The state of California has requested that all carriers provide the following information to aid with the understanding of your plan.
1. A telephone number that the insured or provider can call, during normal business hours, for assistance obtaining mental health benefits coverage information, including the extent to which benefits have been exhausted, in-network provider access information, and claims processing information.
- Please call toll free to our Customer Service Department: 800-899-6520
2. A link to prescription drug formularies or instructions on how to obtain formulary information
- Our company’s prescription card plans do not have formularies
3. A detailed summary description of the process by which the insurer reviews and approves, modifies, or denies requests for health care services as described in Section 10123.135.
4. Lists of providers or instructions on how to obtain a provider list as required by Section 10133.1.
5. A detailed summary of the health insurer's grievance process.
- The grievance process used in California can be found here.
6. A detailed description of how the insured may request continuity of care as described in Section 10133.55.
- Continuity of care requests may be made to our Customer Service Department toll free at 800-899-6520.
7. Information concerning the right, and applicable procedure, of the insured to request an independent medical review pursuant to subdivision (i) of Section 10169.
- Member rights and independent medical review process may be found within the grievance process. External review application and authorization to release medical information are here.
8. We have established and maintain a Language Assistance Program under California law. You can get an interpreter at no cost to talk to your health plan and discuss your claims.
- You may request an interpreter through our Customer Service department toll free at 800-899-6520.