Cigna + Oscar

Form Name Effective Date Download Form
New Group Submission
New Group Submission Checklist 1.21
01/01/2021 Download
Employer Application 1.24
01/01/2024 Download
Employer Application 1.23
01/01/2023 Download
ACH Authorization Form
01/01/2024 Download
Corporate Officer/Proprietor/Partner Verification Statement
01/01/2024 Download
Administration
Business Administrative Guide
01/01/2021 Download
Renewal Guide
04/01/2024 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Enrollment & Change Form 1.24
01/01/2024 Download
Employee Enrollment & Change Form 1.23
01/01/2023 Download
Employee Waiver Form
01/01/2024 Download
Deductible Credit Form
01/01/2024 Download
Deductible Credit Carryover Guidelines
02/01/2024 Download
Disabled Dependent Form
01/01/2024 Download
Express Scripts Home Delivery Order Form
02/01/2024 Download
Claim Forms
HIPAA Authorization to Disclose PHI Form
01/01/2024 Download
Member Medical Claim Form
01/01/2024 Download
Prescription Reimbursement Direct Claim Form
02/01/2024 Download
Form Name Effective Date Download Form
2024 Medical PPO
LocalPlus Network
LocalPlus Platinum $0/$10
01/01/2024 Summary SBC
LocalPlus Platinum $0/$10 INF
01/01/2024 Summary SBC
LocalPlus Platinum $0/$20
01/01/2024 Summary SBC
LocalPlus Platinum $0/$20 INF
01/01/2024 Summary SBC
LocalPlus Platinum $250
01/01/2024 Summary SBC
LocalPlus Platinum $250 INF
01/01/2024 Summary SBC
LocalPlus Platinum $500
01/01/2024 Summary SBC
LocalPlus Platinum $500 INF
01/01/2024 Summary SBC
LocalPlus Gold $0
01/01/2024 Summary SBC
LocalPlus Gold $0 INF
01/01/2024 Summary SBC
LocalPlus Gold $250
01/01/2024 Summary SBC
LocalPlus Gold $250 INF
01/01/2024 Summary SBC
LocalPlus Gold $500
01/01/2024 Summary SBC
LocalPlus Gold $500 INF
01/01/2024 Summary SBC
LocalPlus Gold $750
01/01/2024 Summary SBC
LocalPlus Gold $750 INF
01/01/2024 Summary SBC
LocalPlus Gold $1350
01/01/2024 Summary SBC
LocalPlus Gold $1350 INF
01/01/2024 Summary SBC
LocalPlus Gold $3500 HSA
01/01/2024 Summary SBC
LocalPlus Gold $3500 HSA INF
01/01/2024 Summary SBC
LocalPlus Silver $0
01/01/2024 Summary SBC
LocalPlus Silver $0 INF
01/01/2024 Summary SBC
LocalPlus Silver $1950
01/01/2024 Summary SBC
LocalPlus Silver $1950 INF
01/01/2024 Summary SBC
LocalPlus Silver $2500
01/01/2024 Summary SBC
LocalPlus Silver $2500 INF
01/01/2024 Summary SBC
LocalPlus Silver $2600
01/01/2024 Summary SBC
LocalPlus Silver $2600 INF
01/01/2024 Summary SBC
LocalPlus Silver $3200 HSA
01/01/2024 Summary SBC
LocalPlus Silver $3200 HSA INF
01/01/2024 Summary SBC
LocalPlus Bronze $1000
01/01/2024 Summary SBC
LocalPlus Bronze $1000 INF
01/01/2024 Summary SBC
LocalPlus Bronze $3000
01/01/2024 Summary SBC
LocalPlus Bronze $3000 INF
01/01/2024 Summary SBC
LocalPlus Bronze $6000
01/01/2024 Summary SBC
LocalPlus Bronze $6000 INF
01/01/2024 Summary SBC
LocalPlus Bronze $6300
01/01/2024 Summary SBC
LocalPlus Bronze $6300 INF
01/01/2024 Summary SBC
LocalPlus Bronze $7250
01/01/2024 Summary SBC
LocalPlus Bronze $7250 INF
01/01/2024 Summary SBC
LocalPlus Bronze $5750 HSA
01/01/2024 Summary SBC
LocalPlus Bronze $5750 HSA INF
01/01/2024 Summary SBC
Open Access Plus Network
Open Access Plus Platinum $0/$10
01/01/2024 Summary SBC
Open Access Plus Platinum $0/$10 INF
01/01/2024 Summary SBC
Open Access Plus Platinum $0/$20
01/01/2024 Summary SBC
Open Access Plus Platinum $0/$20 INF
01/01/2024 Summary SBC
Open Access Plus Platinum $250
01/01/2024 Summary SBC
Open Access Plus Platinum $250 INF
01/01/2024 Summary SBC
Open Access Plus Platinum $500
01/01/2024 Summary SBC
Open Access Plus Platinum $500 INF
01/01/2024 Summary SBC
Open Access Plus Gold $0
01/01/2024 Summary SBC
Open Access Plus Gold $0 INF
01/01/2024 Summary SBC
Open Access Plus Gold $250
01/01/2024 Summary SBC
Open Access Plus Gold $250 INF
01/01/2024 Summary SBC
Open Access Plus Gold $500
01/01/2024 Summary SBC
Open Access Plus Gold $500 INF
01/01/2024 Summary SBC
Open Access Plus Gold $750
01/01/2024 Summary SBC
Open Access Plus Gold $750 INF
01/01/2024 Summary SBC
Open Access Plus Gold $1350
01/01/2024 Summary SBC
Open Access Plus Gold $1350 INF
01/01/2024 Summary SBC
Open Access Plus Gold $3500 HSA
01/01/2024 Summary SBC
Open Access Plus Gold $3500 HSA INF
01/01/2024 Summary SBC
Open Access Plus Silver $0
01/01/2024 Summary SBC
Open Access Plus Silver $0 INF
01/01/2024 Summary SBC
Open Access Plus Silver $1950
01/01/2024 Summary SBC
Open Access Plus Silver $1950 INF
01/01/2024 Summary SBC
Open Access Plus Silver $2500
01/01/2024 Summary SBC
Open Access Plus Silver $2500 INF
01/01/2024 Summary SBC
Open Access Plus Silver $2600
01/01/2024 Summary SBC
Open Access Plus Silver $2600 INF
01/01/2024 Summary SBC
Open Access Plus Silver $3200 HSA
01/01/2024 Summary SBC
Open Access Plus Silver $3200 HSA INF
01/01/2024 Summary SBC
Open Access Plus Bronze $1000
01/01/2024 Summary SBC
Open Access Plus Bronze $1000 INF
01/01/2024 Summary SBC
Open Access Plus Bronze $3000
01/01/2024 Summary SBC
Open Access Plus Bronze $3000 INF
01/01/2024 Summary SBC
Open Access Plus Bronze $6000
01/01/2024 Summary SBC
Open Access Plus Bronze $6000 INF
01/01/2024 Summary SBC
Open Access Plus Bronze $6300
01/01/2024 Summary SBC
Open Access Plus Bronze $6300 INF
01/01/2024 Summary SBC
Open Access Plus Bronze $7250
01/01/2024 Summary SBC
Open Access Plus Bronze $7250 INF
01/01/2024 Summary SBC
Open Access Plus Bronze $5750 HSA
01/01/2024 Summary SBC
Open Access Plus Bronze $5750 HSA INF
01/01/2024 Summary SBC
2023 Medical PPO
LocalPlus Network
LocalPlus Platinum $0/$10
01/01/2023 Summary SBC
LocalPlus Platinum $0/$10 INF
01/01/2023 Summary SBC
LocalPlus Platinum $0/$20
01/01/2023 Summary SBC
LocalPlus Platinum $0/$20 INF
01/01/2023 Summary SBC
LocalPlus Platinum $250
01/01/2023 Summary SBC
LocalPlus Platinum $250 INF
01/01/2023 Summary SBC
LocalPlus Platinum $500
01/01/2023 Summary SBC
LocalPlus Platinum $500 INF
01/01/2023 Summary SBC
LocalPlus Gold $0
01/01/2023 Summary SBC
LocalPlus Gold $0 INF
01/01/2023 Summary SBC
LocalPlus Gold $250
01/01/2023 Summary SBC
LocalPlus Gold $250 INF
01/01/2023 Summary SBC
LocalPlus Gold $500
01/01/2023 Summary SBC
LocalPlus Gold $500 INF
01/01/2023 Summary SBC
LocalPlus Gold $750
01/01/2023 Summary SBC
LocalPlus Gold $750 INF
01/01/2023 Summary SBC
LocalPlus Gold $1350
01/01/2023 Summary SBC
LocalPlus Gold $1350 INF
01/01/2023 Summary SBC
LocalPlus Silver $0
01/01/2023 Summary SBC
LocalPlus Silver $0 INF
01/01/2023 Summary SBC
LocalPlus Silver $1950
01/01/2023 Summary SBC
LocalPlus Silver $1950 INF
01/01/2023 Summary SBC
LocalPlus Silver $2500
01/01/2023 Summary SBC
LocalPlus Silver $2500 INF
01/01/2023 Summary SBC
LocalPlus Silver $2600
01/01/2023 Summary SBC
LocalPlus Silver $2600 INF
01/01/2023 Summary SBC
LocalPlus Silver $3000 HSA
01/01/2023 Summary SBC
LocalPlus Silver $3000 HSA INF
01/01/2023 Summary SBC
LocalPlus Bronze $1000
01/01/2023 Summary SBC
LocalPlus Bronze $1000 INF
01/01/2023 Summary SBC
LocalPlus Bronze $3000
01/01/2023 Summary SBC
LocalPlus Bronze $3000 INF
01/01/2023 Summary SBC
LocalPlus Bronze $6000
01/01/2023 Summary SBC
LocalPlus Bronze $6000 INF
01/01/2023 Summary SBC
LocalPlus Bronze $6300
01/01/2023 Summary SBC
LocalPlus Bronze $6300 INF
01/01/2023 Summary SBC
LocalPlus Bronze $7250
01/01/2023 Summary SBC
LocalPlus Bronze $7250 INF
01/01/2023 Summary SBC
LocalPlus Bronze $5750 HSA
01/01/2023 Summary SBC
LocalPlus Bronze $5750 HSA INF
01/01/2023 Summary SBC
Open Access Plus Network
Open Access Plus Platinum $0/$10
01/01/2023 Summary SBC
Open Access Plus Platinum $0/$10 INF
01/01/2023 Summary SBC
Open Access Plus Platinum $0/$20
01/01/2023 Summary SBC
Open Access Plus Platinum $0/$20 INF
01/01/2023 Summary SBC
Open Access Plus Platinum $250
01/01/2023 Summary SBC
Open Access Plus Platinum $250 INF
01/01/2023 Summary SBC
Open Access Plus Platinum $500
01/01/2023 Summary SBC
Open Access Plus Platinum $500 INF
01/01/2023 Summary SBC
Open Access Plus Gold $0
01/01/2023 Summary SBC
Open Access Plus Gold $0 INF
01/01/2023 Summary SBC
Open Access Plus Gold $250
01/01/2023 Summary SBC
Open Access Plus Gold $250 INF
01/01/2023 Summary SBC
Open Access Plus Gold $500
01/01/2023 Summary SBC
Open Access Plus Gold $500 INF
01/01/2023 Summary SBC
Open Access Plus Gold $750
01/01/2023 Summary SBC
Open Access Plus Gold $750 INF
01/01/2023 Summary SBC
Open Access Plus Gold $1350
01/01/2023 Summary SBC
Open Access Plus Gold $1350 INF
01/01/2023 Summary SBC
Open Access Plus Silver $0
01/01/2023 Summary SBC
Open Access Plus Silver $0 INF
01/01/2023 Summary SBC
Open Access Plus Silver $1950
01/01/2023 Summary SBC
Open Access Plus Silver $1950 INF
01/01/2023 Summary SBC
Open Access Plus Silver $2500
01/01/2023 Summary SBC
Open Access Plus Silver $2500 INF
01/01/2023 Summary SBC
Open Access Plus Silver $2600
01/01/2023 Summary SBC
Open Access Plus Silver $2600 INF
01/01/2023 Summary SBC
Open Access Plus Silver $3000 HSA
01/01/2023 Summary SBC
Open Access Plus Silver $3000 HSA INF
01/01/2023 Summary SBC
Open Access Plus Bronze $1000
01/01/2023 Summary SBC
Open Access Plus Bronze $1000 INF
01/01/2023 Summary SBC
Open Access Plus Bronze $3000
01/01/2023 Summary SBC
Open Access Plus Bronze $3000 INF
01/01/2023 Summary SBC
Open Access Plus Bronze $6000
01/01/2023 Summary SBC
Open Access Plus Bronze $6000 INF
01/01/2023 Summary SBC
Open Access Plus Bronze $6300
01/01/2023 Summary SBC
Open Access Plus Bronze $6300 INF
01/01/2023 Summary SBC
Open Access Plus Bronze $7250
01/01/2023 Summary SBC
Open Access Plus Bronze $7250 INF
01/01/2023 Summary SBC
Open Access Plus Bronze $5750 HSA
01/01/2023 Summary SBC
Open Access Plus Bronze $5750 HSA INF
01/01/2023 Summary SBC
Form Name Effective Date Download Form
General Information
Broker Sales Kit
02/01/2024 Download
Broker Appointment Guide
02/01/2024 Download
Broker Client Onboarding Guide
01/01/2021 Download
Care Team Customer Service Flyer
02/01/2024 Download
Cigna + Oscar Partnership
02/01/2024 Download
Dual Network Overview - Bay Area 1.24
01/01/2024 Download
Dual Network Overview - Central Coast 1.24
01/01/2024 Download
Dual Network Overview - Los Angeles & Orange County 1.24
01/01/2024 Download
Dual Network Overview - San Diego County 1.24
01/01/2024 Download
Dual Network Overview - Inland Empire 1.24
01/01/2024 Download
Helpful Information & Resources Flyer
02/01/2024 Download
Hi, we're Oscar Flyer
01/01/2021 Download
Introducing Cigna + Oscar Flyer
02/01/2024 Download
Online and Mobile Tools
02/01/2024 Download
Online Provider Search Instructions
02/01/2024 Download
Pharmacy Benefit Overview
02/01/2024 Download
Pharmacy Network Flyer
02/01/2024 Download
Plan Feature Overview
02/01/2024 Download
Post-enrollment Timeline
01/01/2021 Download
Provider Education FAQ
12/01/2022 Download
Step Tracking Flyer
02/01/2024 Download
Talkspace Member Overview
02/01/2024 Download
Understanding Infertility Benefits
02/01/2024 Download
Underwriting Guide 10.23
01/01/2024 Download
Virtual Primary Care Flyer
01/01/2024 Download
Virtual Urgent Care
02/01/2024 Download
Medical
Small Group Plan Grid 1.24
01/01/2024 Download
Express Scripts Prescription Drug Formulary List 1.24
01/01/2024 Download
Express Scripts Prescription Drug Formulary List (with Infertility) 1.24
01/01/2024 Download
Consumer Directed Healthcare Preventive Medication List 1.24
01/01/2024 Download
Preventive Care Guide
02/01/2024 Download
Form Name Effective Date Download Form
Southern California Small Group Rate Guide [effective 4/1/2024]
04/01/2024 Download
Southern California Small Group Rate Guide w/ Infertility [effective 4/1/2024]
04/01/2024 Download
Northern California Small Group Rate Guide [effective 4/1/2024]
04/01/2024 Download
Northern California Small Group Rate Guide w/ Infertility [effective 4/1/2024]
04/01/2024 Download
Southern California Small Group Rate Guide [effective 1/1/2024]
01/01/2024 Download
Southern California Small Group Rate Guide w/ Infertility [effective 1/1/2024]
01/01/2024 Download
Northern California Small Group Rate Guide [effective 1/1/2024]
01/01/2024 Download
Northern California Small Group Rate Guide w/ Infertility [effective 1/1/2024]
01/01/2024 Download