Enrollment Applications (en Espanol)

1.  CSMHWTF Enrollment Form – 2021

Benefit Summaries (en Espanol)

1.  HealthNet HMO – Full Network GX6 (FX1)
2.  HealthNet HMO – Full Network GX3 (FWY)
3.  HealthNet HMO – ExcelCare GXM (FXF)
4.  HealthNet HMO – ExcelCare GXU (FXM)
5.  HealthNet HMO – ExcelCare GXY (FXP)
6.  HealthNet HMO – ExcelCare GXS (FXL)
7.  HealthNet HMO – Salud Y Mas H11 (G65)
8.  HealthNet HMO – Salud Y Mas H1E (G6G)
9.  HealthNet HMO – SmartCare GWR (FWN)
10.  HealthNet HMO – SmartCare GWV (FWQ)
11.  HealthNet PPO – GYG (modPR3)
12.  HealthNet PPO – GYH (modPR3)
13.  HealthNet PPO/HSA – GYV (modULU)
14.  HealthNet PPO/HSA – GYR (modBS6T)

1.  MetLife HMO High – Dental (MET 85)
2.  MetLife HMO Low – Dental (MET 185)
3.  MetLife PPO High – Dental
4.  MetLife PPO Low – Dental

1.  MetLife High Option – Vision
2.  MetLife Low Option – Vision