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
01/01/2020 Download
Employer Application - HMO Small Group 6.20
06/01/2020 Download
Employer Application - HMO Large Group 1.21
01/01/2021 Download
Employee Declination Spreadsheet
01/01/2020 Download
Employer Group Size Attestation Form
01/01/2020 Download
Small Group Initial Payment ACH Form
01/01/2020 Download
Sole Proprietor, Partner, or Corporate Officer Statement
01/01/2020 Download
In Force Group Forms
Correction to Group Statement
01/01/2020 Download
Administration
Group Administration Manual
01/01/2020 Download
Employer Sharp Connect Registration
01/01/2020 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Application - HMO 1.21
01/01/2021 Download
Declaration of Domestic Partnership
01/01/2020 Download
Request for Continuity of Care
01/01/2020 Download
Request for Continuity of Care (Spanish)
01/01/2020 Download
Claim Forms
Authorization for Use of Disclosure of Health Information
01/01/2020 Download
Medical Claim Form
01/01/2020 Download
Pharmacy Claim Form
01/01/2020 Download
Form Name Effective Date Download Form
2021 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
01/01/2021 Summary SBC
Platinum HMO NG 2
01/01/2021 Summary SBC
Platinum HMO NG 3
01/01/2021 Summary SBC
Platinum HMO NG 4
01/01/2021 Summary SBC
Platinum HMO NG 7
01/01/2021 Summary SBC
Platinum HMO NG 8
01/01/2021 Summary SBC
Gold HMO NG 1
01/01/2021 Summary SBC
Gold HMO NG 2
01/01/2021 Summary SBC
Gold HMO NG 3
01/01/2021 Summary SBC
Gold HMO NG 4
01/01/2021 Summary SBC
Gold HMO NG 5
01/01/2021 Summary SBC
Gold HMO NG 6
01/01/2021 Summary SBC
Gold HMO NG 7
01/01/2021 Summary SBC
Silver HMO NG 1
01/01/2021 Summary SBC
Silver HMO NG 2
01/01/2021 Summary SBC
Bronze HDHP NG 1
01/01/2021 Summary SBC
Mirrored Plans - These are the same plan benefits and HMO networks as available on Covered California for Small Business.
Performance Platinum 90 HMO 0/15 + Child Dental
01/01/2021 Summary SBC
Premier Platinum 90 HMO 0/20 + Child Dental
01/01/2021 Summary SBC
Performance Gold 80 HMO 350/25 + Child Dental
01/01/2021 Summary SBC
Premier Gold 80 HMO 250/35 + Child Dental
01/01/2021 Summary SBC
Performance Silver 70 HMO 2250/50 + Child Dental
01/01/2021 Summary SBC
Premier Silver 70 HMO 2250/55 + Child Dental
01/01/2021 Summary SBC
Premier Silver 70 HDHP HMO 2500/20% + Child Dental
01/01/2021 Summary SBC
Performance Bronze 60 HMO 6300/65 + Child Dental
01/01/2021 Summary SBC
Premier Bronze 60 HDHP HMO 7000/0 + Child Dental
01/01/2021 Summary SBC
Pseudo-Mirrored Plans - These are the same plan benefits available on the Exchange but available with other networks. PeVC = Performance, Value, Choice and PrVC = Premier, Value, Choice.
Platinum 90 HMO 0/20/250 + Child Dental (PeVC)
01/01/2021 Summary SBC
Platinum 90 HMO 0/15/10% + Child Dental (PrVC)
01/01/2021 Summary SBC
Gold 80 HMO 250/35/600 + Child Dental (PeVC)
01/01/2021 Summary SBC
Gold 80 HMO 350/25/20% + Child Dental (PrVC)
01/01/2021 Summary SBC
Silver 70 HMO 2250/55/30% + Child Dental (PeVC-300)
01/01/2021 Summary SBC
Silver 70 HMO 2250/50/30% + Child Dental (PrVC-30%)
01/01/2021 Summary SBC
Silver 70 HDHP HMO 2500/20%/20% + Child Dental (PeVC)
01/01/2021 Summary SBC
Bronze 60 HMO 6300/65/40% + Child Dental (PrVC)
01/01/2021 Summary SBC
Bronze 60 HDHP HMO 7000/0/0 + Child Dental (PeVC)
01/01/2021 Summary SBC
2021 Medical PPO
2020 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
01/01/2020 Summary SBC
Platinum HMO NG 2
01/01/2020 Summary SBC
Platinum HMO NG 3
01/01/2020 Summary SBC
Platinum HMO NG 4
01/01/2020 Summary SBC
Platinum HMO NG 7
01/01/2020 Summary SBC
Platinum HMO NG 8
01/01/2020 Summary SBC
Gold HMO NG 1
01/01/2020 Summary SBC
Gold HMO NG 2
01/01/2020 Summary SBC
Gold HMO NG 3
01/01/2020 Summary SBC
Gold HMO NG 4
01/01/2020 Summary SBC
Gold HMO NG 5
01/01/2020 Summary SBC
Gold HMO NG 6
01/01/2020 Summary SBC
Gold HMO NG 7
01/01/2020 Summary SBC
Silver HMO NG 1
01/01/2020 Summary SBC
Silver HMO NG 2
01/01/2020 Summary SBC
Bronze HDHP NG 1
01/01/2020 Summary SBC
Mirrored Plans - These are the same plan benefits and HMO networks as available on Covered California for Small Business.
Performance Platinum 90 HMO 0/15 + Child Dental
01/01/2020 Summary SBC
Premier Platinum 90 HMO 0/15 + Child Dental
01/01/2020 Summary SBC
Performance Gold 80 HMO 250/25 + Child Dental
01/01/2020 Summary SBC
Premier Gold 80 HMO 250/25 + Child Dental
01/01/2020 Summary SBC
Performance Silver 70 HMO 2250/50 + Child Dental
01/01/2020 Summary SBC
Premier Silver 70 HMO 2250/50 + Child Dental
01/01/2020 Summary SBC
Premier Silver 70 HDHP HMO 2500/20% + Child Dental
01/01/2020 Summary SBC
Performance Bronze 60 HMO 6300/65 + Child Dental
01/01/2020 Summary SBC
Premier Bronze 60 HDHP HMO 6900/0 + Child Dental
01/01/2020 Summary SBC
Pseudo-Mirrored Plans - These are the same plan benefits available on the Exchange but available with other networks. PeVC = Performance, Value, Choice and PrVC = Premier, Value, Choice.
Platinum 90 HMO 0/15/250 + Child Dental (PeVC)
01/01/2020 Summary SBC
Platinum 90 HMO 0/15/10% + Child Dental (PrVC)
01/01/2020 Summary SBC
Gold 80 HMO 250/25/600 + Child Dental (PeVC)
01/01/2020 Summary SBC
Gold 80 HMO 250/25/20% + Child Dental (PrVC)
01/01/2020 Summary SBC
Silver 70 HMO 2250/50/20% + Child Dental (PeVC-300)
01/01/2020 Summary SBC
Silver 70 HMO 2250/50/20% + Child Dental (PrVC-20%)
01/01/2020 Summary SBC
Silver 70 HDHP HMO 2500/20%/20% + Child Dental (PeVC)
01/01/2020 Summary SBC
Bronze 60 HMO 6300/65/40% + Child Dental (PrVC)
01/01/2020 Summary SBC
Bronze 60 HDHP HMO 6900/0/0 + Child Dental (PeVC)
01/01/2020 Summary SBC
2020 Medical PPO
Standard Base Platinum 0 Copay
01/01/2020 Summary SBC
Standard Base Gold 250 Copay
01/01/2020 Summary SBC
Standard Base Silver 2250 Copay
01/01/2020 Summary SBC
Standard Base Bronze 6300 HDHP
01/01/2020 Summary SBC
Form Name Effective Date Download Form
General Information
2021 Small Group Benefit Brochure
01/01/2021 Download
HMO Member Handbook
01/01/2020 Download
Underwriting Guidelines
01/01/2021 Download
Active & Fit Flyer
01/01/2020 Download
Assist America Brochure
01/01/2020 Download
Best Health Coaching
01/01/2020 Download
Mail Order Pharmacy Brochure
01/01/2020 Download
Minute Clinic Flyer
01/01/2020 Download
Network Comparison Brochure
01/01/2020 Download
HMO Licensed Service Areas
01/01/2020 Download
Choice Network Overview
01/01/2020 Download
Value Network Overview
01/01/2020 Download
Performance Network Overview
01/01/2020 Download
Premier Network Overview
01/01/2020 Download
2020 Choice Network Provider & Pharmacy Directory
01/01/2020 Download
2020 Value Network Provider & Pharmacy Directory
01/01/2020 Download
2020 Performance Network Provider & Pharmacy Directory
01/01/2020 Download
2020 Premier Network Provider & Pharmacy Directory
01/01/2020 Download
Pediatric Vision Flyer
01/01/2020 Download
Form Name Effective Date Download Form
Small Group Rate Sheet [effective 4/1/2021]
04/01/2021 Download
Small Group Rate Sheet [effective 7/1/2021]
07/01/2021 Download