EVIDENCE OF COVERAGE /
SUMMARY OF BENEFITS

ANTHEM BLUE CROSS

2023 Anthem Full Network HMO EOC
2023 Anthem Narrow Network HMO EOC
2023 Anthem Vivity HMO EOC
2023 Anthem PPO EOC
2021 Anthem Full Network HMO EOC
2021 Anthem Narrow Network HMO EOC
2021 Anthem Vivity HMO EOC
2021 Anthem PPO EOC
2021 Anthem Full Network HMO SBC
2021 Anthem Narrow Network HMO SBC
2021 Anthem Vivity HMO SBC
2021 Anthem PPO SBC
2020 Anthem Vivity HMO SBC
2020 Anthem Full Network HMO SBC
2020 Anthem Full HMO EOC
2020 Anthem Narrow HMO EOC
2020 Anthem PPO EOC
2020 Anthem Vivity HMO EOC
2020 Anthem Narrow Network (Select HMO) SBC
2020 Anthem PPO SBC
2019 Anthem Narrow Network (Select HMO) EOC
2019 Anthem Vivity HMO EOC
2019 Anthem Full Network (CACare HMO) EOC
2019 Anthem PPO EOC
2019 Anthem Full Network (CACare HMO) SBC
2019 Anthem Narrow Network (Select HMO) SBC
2019 Anthem PPO SBC
2019 Anthem Vivity HMO SBC
2018 Anthem Full Network (CACare HMO) SBC
2018 Anthem Full Network (CACare HMO) EOC
2018 Anthem Narrow Network (Select HMO) SBC
2018 Anthem Narrow Network (Select HMO) EOC
2018 Anthem PPO SBC
2018 Anthem PPO EOC)
2018 Anthem Vivity HMO SBC
2018 Anthem Vivity HMO EOC
2017 Anthem Full Network (CACare HMO) SBC
2017 Anthem Narrow Network (Select HMO) SBC
2017 Anthem PPO SBC
2017 Anthem Vivity HMO SBC
2017 Anthem Full Network (CACare HMO) EOC
2017 Anthem Narrow Network (Select HMO) EOC
2017 Anthem PPO EOC
2017 Anthem Vivity HMO EOC

BLUE SHIELD OF CALIFORNIA

2014 Blue Shield Evidence of Coverage (EOC) Access+ HMO SaveNet (Narrow)
2014 Blue Shield Evidence of Coverage (EOC) Access+ HMO (Full)
2014 Blue Shield Evidence of Coverage (EOC) Shield Spectrum PPO
Blue Shield Access+ HMO SaveNet (Narrow) SBC
Blue Shield Access+ HMO (Full) SBC
Blue Shield Spectrum PPO SBC

KAISER

2023 Kaiser HMO SBC - Civilian Employees
2023 Kaiser HMO SBC - Sworn Employees
2021 Kaiser EOC - Civilian Employees
2021 Kaiser EOC - Sworn Employees
2021 Kaiser SBC - Civilian Employees
2021 Kaiser HMO SBC - Sworn Employees
2020 Kaiser HMO SBC - Civilian Employees
2020 Kaiser HMO EOC - Civilian Employees
2020 Kaiser HMO EOC - Sworn Employees
2019 Kaiser HMO EOC - Civilian Employees
2019 Kaiser HMO SBC - Civilian Employees
2018 Kaiser HMO SBC - Civilian Employees
2018 Kaiser HMO EOC - Civilian Employees
Kaiser Permanente HMO SBC

DENTAL COVERAGE

2020 Delta PPO EOC
2020 Delta Preventative Care EOC
2020 DeltaCare USE DHMO EOC
2019 Delta PPO EOC
2019 Delta Preventive Only EOC
2019 DeltaCare USA HMO EOC
2018 DeltaCare USA DHMO Evidence of Coverage (EOC)
2018 Delta Preventive Evidence of Coverage (EOC)
2018 Delta Preferred Option (PPO) Evidence of Coverage (EOC)
2017 Delta Preferred Option (PPO) Evidence of Coverage (EOC)
2017 Delta Preventive Evidence of Coverage (EOC)
2017 DeltaCare USA DHMO Evidence of Coverage (EOC)
2014 DeltaCare USA DHMO Evidence of Coverage (EOC)
2014 Delta Preferred Option (PPO) Evidence of Coverage (EOC)
2014 Delta Preventive Evidence of Coverage (EOC)

EYEMED

2020 EyeMed Vision Insurance Certificate

STANDARD INSURANCE COMPANY

Group Life Insurance Certificate
Group Short Term Disability Insurance Certificate
Group Long Term Disability Insurance Certificate
Group AD&D Insurance Certificate
2019 Group Life Insurance Certificate & Policy
2016 Group Long Term Disability Certificate & Policy
2016 Group Short Term Disability Certificate & Policy