Documents & Forms Center

Members, Providers

Clinical Guidelines - Diabetes Care 2023

PDF icon 2023-Diabetes-Clinical-Practice-Guideline.pdf

Members

Clone of State of Florida High Deductible Health HMO Plan SBC

PDF icon sof-standard-hmo-plan-sbc.pdf

Medicare 2023, Agents, Members

Communication Directive Form

PDF icon Communication-Directive-Form.pdf

Agents, Employers, Members

Communication Directive Form Instructions

PDF icon Communication Directive 2020.pdf

Members

Consent Form for Minor Child

PDF icon Consent for Minor Child Approved 7 22 21_fillable.pdf

Members

Conversion Option A

PDF icon Conversion Option A.pdf

Members

Conversion Option C

PDF icon Conversion Option C.pdf

Members

Conversion Option C $10/$30/$50

PDF icon ConversionOptionC01-01-21.pdf

Members

Conversion Option M $15/$30/$50

PDF icon ConversionOptionM01-01-21.pdf

Agents, Employers, Members

Coordination of Benefits Instructions and Form

PDF icon Coordination of Benefits Instructions and Form.pdf

Members

COVID-19 Telehealth Flyer - SOF

PDF icon COVID-19 Telehealth Flyer.pdf

Members

COVID-19-PHE-Ending-Letter

PDF icon COVID-19-PHE-Ending-Letter.pdf

Agents, Employers, Members

Enrollment Application

PDF icon Enrollment Application 2023.87.EnrollApp.pdf

Members

Feeding Your Baby

PDF icon Feeding-Your-Baby-Final.pdf

Members

FEHB High Option SBC - 2024

PDF icon FEHBHighOption15.40.100-1-1-24.pdf

Members

FEHB Member Handbook - Effective 1-1-2022

PDF icon FEHB Member Handbook - Effective 1-1-2022.pdf

Members

Final Rate Determination

PDF icon Final Rate Determination for Website_20231103.pdf

Members

General Pregnancy Information

PDF icon General Pregnancy Information.pdf

Agents, Employers, Members

Getting Care In A Disaster Area

PDF icon Getting Care In A Disaster Area.pdf

Agents, Employers, Members, Providers

Glossary of Health Coverage and Medical Terms

PDF icon Glossary of Health Coverage and Medical Terms.pdf

Agents, Employers, Medicare, Members, Providers

Health and Fitness Reimbursement Form

PDF icon Fitness Reimbursement Form 040820 FILLABLE.pdf

Members

Healthline Newsletter Fall 2023

PDF icon 23-CHP-029 Healthline Newsletter Fall 2023-V3_3.pdf

Members

Healthline Newsletter February 2023

PDF icon 23-CHP-002-Healthline-Newsletter-Update-DIGITAL-V2-2.pdf

Members

Healthline Newsletter February 2023

PDF icon 23-CHP-002-Healthline-Newsletter-Update-DIGITAL-V2-2.pdf