Forms & Brochures – Group Medicare Plans
How to View/Download Files
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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.
CA HMO Part C and Part D Star Ratings – English (PDF)
Enrollment and other Forms
- Seniority Plus Enrollment Form – English (PDF)
- Group Retiree COB Enrollment Form – English (PDF)
- Medicare – Medical – MHN 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)
- Directory Notice – English (PDF)