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Member Forms & Publications

The following documents may take a few minutes to download.

Forms & Publications

******** Summary of Benefits
English:
2012
Spanish:
2012
Chinese:
2012
******** Evidence of Coverage
English:
2012
Spanish:
2012
******** View How Our Plan Rated in Quality & Performance
English | Spanish
******** Drug Formulary
English & Spanish:
2012
English Update:
2012
Spanish Update:
2012
Search
******** Prior Authorization Criteria
English:
2012
Spanish:
2012
******** Step Therapy Protocol
English:
2012
Spanish:
2012
******** Low Income Subsidy (LIS) Levels
English:
2012
Spanish:
2012
Chinese:
2012
******** Grievance & Appeals Form
English | Spanish
******** Provider Directory
English & Spanish:
2012
English & Chinese (Chinese):
2012
Search
******** Pharmacy Directory
English & Spanish:
2012
Search
******** Dental Directory
English & Spanish:
2012
Search
******** Appointment of a Representative
English | Spanish

Newsletter & Articles

******** Health Builder
English | Spanish
******** Member Newsletter
Current Edition: English | Spanish
Past Edition 1: English | Spanish
Past Edition 2: English | Spanish
******** Utilization Management Program Synopsis
English | Spanish
******** CCHP Quality Management Synopsis
English | Spanish
******** CCHP Member Information
English:
2012
Spanish:
2012
******** CCHP Financial Statement Information
English | Spanish
******** How does CCHP pay their providers?
English | Spanish
******** CCHP Separation Agreement
English | Spanish

H3815_11148EN CMS Approved 10242011
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