Cigna + Oscar

Form Name Effective Date Download Form
New Group Submission
New Group Submission Checklist 1.21
01/01/2021 Download
Employer Application 1.22
01/01/2022 Download
ACH Authorization Form 1.22
01/01/2022 Download
Corporate Officer/Proprietor/Partner Verification Statement 1.22
01/01/2022 Download
Administration
Business Administrative Guide
01/01/2021 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Enrollment & Change Form 1.22
01/01/2022 Download
Employee Waiver Form 1.22
01/01/2022 Download
Deductible Credit Form
01/01/2021 Download
Express Scripts Home Delivery Order Form
01/01/2021 Download
Claim Forms
Member Medical Claim Form
04/01/2021 Download
Prescription Reimbursement Direct Claim Form
04/01/2021 Download
Form Name Effective Date Download Form
2023 Medical EPO (under construction)
LocalPlus Network
LocalPlus Platinum $0/$10
01/01/2023 Summary SBC
LocalPlus Platinum $250
01/01/2023 Summary SBC
LocalPlus Platinum $500
01/01/2023 Summary SBC
LocalPlus Gold $0
01/01/2023 Summary SBC
LocalPlus Gold $750
01/01/2023 Summary SBC
LocalPlus Gold $1350
01/01/2023 Summary SBC
LocalPlus Silver $1950
01/01/2023 Summary SBC
LocalPlus Bronze $6000
01/01/2023 Summary SBC
LocalPlus Network (plans below are sample documents pending release from carrier)
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 INF
01/01/2023 Summary SBC
LocalPlus Platinum $500 INF
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 INF
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 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 $5750 HSA
01/01/2023 Summary SBC
LocalPlus Bronze $5750 HSA INF
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
Open Access Plus Network (plans below are sample documents pending release from carrier)
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 $5750 HSA
01/01/2023 Summary SBC
Open Access Plus Bronze $5750 HSA 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
2022 Medical EPO
LocalPlus Network
LocalPlus Platinum $0/$10
01/01/2022 Summary SBC
LocalPlus Platinum $0/$10 INF
01/01/2022 Summary SBC
LocalPlus Platinum $0/$20
01/01/2022 Summary SBC
LocalPlus Platinum $0/$20 INF
01/01/2022 Summary SBC
LocalPlus Platinum $250
01/01/2022 Summary SBC
LocalPlus Platinum $250 INF
01/01/2022 Summary SBC
LocalPlus Platinum $500
01/01/2022 Summary SBC
LocalPlus Platinum $500 INF
01/01/2022 Summary SBC
LocalPlus Gold $0
01/01/2022 Summary SBC
LocalPlus Gold $0 INF
01/01/2022 Summary SBC
LocalPlus Gold $250
01/01/2022 Summary SBC
LocalPlus Gold $250 INF
01/01/2022 Summary SBC
LocalPlus Gold $500
01/01/2022 Summary SBC
LocalPlus Gold $500 INF
01/01/2022 Summary SBC
LocalPlus Gold $750
01/01/2022 Summary SBC
LocalPlus Gold $750 INF
01/01/2022 Summary SBC
LocalPlus Gold $1350
01/01/2022 Summary SBC
LocalPlus Gold $1350 INF
01/01/2022 Summary SBC
LocalPlus Silver $0
01/01/2022 Summary SBC
LocalPlus Silver $0 INF
01/01/2022 Summary SBC
LocalPlus Silver $1950
01/01/2022 Summary SBC
LocalPlus Silver $1950 INF
01/01/2022 Summary SBC
LocalPlus Silver $2250
01/01/2022 Summary SBC
LocalPlus Silver $2250 INF
01/01/2022 Summary SBC
LocalPlus Silver $2600
01/01/2022 Summary SBC
LocalPlus Silver $2600 INF
01/01/2022 Summary SBC
LocalPlus Silver $2500 HSA
01/01/2022 Summary SBC
LocalPlus Silver $2500 HSA INF
01/01/2022 Summary SBC
LocalPlus Bronze $1000
01/01/2022 Summary SBC
LocalPlus Bronze $1000 INF
01/01/2022 Summary SBC
LocalPlus Bronze $6000
01/01/2022 Summary SBC
LocalPlus Bronze $6000 INF
01/01/2022 Summary SBC
LocalPlus Bronze $6300
01/01/2022 Summary SBC
LocalPlus Bronze $6300 INF
01/01/2022 Summary SBC
LocalPlus Bronze $5750 HSA
01/01/2022 Summary SBC
LocalPlus Bronze $5750 HSA INF
01/01/2022 Summary SBC
Open Access Plus Network
Open Access Plus Platinum $0/$10
01/01/2022 Summary SBC
Open Access Plus Platinum $0/$10 INF
01/01/2022 Summary SBC
Open Access Plus Platinum $0/$20
01/01/2022 Summary SBC
Open Access Plus Platinum $0/$20 INF
01/01/2022 Summary SBC
Open Access Plus Platinum $250
01/01/2022 Summary SBC
Open Access Plus Platinum $250 INF
01/01/2022 Summary SBC
Open Access Plus Platinum $500
01/01/2022 Summary SBC
Open Access Plus Platinum $500 INF
01/01/2022 Summary SBC
Open Access Plus Gold $0
01/01/2022 Summary SBC
Open Access Plus Gold $0 INF
01/01/2022 Summary SBC
Open Access Plus Gold $250
01/01/2022 Summary SBC
Open Access Plus Gold $250 INF
01/01/2022 Summary SBC
Open Access Plus Gold $500
01/01/2022 Summary SBC
Open Access Plus Gold $500 INF
01/01/2022 Summary SBC
Open Access Plus Gold $750
01/01/2022 Summary SBC
Open Access Plus Gold $750 INF
01/01/2022 Summary SBC
Open Access Plus Gold $1350
01/01/2022 Summary SBC
Open Access Plus Gold $1350 INF
01/01/2022 Summary SBC
Open Access Plus Silver $0
01/01/2022 Summary SBC
Open Access Plus Silver $0 INF
01/01/2022 Summary SBC
Open Access Plus Silver $1950
01/01/2022 Summary SBC
Open Access Plus Silver $1950 INF
01/01/2022 Summary SBC
Open Access Plus Silver $2250
01/01/2022 Summary SBC
Open Access Plus Silver $2250 INF
01/01/2022 Summary SBC
Open Access Plus Silver $2600
01/01/2022 Summary SBC
Open Access Plus Silver $2600 INF
01/01/2022 Summary SBC
Open Access Plus Silver $2500 HSA
01/01/2022 Summary SBC
Open Access Plus Silver $2500 HSA INF
01/01/2022 Summary SBC
Open Access Plus Bronze $1000
01/01/2022 Summary SBC
Open Access Plus Bronze $1000 INF
01/01/2022 Summary SBC
Open Access Plus Bronze $6000
01/01/2022 Summary SBC
Open Access Plus Bronze $6000 INF
01/01/2022 Summary SBC
Open Access Plus Bronze $6300
01/01/2022 Summary SBC
Open Access Plus Bronze $6300 INF
01/01/2022 Summary SBC
Open Access Plus Bronze $5750 HSA
01/01/2022 Summary SBC
Open Access Plus Bronze $5750 HSA INF
01/01/2022 Summary SBC
2021 Medical EPO
LocalPlus Network
LocalPlus Platinum 0 Option 1
01/01/2021 Summary SBC
LocalPlus Platinum 0 Option 1 INF
01/01/2021 Summary SBC
LocalPlus Platinum 0 Option 2
01/01/2021 Summary SBC
LocalPlus Platinum 0 Option 2 INF
01/01/2021 Summary SBC
LocalPlus Platinum 250
01/01/2021 Summary SBC
LocalPlus Platinum 250 INF
01/01/2021 Summary SBC
LocalPlus Platinum 500
01/01/2021 Summary SBC
LocalPlus Platinum 500 INF
01/01/2021 Summary SBC
LocalPlus Gold 0
01/01/2021 Summary SBC
LocalPlus Gold 0 INF
01/01/2021 Summary SBC
LocalPlus Gold 250
01/01/2021 Summary SBC
LocalPlus Gold 250 INF
01/01/2021 Summary SBC
LocalPlus Gold 750
01/01/2021 Summary SBC
LocalPlus Gold 750 INF
01/01/2021 Summary SBC
LocalPlus Gold 1200
01/01/2021 Summary SBC
LocalPlus Gold 1200 INF
01/01/2021 Summary SBC
LocalPlus Silver 1700
01/01/2021 Summary SBC
LocalPlus Silver 1700 INF
01/01/2021 Summary SBC
LocalPlus Silver 2000
01/01/2021 Summary SBC
LocalPlus Silver 2000 INF
01/01/2021 Summary SBC
LocalPlus Silver 2250 Option 1
01/01/2021 Summary SBC
LocalPlus Silver 2250 Option 1 INF
01/01/2021 Summary SBC
LocalPlus Silver 2250 Option 2
01/01/2021 Summary SBC
LocalPlus Silver 2250 Option 2 INF
01/01/2021 Summary SBC
LocalPlus Bronze 6000
01/01/2021 Summary SBC
LocalPlus Bronze 6000 INF
01/01/2021 Summary SBC
LocalPlus Bronze 6300
01/01/2021 Summary SBC
LocalPlus Bronze 6300 INF
01/01/2021 Summary SBC
LocalPlus Bronze 5500 HSA
01/01/2021 Summary SBC
LocalPlus Bronze 5500 HSA INF
01/01/2021 Summary SBC
LocalPlus Bronze 6500 HSA
01/01/2021 Summary SBC
LocalPlus Bronze 6500 HSA INF
01/01/2021 Summary SBC
Open Access Plus Network
Open Access Plus Platinum 0 Option 1
01/01/2021 Summary SBC
Open Access Plus Platinum 0 Option 1 INF
01/01/2021 Summary SBC
Open Access Plus Platinum 0 Option 2
01/01/2021 Summary SBC
Open Access Plus Platinum 0 Option 2 INF
01/01/2021 Summary SBC
Open Access Plus Platinum 250
01/01/2021 Summary SBC
Open Access Plus Platinum 250 INF
01/01/2021 Summary SBC
Open Access Plus Platinum 500
01/01/2021 Summary SBC
Open Access Plus Platinum 500 INF
01/01/2021 Summary SBC
Open Access Plus Gold 0
01/01/2021 Summary SBC
Open Access Plus Gold 0 INF
01/01/2021 Summary SBC
Open Access Plus Gold 250
01/01/2021 Summary SBC
Open Access Plus Gold 250 INF
01/01/2021 Summary SBC
Open Access Plus Gold 750
01/01/2021 Summary SBC
Open Access Plus Gold 750 INF
01/01/2021 Summary SBC
Open Access Plus Gold 1200
01/01/2021 Summary SBC
Open Access Plus Gold 1200 INF
01/01/2021 Summary SBC
Open Access Plus Silver 1700
01/01/2021 Summary SBC
Open Access Plus Silver 1700 INF
01/01/2021 Summary SBC
Open Access Plus Silver 2000
01/01/2021 Summary SBC
Open Access Plus Silver 2000 INF
01/01/2021 Summary SBC
Open Access Plus Silver 2250 Option 1
01/01/2021 Summary SBC
Open Access Plus Silver 2250 Option 1 INF
01/01/2021 Summary SBC
Open Access Plus Silver 2250 Option 2
01/01/2021 Summary SBC
Open Access Plus Silver 2250 Option 2 INF
01/01/2021 Summary SBC
Open Access Plus Bronze 6000
01/01/2021 Summary SBC
Open Access Plus Bronze 6000 INF
01/01/2021 Summary SBC
Open Access Plus Bronze 6300
01/01/2021 Summary SBC
Open Access Plus Bronze 6300 INF
01/01/2021 Summary SBC
Open Access Plus Bronze 5500 HSA
01/01/2021 Summary SBC
Open Access Plus Bronze 5500 HSA INF
01/01/2021 Summary SBC
Open Access Plus Bronze 6500 HSA
01/01/2021 Summary SBC
Open Access Plus Bronze 6500 HSA INF
01/01/2021 Summary SBC
Form Name Effective Date Download Form
General Information
Broker Appointment Guide
03/01/2021 Download
Broker Client Onboarding Guide
01/01/2021 Download
Care Team Customer Service Flyer
04/01/2021 Download
Doctor on Call Flyer
04/01/2021 Download
What is an Exclusive Provider Organization (EPO)
04/01/2021 Download
Helpful Information & Resources Flyer
01/01/2022 Download
Hi, we're Oscar Flyer
01/01/2021 Download
Introducing Cigna + Oscar Flyer
03/01/2021 Download
Online and Mobile Tools
01/01/2021 Download
LocalPlus Network Overview 1.22
01/01/2022 Download
Open Access Plus Network Overview 1.22
01/01/2022 Download
Dual Network Overview - Bay Area 1.22
01/01/2022 Download
Dual Network Overview - Central Coast 1.22
01/01/2022 Download
Dual Network Overview - Los Angeles & Orange County 1.22
01/01/2022 Download
Dual Network Overview - San Diego County 1.22
01/01/2022 Download
Dual Network Overview - Inland Empire 1.22
01/01/2022 Download
Post-enrollment Timeline
01/01/2021 Download
Provider Education FAQ
12/01/2022 Download
Step Tracking Flyer
01/01/2021 Download
Underwriting Guide 10.21
10/01/2021 Download
What's Included in Your Plan for $0
01/01/2021 Download
Medical
Small Group Plan Grid 1.22
01/01/2022 Download
Small Group Plan Grid 1.23
01/01/2023 Download
Express Scripts Prescription Drug Formulary List
01/01/2021 Download
Preventive Care Brochure
01/01/2021 Download
Form Name Effective Date Download Form
Northern California Small Group Rate Guide [effective 1/1/2022]
01/01/2022 Download
Southern California Small Group Rate Guide [effective 1/1/2022]
01/01/2022 Download
Northern California Small Group Rate Guide [effective 1/1/2023]
01/01/2023 Download
Southern California Small Group Rate Guide [effective 1/1/2023]
01/01/2023 Download