Forms & Brochures – Group Medicare Plans
How to View/Download Files
To view or download a file, click the desired link. The PDF file will open in a new window or tab of your browser. From there, you can also download or print the file.
Tag Lines & Nondiscrimination Notice – Multilingual (PDF)
*NOTE: This document must be provided in conjunction with Enrollment Forms, Summary of Benefits, ANOC/EOC and Plan Ratings.
Enrollment and other Forms
- Seniority Plus Enrollment Form – English (PDF)
- Group Retiree COB Enrollment Form – English (PDF)
- Medicare – Medical – Behavioral Health Claim Form – English (PDF)
Brochures, Flyers and Notices
- Seniority Plus Overview Brochure – English (PDF)
- HMO COB Brochure – English (PDF)
- PPO COB Brochure – English (PDF)
- Healthy Discounts Brochure – English (PDF)
- Silver&Fit Flyer (PDF)
- Dental 8R Plan Flyer (PDF)
- Vision Plan 1A (PDF)
- Vision Plan 3S (PDF)
- Vision Plan 6X (PDF)
- Vision Plan 6Y (PDF)
- County of Kern Transportation Flyer – English (PDF)
- Chiropractic-Acupuncture Flyer – Plan CWU (PDF)
- Chiropractic-Acupuncture Flyer – Plan CWV (PDF)
- Chiropractic-Acupuncture Flyer – Plan CXL (PDF)
- Chiropractic-Acupuncture Flyer – Plan CXN (PDF)
- MAPD Fulfillment Notice (PDF)
- MA Fulfillment Notice (PDF)