Plan Materials - English
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2020 How To Access Notice
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2020 ANOC Plan 001
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2020 ANOC Plan 002
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2020 ANOC Plan 003
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2020 Summary of Benefits
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2020 Drug Formulary - Choice
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2020 Drug Formulary - Plus
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2020 Enrollment Form
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2020 Low Income Subsidy Premium
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2020 Dental Benefit Choice Plan 001
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2020 Dental Benefit Choice Plan 002
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2020 Dental Benefit Plus Plan 003
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2020 Over The Counter Catalog
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2020 Evidence of Coverage Plan 001
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2020 Evidence of Coverage Plan 002
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2020 Evidence of Coverage Plan 003
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2020 Provider and Pharmacy Directory
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2019 Summary of Benefits
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2019 Formulary (List of Covered Drugs)
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2019 Provider and Pharmacy Directory
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2019 Enrollment Form
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Low Income Subsidy (LIS) Premium Summary Chart
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2019 Dental Benefit Book - Vitality Choice
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2019 Dental Benefit Book -Vitality Plus
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2019 Over-The-Counter (OTC) Catalog
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2019 Evidence of Coverage - Vitality Choice Plan 001 - San Joaquin County
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2019 Evidence of Coverage - Vitality Choice Plan 002 - Santa Clara County
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2019 Evidence of Coverage - Vitality Plus Plan 003 - San Joaquin and Santa Clara County
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To view the documents in other languages click here: Spanish | Chinese | Korean | Vietnamese