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)