Platinum 90 HMO

Platinum 90 HMO

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2019 Benefit Highlights

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Plan Benefit Highlights

Summary of Benefits (SBC)    Chinese    Spanish

Combined Evidence of Coverage (EOC) and Disclosure Form for Off Exchange

Combined Evidence of Coverage (EOC) and Disclosure Form for Covered CA

Covered CA Drug Preview Tool (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.)