Cigna + Oscar

Form Name Effective Date Download Form
New Group Submission
New Group Submission Checklist 1.21
01/01/2021 Download
Employer Application 1.21
01/01/2021 Download
ACH Authorization Form
01/01/2021 Download
Corporate Officer/Proprietor/Partner Verification Statement
01/01/2021 Download
Administration
Business Administrative Guide
01/01/2021 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Enrollment & Change Form 1.21
01/01/2021 Download
Employee Waiver Form 1.21
01/01/2021 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
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
01/01/2021 Download
Doctor on Call Flyer
01/01/2021 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
01/01/2021 Download
Open Access Plus Network Overview
01/01/2021 Download
So Cal LocalPlus Network Overview
02/01/2021 Download
Post-enrollment Timeline
01/01/2021 Download
Step Tracking Flyer
01/01/2021 Download
Underwriting Guide 1.21
01/01/2021 Download
What's Included in Your Plan for $0
01/01/2021 Download
Medical
Small Group Plan Grid 1.21
01/01/2021 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 4/1/2021]
04/01/2021 Download
Southern California Small Group Rate Guide [effective 4/1/2021]
04/01/2021 Download
Northern California Small Group Rate Guide [effective 7/1/2021]
07/01/2021 Download
Southern California Small Group Rate Guide [effective 7/1/2021]
07/01/2021 Download