Changing the way you
receive healthcare

  • Publications and Forms

    The following publications and forms are for plan members. All publications below are applicable to the plan year indicated. If you need a publication or form that is not listed below, please contact Member Services. If you would like a printed copy of any of the documents below, please contact Member Services.

    2021 Plan Publications

    Provider and Pharmacy Directories

    To report any errors in the PHP provider or pharmacy, please send an email to, or send a message using our web form. You may also report directory errors by calling Member Services at (833) 267-6768 (TTY 711). Agents are available 8:00 am to 8:00 pm, seven days a week.

    Other Publications and Forms

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    You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.

    H3572_4006 101520_2021