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My Plan Documents

MyChart

You can find all of your plan documents by logging into MyChart.

These documents include:

Evidence of Coverage
Explanation of Benefits (EOB) statements
Low Income Subsidy documents
Notice of Privacy Practices
Star Rating Sheet
Supplemental Benefit Packet
Other documents, plus the Online Pharmacy Benefit Tool where you can view all of your prescriptions

Quickly access your plan documents without logging into MyChart account. Simply enter your member ID number in our Document Lookup tool.

If you would like to view your Summary of Benefits, please select the document below.

This document provides a brief summary to compare the benefits for all plan options.

If you have questions, please contact Customer Service.

This webpage was updated on September 1, 2020.