle Plus Platinum 1
- Oxford LIberty Platinum EPO 40/80 411
- EmblemHealth Prime Gold POS
- EmblemHealth Prime Gold Premier
- EmblemHealth Select Care Gold Premier
- Healthfirst Gold Pro EPO
- Healthfirst Gold 25/50/0 Pro EPO
- Oscar Circle Gold
- Oscar Circle Plus Gold
- Oscar Circle Plus Gold
- Oscar Circle Gold 1000
- Oscar Circle Plus Gold 1000
- Oscar Circle Gold 1250
- Oscar Circle Plus Gold 1250
- Oscar Circle Gold 2000
- Oscar Circle Plus Gold 2000
- Oxford LIberty Gold EPO 25/50 ZD
- Oxford Liberty Gold EPO 30/60 G
- Oxford Liberty Gold EPO 30/60
- Oxford Metro Gold EPO 25/40
- Oxford Metro Gold EPO 25/40 G
- EmblemHealth Prime Silver Premier
- EmblemHealth Select Care Silver Premier
- EmblemHealth Select Care Silver Value
- EmblemHealth Select Care Silver Value G
- EmblemHealth Prime Silver HSA
- Healthfirst Silver Pro EPO
- Healthfirst Silver 40/75/4700 Pro EPO
- Oscar Circle Silver
- Oscar Circle Plus Silver
- Oscar Circle Silver 3000
- Oscar Circle Plus Silver 3000
- Oscar Circle Silver 4500
- Oscar Circle Plus Silver 4500
- Oscar Circle Silver HSA 3000
- Oscar Circle Plus Silver HSA 3000
- Oxford Metro Silver PEO 50/100 ZD
- Oxford Liberty Silver EPO 40/70
- Oxford Liberty Silver EPO 25/50 G
- Oxford Metro Silver EPO 30/80 G
- EmblemHealth Prime Bronze HSA
- EmblemHealth Select Care Bronze Premier
- EmblemHealth Select Care Bronze Value
- EmblemHealth Millennium Bronze Premier G
- EmblemHealth Millennium Bronze Value G
- Healthfirst Bronze Pro EPO HSA
- Healthfirst Bronze 6650 Pro EPO HSA
- Healthfirst Bronze 8150 Pro EPO
- Oscar Circle Plus Bronze 4500
- Oscar Circle Bronze 8150
- Oscar Circle Plus Bronze 8150
- OScar Circle Bronze HSA 6750
- Oscar Circle Plus Bronze 6750
- Oxford LIberty Bronze EPO HSA 4000
- Oxford Metro Bronze EPO HSA 6750 G
2021 Resumen De La Cobertura De Beneficio (SBC)
- EmblemHealth Prime Platinum PPO
- EmblemHealth Prime Platinum Premier
- EmblemHealth Select Care Platinum Premier
- Healthfirst Platinum Pro EPO
- Oxford Liberty Platinum EPO
- EmblemHealth Prime Gold PPO
- EmblemHealth Prime Gold Premier
- EmblemHealth Prime Gold Virtual
- EmblemHealth Select Care Gold Premier
- EmblemHealth Select Care Gold Value
- EmblemHealth Millennium Gold Virtual
- Healthfirst Gold Pro EPO
- Healthfirst Gold 25/50/0 Pro EPO
- Oxford Metro Gold EPO 25/40 G
- Oxford Metro Gold EPO 25/40
- Oxford Liberty Gold 30/60
- Oxford Liberty Gold 30/60 G
- Oxford Liberty Gold 25/50 ZD
- Oxford Liberty Gold HSA 1500 Motion
- EmblemHealth Prime Silver Premier
- EmblemHealth Select Care Silver Premier
- EmblemHealth Select Care Silver Value
- EmblemHealth Millennium Silver Value G
- EmblemHealth Prime Silver HSA
- Healthfirst Silver Pro EPO
- Healthfirst Silver 40/75/4700 Pro EPO
- Oxford Metro Silver EPO 30/80 G
- Oxford Liberty Silver EPO 50/100 ZD
- Oxford Liberty Silver EPO 25/50
- Oxford Liberty Silver EPO 40/70
- Oxford Liberty Silver HSA 4000 Motion
- EmblemHealth Prime Bronze HSA
- EmblemHealth Select Care Bronze Premier
- EmblemHealth Select Care Bronze Value
- EmblemHealth Millennium Bronze Premier G
- EmblemHealth Millennium Bronze Value G
- Healthfirst Bronze Pro EPO HSA
- Healthfirst Bronze 6850 Pro EPO HSA
- Healthfirst Bronze 8150 Pro EPO
- Oxford Metro Bronze HSA 7000 G
- Oxford Liberty Bronze HSA 5750