Employer Member

For more detailed information about your health plan, such as Benefit Highlights, Summary of Benefits, Evidence of Coverage, and Comprehensive Formulary (drug list), please click on the name of the plan you are enrolled-in below. Contact Member Services for questions about Mental Health Benefits, In-Network Provider Access, Claims Processing, and ANY other questions or concerns regarding your CCHP membership.

Ruby 10 HMO Platinum

Ruby 10 HMO Platinum20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Ruby 20 HMO Platinum

Ruby 20 HMO Platinum20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Ruby 40 HMO Platinum

Ruby 40 HMO Platinum20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Opal 25 HMO Platinum

Opal 25 HMO Platinum20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Opal 50 HMO Platinum

Opal 50 HMO Platinum20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Platinum 90 HMO

Platinum 90 HMO20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form | Covered California

Gold 80 HMO

Gold 80 HMO20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form | Covered California

Covered CA Drug Preview Tool (Formulary)

Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.

Silver 70 HMO

Silver 70 HMO20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form | Covered California

Bronze 60 HMO

Bronze 60 HMO20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form | Covered California

Covered CA Drug Preview Tool (Formulary)

Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.

Bronze 60 HDHP HMO

Bronze 60 HDHP HMO20192020

2019

2020

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form | Covered California

Covered CA Drug Preview Tool (Formulary)

Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.

Dental & Vision Plans

Dental and vision plan benefit information can be found below, regardless of your plan type or name. If you have any other questions, please contact Member Services.

Pediatric Dental Summary 2019 2020

Pediatric Vision Summary 2019 2020

Delta Dental In-Network Provider Search

Optional Vision Rider – VSP (CCHP’s Vision Partner)

2019 Adult Vision Summary (B)

VSP In-Network Provider Search / Member Account Access

Member Resources

Pharmacy Locator

CCHP Pharmacy Directory English, Chinese | Updated 5/2019

CCHP Pharmacy Directory - Covered CA English, Chinese | Updated 5/2019

CCHP Pharmaceutical Management Procedures

List of Covered Drugs (Formulary) for Jade, Amber, Silver 70 Off Exchange and ActiveChoice PPO Plans Updated 1/2020

List of Covered Drugs (Formulary) for all Platinum, Gold, Sliver, Bronze and Minimum Coverage Plans Updated 1/2020

Price Inquiry, Estimating the Cost of Care

Independent Medical Review & Enrollee Grievance Process

Continuity of Care

Prior Authorization Process

How to Pay

Community Health Newsletter

Plain Language Filing Description

Contact Member Services for additional questions including:

Mental Health Benefits
In-network Provider Access
Claims Processing
Primary Care Physician changes
Address or phone changes
Enrollment or disenrollment procedures
Any other questions

Provider Directory

Start an online provider search

CCHP Provider Directory English, Chinese | Updated 12/2019 CCHP Provider Directory - Covered CA English, Chinese | Updated 12/2019

Please call, email or submit form if you find any inaccuracies with the provider information on our website. You can also use this page to report any changes in the provider’s information such as phone number, language, and location.

ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Call 1-888-775-7888 (TTY: 1-877-681-8898).

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電1-888-775-7888 (TTY: 1-877-681-8898) 。

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-775-7888 (TTY: 1-877-681-8898).

CCHP provides full and equal access to covered services, including enrollees with disabilities as required under the Federal Americans with Disabilities Act of 1990 and section 504 of the Rehabilitation Act of 1973.

Member Services

Contact our friendly Member Services staff.