Details about our plans are included in the information below.

• Summary of Benefits (PDF)
• Evidence of Coverage
• Basic EOC Appeals & Exceptions (PDF)
• Premier EOC Appeals & Exceptions (PDF)
• Useful Telephone Numbers
• Enrollment Guidelines
• Forms
• Formulary Search
• Pharmacy Directory (PDF)
• Out-of-Network Pharmacy (PDF)
• Low-Income Subsidy Table (PDF)
• Quality Assurance Policies & Procedures (PDF)
• Medication Therapy Management (PDF)
• Prescription Drug Plan Ratings (PDF)
• Drug Transition Policy (What if my drug is not on the formulary?) (PDF)
• Basic Rights & Responsibilities Upon Disenrollment (PDF)
• Premier Rights & Responsibilities Upon Disenrollment (PDF)
• Can I Appoint a Representative?
• Designate Someone to Speak on My Behalf
• HIV Screening Notice (PDF)
• Report Fraud and Abuse
• Privacy Notice (PDF)
• Disclaimers