CaliforniaChoice

At┬áCaliforniaChoice, we understand the unique needs of small businesses. As the only Small Group Private Exchange in California, our goal is to provide great benefits, simple administration, and the best customer service, year-round, to all our customers. We’ve worked with brokers, small business owners, and employees for more than 17 years and we love what we do.

Provider Finder

Form Name Effective Date Download Form
New Group Submission
CalChoice Medical Submission Checklist
01/01/2020 Download
CalChoice Dental/Life Submission Checklist
01/01/2020 Download
Employer Application 10.20 to 12.20 Effective Dates
10/01/2020 Download
Employer Application 1.21 Effective Dates
01/01/2021 Download
ACH Payment Form Effective 4.20
04/01/2020 Download
Owner Partner Statement Form
01/01/2020 Download
Case Submission Acknowledgement (for groups submitted after the requested effective date)
01/01/2020 Download
Common Ownership Statement
01/01/2020 Download
Full FSA Election Form
01/01/2020 Download
Group Size Attestation
01/01/2020 Download
Prior Carrier Cancellation Letter Template
01/01/2020 Download
In Force Group Forms
Employee Termination Notification
01/01/2019 Download
Employer Change Request Form 10.20 to 12.20 Effective Dates
10/01/2020 Download
Employer Change Request Form 1.21 Effective Dates
01/01/2021 Download
Employer Group Contact Change
01/01/2019 Download
Employer In Force Group Dental Application 7.20
07/01/2020 Download
Employer In Force Group Voluntary Vision Application 1.20
01/01/2020 Download
Employer Recertification Agreement 1.20 to 6.20 Effective Dates
01/01/2020 Download
Exception Review Request Form
01/01/2019 Download
Group COBRA Direct Billing Contract
01/01/2020 Download
New Hire Enrollment Quote Request
01/01/2020 Download
Administration
Employer Administrative Guide
07/01/2020 Download
Employer Program Guide 10.20 to 12.20 Effective Dates
10/01/2020 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Enrollment Form 10.20 to 12.20 Effective Dates
10/01/2020 Download
Employee Enrollment Form 1.21 Effective Dates
01/01/2021 Download
Employee Change Request Form 10.20 to 12.20 Effective Dates
10/01/2020 Download
Employee Change Request Form 1.21 Effective Dates
01/01/2021 Download
Disabled Dependent Certification Form
01/01/2020 Download
Affidavit of Domestic Partnership
01/01/2020 Download
COBRA Forms
COBRA Enrollment Application
01/01/2020 Download
Claim Forms
RX Claim Form - Anthem Express Scripts
Download
RX Claim Form - Health Net
Download
RX Claim Form - Sharp
Download
RX Claim Form - UHC
Download
RX by Mail Claim Form - Anthem
Download
RX by Mail Claim Form - Health Net
Download
RX by Mail Claim Form - Kaiser
Download
RX by Mail Claim Form - Sharp
Download
RX by Mail Claim Form - UHC
Download
Form Name Effective Date Download Form
2021 Medical Plan Benefit Summary Booklets
January - March 2021 Effective Dates
All Tiers Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Platinum Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Platinum/Gold Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Platinum/Gold/Silver Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Gold Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Gold/Silver Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Gold/Silver/Bronze Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Silver Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Silver/Bronze Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
Bronze Benefit Summaries 1.21 - 3.21 Effective Dates
01/01/2021 Summary
2021 Medical HMO SBCs
Anthem HMO
Anthem Blue Cross Platinum Select HMO A
01/01/2021 SBC
Anthem Blue Cross Gold Select HMO A
01/01/2021 SBC
Anthem Blue Cross Gold CaliforniaCare HMO B
01/01/2021 SBC
Anthem Blue Cross Silver Select HMO A
01/01/2021 SBC
Anthem Blue Cross Silver CaliforniaCare HMO B
01/01/2021 SBC
Health Net HMO
Health Net Platinum WholeCare HMO C
01/01/2021 SBC
Health Net Platinum Salud HMO D
01/01/2021 SBC
Health Net Platinum Full Network HMO E
01/01/2021 SBC
Health Net Platinum Wholecare HMO F
01/01/2021 SBC
Health Net Platinum Salud HMO G
01/01/2021 SBC
Health Net Platinum Full Network HMO H
01/01/2021 SBC
Health Net Gold WholeCare HMO A
01/01/2021 SBC
Health Net Gold WholeCare HMO B
01/01/2021 SBC
Health Net Gold WholeCare HMO C
01/01/2021 SBC
Health Net Gold Salud HMO D
01/01/2021 SBC
Health Net Gold Full Network HMO E
01/01/2021 SBC
Health Net Gold Full Network HMO F
01/01/2021 SBC
Health Net Silver WholeCare HMO A
01/01/2021 SBC
Health Net Silver CommunityCare HMO C
01/01/2021 SBC
Health Net Bronze CommunityCare HMO A
01/01/2021 SBC
Kaiser Permanente HMO
Kaiser Platinum HMO A
01/01/2021 SBC
Kaiser Platinum HMO B
01/01/2021 SBC
Kaiser Gold HMO B
01/01/2021 SBC
Kaiser Gold HMO C
01/01/2021 SBC
Kaiser Gold HMO D
01/01/2021 SBC
Kaiser Silver HMO A
01/01/2021 SBC
Kaiser Silver HMO B
01/01/2021 SBC
Kaiser Silver HMO C
01/01/2021 SBC
Kaiser Silver HMO D (HSA Eligible)
01/01/2021 SBC
Kaiser Silver HMO E
01/01/2021 SBC
Kaiser Bronze HMO A
01/01/2021 SBC
Kaiser Bronze HMO B
01/01/2021 SBC
Kaiser Bronze HMO C (HSA Eligible)
01/01/2021 SBC
Sharp HMO
Sharp Platinum Premier HMO A
01/01/2021 SBC
Sharp Platinum Performance HMO B
01/01/2021 SBC
Sharp Platinum Premier HMO C
01/01/2021 SBC
Sharp Gold Performance HMO A
01/01/2021 SBC
Sharp Gold Premier HMO B
01/01/2021 SBC
Sharp Gold Performance HMO D
01/01/2021 SBC
Sharp Silver Premier HMO A
01/01/2021 SBC
Sharp Silver Performance HMO B
01/01/2021 SBC
Sharp Silver Premier HMO C
01/01/2021 SBC
Sharp Bronze Premier HMO A
01/01/2021 SBC
Sharp Bronze Performance HMO B (HSA Eligible)
01/01/2021 SBC
Sutter Health Plus HMO
Sutter Health Plus Platinum HMO A
01/01/2021 SBC
Sutter Health Plus Platinum HMO B
01/01/2021 SBC
Sutter Health Plus Gold HMO A
01/01/2021 SBC
Sutter Health Plus Gold HMO B
01/01/2021 SBC
Sutter Health Plus Silver HMO B
01/01/2021 SBC
Sutter Health Plus Silver HMO C (HSA Eligible)
01/01/2021 SBC
Sutter Health Plus Bronze HMO A
01/01/2021 SBC
Sutter Health Plus Bronze HMO B (HSA Eligible)
01/01/2021 SBC
UnitedHealthcare HMO
UHC Platinum SignatureValue HMO A
01/01/2021 SBC
UHC Platinum Alliance HMO C
01/01/2021 SBC
UHC Platinum Advantage HMO D
01/01/2021 SBC
UHC Platinum SignatureValue HMO E
01/01/2021 SBC
UHC Platinum Advantage HMO F
01/01/2021 SBC
UHC Platinum Alliance HMO G
01/01/2021 SBC
UHC Gold SignatureValue HMO A
01/01/2021 SBC
UHC Gold Alliance HMO B
01/01/2021 SBC
UHC Gold Advantage HMO E
01/01/2021 SBC
UHC Gold SignatureValue HMO F
01/01/2021 SBC
UHC Gold Alliance HMO G
01/01/2021 SBC
UHC Gold SignatureValue HMO H
01/01/2021 SBC
UHC Gold Advantage HMO I
01/01/2021 SBC
UHC Gold Alliance HMO J
01/01/2021 SBC
UHC Gold Advantage HMO K
01/01/2021 SBC
UHC Silver SignatureValue HMO A
01/01/2021 SBC
UHC Silver Advantage HMO B
01/01/2021 SBC
UHC Silver Alliance HMO E
01/01/2021 SBC
Western Health Advantage HMO
Western Health Platinum HMO A
01/01/2021 SBC
Western Health Platinum HMO B
01/01/2021 SBC
Western Health Platinum HMO C
01/01/2021 SBC
Western Health Gold HMO A
01/01/2021 SBC
Western Health Gold HMO B
01/01/2021 SBC
Western Health Gold HMO C
01/01/2021 SBC
Western Health Gold HMO D (HSA Eligible)
01/01/2021 SBC
Western Health Silver HMO A
01/01/2021 SBC
Western Health Silver HMO B
01/01/2021 SBC
Western Health Silver HMO C (HSA Eligible)
01/01/2021 SBC
Western Health Bronze HMO B
01/01/2021 SBC
Western Health Bronze HMO C (HSA Eligible)
01/01/2021 SBC
2021 Medical EPO SBCs
Anthem Blue Cross EPO
Anthem Blue Cross Silver EPO A
01/01/2021 SBC
Anthem Blue Cross Silver EPO B (HSA Eligible)
01/01/2021 SBC
Anthem Blue Cross Bronze EPO A
01/01/2021 SBC
Oscar EPO
Oscar Platinum EPO A
01/01/2021 SBC
Oscar Platinum EPO B
01/01/2021 SBC
Oscar Gold EPO A
01/01/2021 SBC
Oscar Gold EPO B
01/01/2021 SBC
Oscar Gold EPO C
01/01/2021 SBC
Oscar Gold EPO D
01/01/2021 SBC
Oscar Silver EPO A (HSA Eligible)
01/01/2021 SBC
Oscar Silver EPO B
01/01/2021 SBC
Oscar Silver EPO C
01/01/2021 SBC
Oscar Silver EPO D
01/01/2021 SBC
Oscar Bronze EPO A (HSA Eligible)
01/01/2021 SBC
Oscar Bronze EPO B
01/01/2021 SBC
Oscar Bronze EPO C
01/01/2021 SBC
2021 Medical PPO SBCs
Anthem Blue Cross PPO
Anthem Blue Cross Gold Advantage PPO A
01/01/2021 SBC
Anthem Blue Cross Gold Select PPO B
01/01/2021 SBC
Anthem Blue Cross Gold Select PPO C
01/01/2021 SBC
Anthem Blue Cross Gold Select PPO D
01/01/2021 SBC
Anthem Blue Cross Gold PPO E
01/01/2021 SBC
Anthem Blue Cross Silver Advantage PPO A
01/01/2021 SBC
Anthem Blue Cross Silver Select PPO B
01/01/2021 SBC
Anthem Blue Cross Silver PPO C
01/01/2021 SBC
Anthem Blue Cross Bronze PPO A (HSA Eligible)
01/01/2021 SBC
Anthem Blue Cross Bronze Select PPO B (HSA Eligible)
01/01/2021 SBC
2020 Medical Plan Benefit Summary Booklets
January - April 2020 Effective Dates
All Tiers Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Platinum Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Platinum/Gold Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Platinum/Gold/Silver Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Gold Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Gold/Silver Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Silver Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Silver/Bronze Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
Bronze Benefit Summaries 1.20 - 4.20 Effective Dates
01/01/2020 Summary
May - June 2020 Effective Dates
All Tiers Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Platinum Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Platinum/Gold Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Platinum/Gold/Silver Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Gold Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Gold/Silver Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Silver Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Silver/Bronze Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
Bronze Benefit Summaries 5.20 - 6.20 Effective Dates
05/01/2020 Summary
July - September 2020 Effective Dates
All Tiers Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Platinum Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Platinum/Gold Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Platinum/Gold/Silver Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Gold Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Gold/Silver Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Gold/Silver/Bronze Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Silver Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Silver/Bronze Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
Bronze Benefit Summaries 7.20 - 9.20 Effective Dates
07/01/2020 Summary
October - December 2020 Effective Dates
All Tiers Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Platinum Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Platinum/Gold Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Platinum/Gold/Silver Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Gold Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Gold/Silver Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Gold/Silver/Bronze Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Silver Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Silver/Bronze Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
Bronze Benefit Summaries 10.20 - 12.20 Effective Dates
10/01/2020 Summary
2020 Medical HMO SBCs
Anthem HMO
Anthem Blue Cross Platinum Select HMO A
01/01/2020 SBC
Anthem Blue Cross Gold Select HMO A
01/01/2020 SBC
Anthem Blue Cross Gold CaliforniaCare HMO B
01/01/2020 SBC
Anthem Blue Cross Silver Select HMO A
01/01/2020 SBC
Anthem Blue Cross Silver CaliforniaCare HMO B
01/01/2020 SBC
Health Net HMO
Health Net Platinum WholeCare HMO C
01/01/2020 SBC
Health Net Platinum Salud HMO D
01/01/2020 SBC
Health Net Platinum Full Network HMO E
01/01/2020 SBC
Health Net Gold WholeCare HMO A
01/01/2020 SBC
Health Net Gold WholeCare HMO B
01/01/2020 SBC
Health Net Gold WholeCare HMO C
01/01/2020 SBC
Health Net Gold Salud HMO D
01/01/2020 SBC
Health Net Gold Full Network HMO E
01/01/2020 SBC
Health Net Gold Full Network HMO F
01/01/2020 SBC
Health Net Silver WholeCare HMO A
01/01/2020 SBC
Health Net Silver CommunityCare HMO C
01/01/2020 SBC
Health Net Bronze CommunityCare HMO A
01/01/2020 SBC
Kaiser Permanente HMO
Kaiser Platinum HMO A
01/01/2020 SBC
Kaiser Platinum HMO B
01/01/2020 SBC
Kaiser Gold HMO A
01/01/2020 SBC
Kaiser Gold HMO B
01/01/2020 SBC
Kaiser Silver HMO A
01/01/2020 SBC
Kaiser Silver HMO B
01/01/2020 SBC
Kaiser Silver HMO C
01/01/2020 SBC
Kaiser Silver HMO D (HSA Eligible)
01/01/2020 SBC
Kaiser Bronze HMO A
01/01/2020 SBC
Kaiser Bronze HMO C (HSA Eligible)
01/01/2020 SBC
Sharp HMO
Sharp Platinum Premier HMO A
01/01/2020 SBC
Sharp Platinum Performance HMO B
01/01/2020 SBC
Sharp Platinum Premier HMO C
01/01/2020 SBC
Sharp Gold Performance HMO A
01/01/2020 SBC
Sharp Gold Premier HMO B
01/01/2020 SBC
Sharp Gold Performance HMO D
01/01/2020 SBC
Sharp Silver Premier HMO A
01/01/2020 SBC
Sharp Silver Performance HMO B
01/01/2020 SBC
Sharp Silver Premier HMO C
01/01/2020 SBC
Sharp Bronze Premier HMO A
01/01/2020 SBC
Sharp Bronze Performance HMO B (HSA Eligible)
01/01/2020 SBC
Sutter Health Plus HMO
Sutter Health Plus Platinum HMO A
01/01/2020 SBC
Sutter Health Plus Platinum HMO B
01/01/2020 SBC
Sutter Health Plus Gold HMO A
01/01/2020 SBC
Sutter Health Plus Gold HMO B
01/01/2020 SBC
Sutter Health Plus Silver HMO B
01/01/2020 SBC
Sutter Health Plus Silver HMO C (HSA Eligible)
01/01/2020 SBC
Sutter Health Plus Bronze HMO A
01/01/2020 SBC
Sutter Health Plus Bronze HMO B (HSA Eligible)
01/01/2020 SBC
UnitedHealthcare HMO
UHC Platinum SignatureValue HMO A
01/01/2020 SBC
UHC Platinum Focus HMO B
01/01/2020 SBC
UHC Platinum Alliance HMO C
01/01/2020 SBC
UHC Gold SignatureValue HMO A
01/01/2020 SBC
UHC Gold Alliance HMO B
01/01/2020 SBC
UHC Gold Focus HMO C
01/01/2020 SBC
UHC Gold Advantage HMO E [new effective 10/1/2020]
10/01/2020 SBC
UHC Silver SignatureValue HMO A
01/01/2020 SBC
UHC Silver Advantage HMO B
01/01/2020 SBC
UHC Silver Alliance HMO C
01/01/2020 SBC
UHC Silver Focus HMO D
01/01/2020 SBC
UHC Bronze Alliance HMO A
01/01/2020 SBC
UHC Bronze Alliance HMO B (HSA Eligible)
01/01/2020 SBC
Western Health Advantage HMO
Western Health Platinum HMO A
01/01/2020 SBC
Western Health Platinum HMO B
01/01/2020 SBC
Western Health Gold HMO A
01/01/2020 SBC
Western Health Gold HMO B
01/01/2020 SBC
Western Health Gold HMO C
01/01/2020 SBC
Western Health Gold HMO D (HSA Eligible)
01/01/2020 SBC
Western Health Silver HMO A
01/01/2020 SBC
Western Health Silver HMO B
01/01/2020 SBC
Western Health Silver HMO C (HSA Eligible)
01/01/2020 SBC
Western Health Bronze HMO B
01/01/2020 SBC
Western Health Bronze HMO C (HSA Eligible)
01/01/2020 SBC
2020 Medical PPO and EPO SBCs
Anthem Blue Cross PPO and EPO
Anthem Blue Cross Gold Advantage PPO A
01/01/2020 SBC
Anthem Blue Cross Gold Select PPO B
01/01/2020 SBC
Anthem Blue Cross Gold Select PPO C
01/01/2020 SBC
Anthem Blue Cross Gold Select PPO D
01/01/2020 SBC
Anthem Blue Cross Gold PPO E [new effective 7/1/2020]
07/01/2020 SBC
Anthem Blue Cross Silver Advantage PPO A
01/01/2020 SBC
Anthem Blue Cross Silver Select PPO B
01/01/2020 SBC
Anthem Blue Cross Silver PPO C [new effective 7/1/2020]
07/01/2020 SBC
Anthem Blue Cross Silver EPO A
01/01/2020 SBC
Anthem Blue Cross Silver EPO B (HSA Eligible)
01/01/2020 SBC
Anthem Blue Cross Bronze PPO A (HSA Eligible) [new effective 7/1/2020]
07/01/2020 SBC
Anthem Blue Cross Bronze Select PPO B (HSA Eligible) [new effective 7/1/2020]
07/01/2020 SBC
Anthem Blue Cross Bronze EPO A [plan discontinued 4/30/2020]
01/01/2020 SBC
Anthem Blue Cross Bronze EPO A [updated benefits for groups effective 5/1/2020 and later]
05/01/2020 SBC
Oscar EPO
Oscar Platinum EPO A
01/01/2020 SBC
Oscar Platinum EPO B
01/01/2020 SBC
Oscar Gold EPO A
01/01/2020 SBC
Oscar Gold EPO B
01/01/2020 SBC
Oscar Gold EPO C
01/01/2020 SBC
Oscar Gold EPO D
01/01/2020 SBC
Oscar Silver EPO A (HSA Eligible)
01/01/2020 SBC
Oscar Silver EPO B
01/01/2020 SBC
Oscar Silver EPO C
01/01/2020 SBC
Oscar Silver EPO D [new effective 10/1/2020]
10/01/2020 SBC
Oscar Bronze EPO A (HSA Eligible)
01/01/2020 SBC
Oscar Bronze EPO B
01/01/2020 SBC
Oscar Bronze EPO C [new effective 10/1/2020]
10/01/2020 SBC
2019 Medical Plan Benefit Summary Booklets
January - March 2019 Effective Dates
All Tiers Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Platinum Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Platinum/Gold Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Platinum/Gold/Silver Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Gold Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Gold/Silver Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Silver Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Silver/Bronze Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
Bronze Benefit Summaries 1.19 - 3.19 Effective Dates
01/01/2019 Summary
April - August 2019 Effective Dates
All Tiers Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Platinum Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Platinum/Gold Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Platinum/Gold/Silver Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Gold Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Gold/Silver Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Silver Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Silver/Bronze Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
Bronze Benefit Summaries 4.19 - 8.19 Effective Dates
04/01/2019 Summary
September 2019 Effective Dates
All Tiers Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Platinum Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Platinum/Gold Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Platinum/Gold/Silver Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Gold Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Gold/Silver Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Silver Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Silver/Bronze Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
Bronze Benefit Summaries 9.19 Effective Dates
09/01/2019 Summary
October - December 2019 Effective Dates
All Tiers Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Platinum Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Platinum/Gold Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Platinum/Gold/Silver Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Gold Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Gold/Silver Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Silver Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Silver/Bronze Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
Bronze Benefit Summaries 10.19 - 12.19 Effective Dates
10/01/2019 Summary
2019 Medical HMO and HSP SBCs
Anthem HMO
Anthem Blue Cross Platinum Select HMO A
01/01/2019 SBC
Anthem Blue Cross Platinum Select HMO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Gold Select HMO A
01/01/2019 SBC
Anthem Blue Cross Gold Select HMO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Gold CaliforniaCare HMO B [New 9.19]
09/01/2019 SBC
Anthem Blue Cross Silver Select HMO A
01/01/2019 SBC
Anthem Blue Cross Silver Select HMO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Silver CaliforniaCare HMO B [New 9.19]
09/01/2019 SBC
Health Net HMO and HSP
Health Net Platinum WholeCare HMO C
01/01/2019 SBC
Health Net Platinum Salud HMO D
01/01/2019 SBC
Health Net Platinum SmartCare HMO E
01/01/2019 SBC
Health Net Gold WholeCare HMO A
01/01/2019 SBC
Health Net Gold WholeCare HMO B
01/01/2019 SBC
Health Net Gold WholeCare HMO C
01/01/2019 SBC
Health Net Gold Salud HMO D
01/01/2019 SBC
Health Net Gold SmartCare HMO E
01/01/2019 SBC
Health Net Silver WholeCare HMO A
01/01/2019 SBC
Health Net Silver CommunityCare HMO B
01/01/2019 SBC
Health Net Silver PureCare HSP A
01/01/2019 SBC
Health Net Bronze PureCare HSP A
01/01/2019 SBC
Kaiser Permanente HMO
Kaiser Platinum HMO A
01/01/2019 SBC
Kaiser Platinum HMO B
01/01/2019 SBC
Kaiser Gold HMO A
01/01/2019 SBC
Kaiser Gold HMO B
01/01/2019 SBC
Kaiser Silver HMO A
01/01/2019 SBC
Kaiser Silver HMO B
01/01/2019 SBC
Kaiser Silver HMO C
01/01/2019 SBC
Kaiser Silver HMO D (HSA Eligible)
01/01/2019 SBC
Kaiser Bronze HMO A
01/01/2019 SBC
Kaiser Bronze HMO C (HSA Eligible)
01/01/2019 SBC
Sharp HMO
Sharp Platinum Premier HMO A
01/01/2019 SBC
Sharp Platinum Performance HMO B
01/01/2019 SBC
Sharp Platinum Premier HMO C
01/01/2019 SBC
Sharp Gold Performance HMO A
01/01/2019 SBC
Sharp Gold Premier HMO B
01/01/2019 SBC
Sharp Gold Performance HMO D
01/01/2019 SBC
Sharp Silver Premier HMO A
01/01/2019 SBC
Sharp Silver Performance HMO B
01/01/2019 SBC
Sharp Silver Premier HMO C
01/01/2019 SBC
Sharp Bronze Premier HMO A
01/01/2019 SBC
Sharp Bronze Performance HMO B (HSA Eligible)
01/01/2019 SBC
Sutter Health Plus HMO
Sutter Health Plus Platinum HMO A
01/01/2019 SBC
Sutter Health Plus Platinum HMO B
01/01/2019 SBC
Sutter Health Plus Gold HMO A
01/01/2019 SBC
Sutter Health Plus Gold HMO B
01/01/2019 SBC
Sutter Health Plus Silver HMO B
01/01/2019 SBC
Sutter Health Plus Silver HMO C (HSA Eligible)
01/01/2019 SBC
Sutter Health Plus Bronze HMO A
01/01/2019 SBC
Sutter Health Plus Bronze HMO B (HSA Eligible)
01/01/2019 SBC
UnitedHealthcare HMO
UHC Platinum SignatureValue HMO A
01/01/2019 SBC
UHC Platinum Focus HMO B
01/01/2019 SBC
UHC Platinum Advantage HMO C
01/01/2019 SBC
UHC Gold SignatureValue HMO A
01/01/2019 SBC
UHC Gold Alliance HMO B
01/01/2019 SBC
UHC Gold Focus HMO C
01/01/2019 SBC
UHC Gold Advantage HMO D
01/01/2019 SBC
UHC Silver SignatureValue HMO A
01/01/2019 SBC
UHC Silver Advantage HMO B
01/01/2019 SBC
UHC Silver Alliance HMO C
01/01/2019 SBC
UHC Silver Focus HMO D
01/01/2019 SBC
UHC Bronze Alliance HMO B (HSA Eligible)
01/01/2019 SBC
Western Health Advantage HMO
Western Health Platinum HMO A
01/01/2019 SBC
Western Health Platinum HMO B
01/01/2019 SBC
Western Health Gold HMO A
01/01/2019 SBC
Western Health Gold HMO B
01/01/2019 SBC
Western Health Gold HMO C
01/01/2019 SBC
Western Health Gold HMO D (HSA Eligible)
01/01/2019 SBC
Western Health Silver HMO A
01/01/2019 SBC
Western Health Silver HMO B
01/01/2019 SBC
Western Health Silver HMO C (HSA Eligible)
01/01/2019 SBC
Western Health Bronze HMO B
01/01/2019 SBC
Western Health Bronze HMO C (HSA Eligible)
01/01/2019 SBC
Western Health Bronze HMO D (HSA Eligible) - Discontinued effective 4.19
01/01/2019 SBC
2019 Medical PPO and EPO SBCs
Anthem Blue Cross PPO and EPO
Anthem Blue Cross Gold Advantage PPO A
01/01/2019 SBC
Anthem Blue Cross Gold Advantage PPO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Gold Select PPO B
01/01/2019 SBC
Anthem Blue Cross Gold Select PPO B [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Gold Select PPO C
01/01/2019 SBC
Anthem Blue Cross Gold Select PPO C [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Gold Select PPO D
01/01/2019 SBC
Anthem Blue Cross Gold Select PPO D [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Silver Advantage PPO A
01/01/2019 SBC
Anthem Blue Cross Silver Advantage PPO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Silver Select PPO B
01/01/2019 SBC
Anthem Blue Cross Silver Select PPO B [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Silver EPO A
01/01/2019 SBC
Anthem Blue Cross Silver EPO A [Benefit Update 10.19]
10/01/2019 SBC
Anthem Blue Cross Silver EPO B (HSA Eligible)
01/01/2019 SBC
Anthem Blue Cross Bronze EPO A
01/01/2019 SBC
Anthem Blue Cross Bronze EPO A [Benefit Update 10.19]
10/01/2019 SBC
Oscar EPO
Oscar Platinum EPO A
01/01/2019 SBC
Oscar Platinum EPO B
01/01/2019 SBC
Oscar Gold EPO A
01/01/2019 SBC
Oscar Gold EPO B
01/01/2019 SBC
Oscar Gold EPO C
01/01/2019 SBC
Oscar Gold EPO D
01/01/2019 SBC
Oscar Silver EPO A (HSA Eligible)
01/01/2019 SBC
Oscar Silver EPO B
01/01/2019 SBC
Oscar Silver EPO C
01/01/2019 SBC
Oscar Bronze EPO A (HSA Eligible)
01/01/2019 SBC
Oscar Bronze EPO B
01/01/2019 SBC
Form Name Effective Date Download Form
General Information
CaliforniaChoice Fast Facts Brochure 1.20 to 6.20 Effective Dates
01/01/2020 Download
CaliforniaChoice Fast Facts Brochure 7.20
07/01/2020 Download
CaliforniaChoice Underwriting Guidelines 1.20 to 6.20
01/01/2020 Download
CaliforniaChoice Underwriting Guidelines 7.20
07/01/2020 Download
CaliforniaChoice Total Choice Option [new effective 12/1/2020]
12/01/2020 Download
Cal Perks Flyer
01/01/2020 Download
Employer Guide to Optional Benefits 1.20 to 3.20 Effective Dates
01/01/2020 Download
Employer Guide to Optional Benefits 4.20 to 6.20 Effective Dates
04/01/2020 Download
Employer Guide to Optional Benefits 7.20 to 9.20 Effective Dates
07/01/2020 Download
Mammoth HR Cheat Sheet Flyer
08/01/2020 Download
Mobile App Flyer 1.20
01/01/2020 Download
Payroll & HRIS Solutions via CaliforniaChoice
01/01/2020 Download
POP Flyer
01/01/2020 Download
Smart Decision Technology Overview for Brokers
01/01/2020 Download
Smart Decision Technology Overview for Employers
01/01/2020 Download
Smart Decision Technology - Automated Choice Profiler
01/01/2020 Download
Smart Decision Technology - Online Enrollment
01/01/2020 Download
Smart Decision Technology - Online Provider Search
01/01/2020 Download
Smart Decision Technology - Online Rx Search
01/01/2020 Download
Value Plus Benefits Flyer
01/01/2020 Download
Website Features Flyer
01/01/2020 Download
Schedule Of Commissions
01/01/2020 Download
Medical
Anthem Advantage PPO Tier Hospital Network
01/01/2018 Download
CaliforniaChoice HSA Guide 1.20
01/01/2020 Download
CaliforniaChoice HSA Guide 1.21
01/01/2021 Download
CaliforniaChoice Member Enrollment Guide 1.20 to 3.20 Effective Dates
01/01/2020 Download
CaliforniaChoice Member Enrollment Guide 4.20 Effective Dates
04/01/2020 Download
CaliforniaChoice Member Enrollment Guide 5.20 to 6.20 Effective Dates
05/01/2020 Download
CaliforniaChoice Renewal Plan Transition Guide 1.20 to 3.20 Effective Dates
01/01/2020 Download
CaliforniaChoice Renewal Plan Transition Guide 4.20 to 9.20 Effective Dates
04/01/2020 Download
CaliforniaChoice Renewal Plan Transition Guide1.21 Effective Dates
01/01/2021 Download
CaliforniaChoice Summary of Changes for Groups Renewing 1.20 to 3.20
01/01/2020 Download
CaliforniaChoice Summary of Changes for Groups Renewing 4.20
04/01/2020 Download
CaliforniaChoice Summary of Changes for Groups Renewing 5.20 to 6.20
05/01/2020 Download
CaliforniaChoice Summary of Changes for Groups Renewing 7.20 to 8.20
07/01/2020 Download
CaliforniaChoice Summary of Changes for Groups Renewing 10.20 to 11.20
10/01/2020 Download
CaliforniaChoice Summary of Changes for Groups Renewing 1.21
01/01/2021 Download
Infertility Benefit Grid 1.20 to 6.20 Effective Dates
01/01/2020 Download
Infertility Benefit Grid 10.20 to 12.20 Effective Dates
10/01/2020 Download
Infertility Benefit Grid 1.21 Effective Dates
01/01/2021 Download
Medicare Part D Credibility 1.20 to 6.20 Effective Dates
01/01/2020 Download
Medicare Part D Credibility 10.20 to 12.20 Effective Dates
10/01/2020 Download
Medicare Part D Credibility 1.21 Effective Dates
01/01/2021 Download
Network Availability by Carrier & Plan 7.20
07/01/2020 Download
Network Availability by Carrier & Plan 10.20
10/01/2020 Download
Online Provider Search Instructions
01/01/2020 Download
Provider Network Definitions 1.20
01/01/2020 Download
Provider Network Definitions 10.20
10/01/2020 Download
Provider Network Definitions 1.21
01/01/2021 Download
SBC-EOC Flyer
01/01/2020 Download
Ancillary
Chiropractic Benefits Flyer
01/01/2020 Download
Dental Benefits Flyer 1.20 to 6.20 Effective Dates
01/01/2020 Download
Dental Benefits Flyer 7.20
07/01/2020 Download
Hearing Value Added Benefit Flyer
01/01/2020 Download
Life Insurance Benefits Flyer 1.20
01/01/2020 Download
Vision Benefits Flyer
01/01/2020 Download
Video Name Watch Video
Intro to CaliforniaChoice Watch Video
CaliforniaChoice What is Defined Contribution? Watch Video
CaliforniaChoice Health Insurance Plans Watch Video
CaliforniaChoice Ease of Administration Watch Video
CaliforniaChoice Additional Plans and Perks Watch Video
CaliforniaChoice Working with Health Insurance Brokers Watch Video
Form Name Effective Date Download Form
Rate Guide Summary [effective 10/1/2020]
10/01/2020 Download
Rate Guide Summary [effective 1/1/2021 to 3/1/2021]
01/01/2021 Download