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.

2019 Plan Publications

2019 Summary of Benefits
2019 Quality and Performance Ratings (Every year, Medicare evaluates plans based on a 5-star rating system.)
2019 Annual Notice of Changes (ANOC)
2019 Evidence of Coverage
2019 Comprehensive Formulary (effective August 1, 2019; last updated July 25, 2019)
2019 Prescription Drug Prior Authorization Criteria (effective August 1, 2019)
2019 Prescription Drug Step Therapy Criteria (effective August 1, 2019)

Provider and Pharmacy Directories

Search online using our Network Provider/Facility/Pharmacy Search application
Provider and Part B Pharmacy Directory (last updated June 1, 2019)
Part D Pharmacy Directory (last updated June 1, 2019)

To report any errors in the PHP provider or pharmacy, please send an email to [email protected], or send a message using our web form. You may also report directory errors by calling Member Services at (800) 263-0067, Option 2 (TTY 711). Agents are available 8:00 am to 8:00 pm, seven days a week.

Other Publications and Forms

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.

H5852_4006 2019 101518

PHP, California