Employer Group Plans

Balance by CCHP - Employer Group Plans

Health Plans

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

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Ruby 20 HMO Platinum

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Ruby 40 HMO Platinum

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Opal 25 HMO Gold

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Opal 50 HMO Silver

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Drug Price Check & Pharmacy Locator

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Platinum 90 HMO

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Gold 80 HMO

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Silver 70 HMO

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Bronze 60 HMO

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

Bronze 60 HDHP HMO

2019

Plan Benefit Highlights

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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

2020

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

2021

Summary of Benefits (SBC)

Combined Evidence of Coverage (EOC) and Disclosure Form

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 | 2021

Pediatric Vision Summary 2019 | 2020 | 2021

Delta Dental In-Network Provider Search

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

Adult Vision Summary (B) 2019 | 2020 | 2021

VSP In-Network Provider Search / Member Account Access

Member Resources

Pharmacy Locator & Drug Preview Tool (Formulary)

CCHP Pharmacy Directory (All Plans) 2019 | 2020 | 2021
Updated 7/2021

CCHP Pharmaceutical Management Procedures

List of Covered Drugs (Formulary) for Commercial Plans
Updated 9/1/2021

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

Notice of Privacy Practices

CAHPS Survey

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

CCHP Nurse Advice Line at 1-888-243-8310 available 24 hours a day, seven days a week—including weekends and holidays.

Urgent Care Facilities

Jade | HPMG (By clicking on these links, you will leave CCHP’s website)

Provider Directory

Start an online provider search

CCHP Provider Directory 2019 | 2020 | 2021
English, Chinese | Updated 3/2021

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.

Call

1-888-775-7888 or 1-415-834-2118,TTY 1-877-681-8898

From 8:00 a.m. to 8:00 p.m., 7 days a week

e-Mail

memberservices@cchphealthplan.com

Member Portal Sign-In

Visit

386 Gellert Boulevard

Daly City, CA 94105

Monday-Friday from 9:00 a.m. to 5:30 p.m.

If you have any questions, please visit, call or email us.

445 Grant Ave

San Francisco, CA 94108

Monday-Saturday from 9:00 a.m. to 5:00 p.m.

If you have any questions, please visit, call or email us.

Balance by CCHP - Employer Group Plans

Health Plans

Ruby 10 HMO Platinum

Ruby 20 HMO Platinum

Ruby 40 HMO Platinum

Opal 25 HMO Gold

Opal 50 HMO Silver

Platinum 90 HMO

Gold 80 HMO

Silver 70 HMO

Bronze 60 HMO

Bronze 60 HDHP HMO

Dental & Vision Plans

Member Resources

Urgent Care Facilities

Provider Directory

Member Services

Call

e-Mail

Visit

Health Care Plans

Members

About CCHP