Sharp Health Plan

At Sharp Healthcare, it is our mission to improve the health of everyone we serve. And at San Diego’s leading health care provider, we’re proud to touch the lives of more individuals in our community than any other health care system.

Provider Finder

Form Name Effective Date Download Form
New Group Submission
New Business Submission Checklist
01/01/2018 Download
Employer Application - HMO Small Group
01/01/2018 Download
Employer Application - PPO (enrollment restrictions apply)
01/01/2018 Download
Employee Declination Spreadsheet
01/01/2018 Download
Employer Group Size Attestation Form
01/01/2018 Download
Sole Proprietor, Partner, or Corporate Officer Statement
01/01/2018 Download
In Force Group Forms
Correction to Group Statement
01/01/2018 Download
Administration
Group Administration Manual
01/01/2018 Download
Employer Sharp Connect Registration
01/01/2018 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Application - HMO
01/01/2018 Download
Employee Application - HMO (Spanish)
01/01/2018 Download
Employee Application - PPO
01/01/2018 Download
Declaration of Domestic Partnership
01/01/2018 Download
Request for Continuity of Care
01/01/2018 Download
Request for Continuity of Care (Spanish)
01/01/2018 Download
Claim Forms
Authorization for Use of Disclosure of Health Information
01/01/2018 Download
Medical Claim Form
01/01/2018 Download
Pharmacy Claim Form
01/01/2018 Download
Form Name Effective Date Download Form
2018 Medical HMO
Non-Mirrored Plans - These benefits are not available on the Exchange and are available with any Sharp network; Choice, Value, Performance and Premier.
Platinum HMO NG 1
01/01/2018 Summary SBC
Platinum HMO NG 2
01/01/2018 Summary SBC
Platinum HMO NG 3
01/01/2018 Summary SBC
Platinum HMO NG 4
01/01/2018 Summary SBC
Platinum HMO NG 5
01/01/2018 Summary SBC
Platinum HMO NG 6
01/01/2018 Summary SBC
Platinum HMO NG 7
01/01/2018 Summary SBC
Platinum HMO NG 8
01/01/2018 Summary SBC
Platinum HMO NG 9
01/01/2018 Summary SBC
Gold HMO NG 1
01/01/2018 Summary SBC
Gold HMO NG 2
01/01/2018 Summary SBC
Gold HMO NG 3
01/01/2018 Summary SBC
Gold HMO NG 4
01/01/2018 Summary SBC
Gold HMO NG 5
01/01/2018 Summary SBC
Gold HMO NG 6
01/01/2018 Summary SBC
Gold HMO NG 7
01/01/2018 Summary SBC
Silver HMO NG 1
01/01/2018 Summary SBC
Silver HMO NG 2
01/01/2018 Summary SBC
Bronze HDHP NG 1
01/01/2018 Summary SBC
Mirrored Plans - These are the same plan benefits and HMO networks as available on Covered California for Small Business.
Platinum 90 HMO 0/15 + Child Dental Performance
01/01/2018 Summary SBC
Platinum 90 HMO 0/15 + Child Dental Premier
01/01/2018 Summary SBC
Gold 80 HMO 0/25 + Child Dental Performance
01/01/2018 Summary SBC
Gold 80 HMO 0/25 + Child Dental Premier
01/01/2018 Summary SBC
Silver 70 HMO 2000/45 + Child Dental Performance
01/01/2018 Summary SBC
Silver 70 HMO 2000/45 + Child Dental Premier
01/01/2018 Summary SBC
Silver 70 HDHP HMO 2000/20% + Child Dental Premier
01/01/2018 Summary SBC
Bronze 60 HMO 6300/75 + Child Dental Performance
01/01/2018 Summary SBC
Bronze 60 HDHP HMO 4800/40% + Child Dental Premier
01/01/2018 Summary SBC
Pseudo-Mirrored Plans - These are the same plan benefits available on the Exchange but available with other networks. Pe/V/C = Performance, Value, Choice and Pr/V/C = Premier, Value, Choice.
Platinum 90 HMO 0/15/250 + Child Dental (Pe/V/C)
01/01/2018 Summary SBC
Platinum 90 HMO 0/15/10% + Child Dental (Pr/V/C)
01/01/2018 Summary SBC
Gold 80 HMO 0/25/600 + Child Dental (Pe/V/C)
01/01/2018 Summary SBC
Gold 80 HMO 0/25/20% + Child Dental (Pr/V/C)
01/01/2018 Summary SBC
Silver 70 HMO 2000/45/20%-300 + Child Dental (Pe/V/C)
01/01/2018 Summary SBC
Silver 70 HMO 2000/45/20%-20% + Child Dental (Pr/V/C)
01/01/2018 Summary SBC
Silver 70 HDHP HMO 2000/20%/20% + Child Dental (Pe/V/C)
01/01/2018 Summary SBC
Bronze 60 HMO 6300/75/100% + Child Dental (Pr/V/C)
01/01/2018 Summary SBC
Bronze 60 HDHP HMO 4800/40%/40% + Child Dental (Pe/V/C)
01/01/2018 Summary SBC
2018 Medical PPO
Standard Base Platinum 0 Copay
01/01/2018 Summary SBC
Standard Base Gold 0 Copay
01/01/2018 Summary SBC
Standard Base Silver 2000 Copay
01/01/2018 Summary SBC
Standard Base Bronze 4800 HDHP
01/01/2018 Summary SBC
2017 Medical HMO
Non-Mirrored Plans
Platinum HMO NG 1 (formerly Sharp Platinum 90 HMO 0/10/300 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 2 (formerly Sharp Platinum 90 HMO A 0/15/250 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 3 (formerly Sharp Platinum 90 HMO A 0/20/500 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 4 (formerly Sharp Platinum 90 HMO A 0/20/1000 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 5 (formerly Sharp Platinum 90 HMO 0/20/300 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 6 (formerly Sharp Platinum 90 HMO B 0/20/1000 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 7 (formerly Sharp Platinum 90 HMO B 0/20/500 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 8 (formerly Sharp Platinum 90 HMO 0/20/250 Plan)
01/01/2017 Summary SBC
Platinum HMO NG 9 (formerly Sharp Platinum 90 HMO 0/10/350 Plan)
01/01/2017 Summary SBC
Gold HMO NG 1 (formerly Sharp Gold 80 HMO 0/35/1500 Plan)
01/01/2017 Summary SBC
Gold HMO NG 2 (formerly Sharp Gold 80 HMO 0/30/1000 Plan)
01/01/2017 Summary SBC
Gold HMO NG 3 (formerly Sharp Gold 80 HMO 0/40/1000 Plan)
01/01/2017 Summary SBC
Gold HMO NG 4 (formerly Sharp Gold 80 HMO 0/40/40% Plan)
01/01/2017 Summary SBC
Gold HMO NG 5 (formerly Sharp Gold 80 HMO 0/30/30% Plan)
01/01/2017 Summary SBC
Gold HMO NG 6 (formelry Sharp Gold 80 HMO 1000/30/30% Plan)
01/01/2017 Summary SBC
Gold HMO NG 7 (formerly Sharp Gold 80 HMO 500/10/50% Plan)
01/01/2017 Summary SBC
Silver HMO NG 1 (formerly Sharp Silver 70 HMO 1750/40/40% Plan)
01/01/2017 Summary SBC
Silver HMO NG 2 (formerly Sharp Silver 70 HMO 2000/40/50% Plan)
01/01/2017 Summary SBC
Bronze HDHP NG 1 (formerly Sharp Bronze 60 HDHP 6500/60/50% Plan)
01/01/2017 Summary SBC
Mirrored Plans
Mirrored - Sharp Platinum 90 HMO 0/15 + Child Dental 1 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Platinum 90 HMO 0/15 + Child Dental 2 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Gold 80 HMO 0/30 + Child Dental 1 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Gold 80 HMO 0/30 + Child Dental 2 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Silver 70 HDHP HMO 2000/20% + Child Dental Plan
01/01/2017 Summary SBC
Mirrored - Sharp Silver 70 HMO 2000/45 + Child Dental 1 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Silver 70 HMO 2000/45 + Child Dental 2 Plan
01/01/2017 Summary SBC
Mirrored - Sharp Bronze 60 HDHP HMO 4800/40% + Child Dental Plan
01/01/2017 Summary SBC
Mirrored - Sharp Bronze 60 HMO 6300/75 + Child Dental Plan
01/01/2017 Summary SBC
2017 Medical PPO
Platinum 0 Copay
01/01/2017 Summary SBC
Gold 0 Copay
01/01/2017 Summary SBC
Silver 2000 Copay
01/01/2017 Summary SBC
Bronze 4800 HDHP
01/01/2017 Summary SBC
Form Name Effective Date Download Form
Sharp Small Group Benefit Brochure
01/01/2018 Download
Assist America Brochure
01/01/2018 Download
Best Health Coaching
01/01/2018 Download
Mail Order Pharmacy Brochure
01/01/2018 Download
Minute Clinic Flyer
01/01/2018 Download
Pediatric Vision Flyer
01/01/2018 Download
Sharp Network Comparison Brochure
01/01/2018 Download
Sharp HMO Licensed Service Areas
01/01/2018 Download
Sharp Underwriting Matrix
01/01/2018 Download
2018 Choice Provider Directory
01/01/2018 Download
2018 Value Network Provider Directory
01/01/2018 Download
2018 Performance Network Provider Directory
01/01/2018 Download
2018 Premier Network Provider Directory
01/01/2018 Download
Form Name Effective Date Download Form
Health Plan Contact Sheet
Download