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RBG, SAN JOSE - PLANS
BLUE SHIELD OF CALIFORNIA TYPE RELEASED DOWNLOAD
Medical Plans
Mirror Gold 80 Network 1 HMO - 2016
HMO 6/17/2016 Download
Mirror Gold 80 Network 2 HMO - 2016
HMO 6/17/2016 Download
Mirror Paltinum 90 Network 1 HMO - 2016
HMO 6/17/2016 Download
Mirror Platinum 90 Network 2 HMO - 2016
HMO 6/17/2016 Download
Mirror Silver 70 Network 1 HMO - 2016
HMO 6/17/2016 Download
Mirror Silver 70 Network 2 HMO - 2016
HMO 6/17/2016 Download
Off Ex Gold Access+ HMO 1700/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Access+ HMO 750/30 (7-16)
HMO 6/17/2016 Download
Off Ex Gold Access+ HMO 750/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Local Access+ HMO 1700/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Local Access+ HMO 750/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Local Access+ HMO 750/30 (7-16)
HMO 6/17/2016 Download
Off Ex Gold Trio ACO HMO 1700/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Trio ACO HMO 1700/30 (7-16)
HMO 6/17/2016 Download
Off Ex Gold Trio ACO HMO 750/30 (1-16)
HMO 6/21/2016 Download
Off Ex Gold Trio ACO HMO 750/30 (7/16)
HMO 6/17/2016 Download
Off Ex Platinum Access+ HMO 0/20 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Access+ HMO 0/20 (7-16)
HMO 6/17/2016 Download
Off Ex Platinum Access+ HMO 0/25 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Access+ HMO 0/25 (7-16)
HMO 6/17/2016 Download
Off Ex Platinum Access+ HMO 0/30 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Access+ HMO 0/30 (7-16)
HMO 6/17/2016 Download
Off Ex Platinum Local Access+ HMO 0/20 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Local Access+ HMO 0/20 (7-16)
HMO 6/17/2016 Download
Off Ex Platinum Local Access+ HMO 0/25 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Local Access+ HMO 0/25 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Local Access+ HMO 0/30 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Local Access+ HMO 0/30 (7-16)
HMO 6/17/2016 Download
Off Ex Platinum Trio ACO HMO 0/20 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Trio ACO HMO 0/25 (1-16)
HMO 6/21/2016 Download
Off Ex Platinum Trio ACO HMO 0/30 (1-16)
HMO 6/21/2016 Download
Off Ex Silver Access+ HMO 1700/55 (1-16)
HMO 6/21/2016 Download
Off Ex Silver Access+ HMO 1700/55 (7-16)
HMO 6/17/2016 Download
Off Ex Silver Local Access+ HMO 1700/55 (1-16)
HMO 6/21/2016 Download
Off Ex Silver Local Access+ HMO 1700/55 (7-16)
HMO 6/17/2016 Download
Off Ex Silver Trio ACO HMO 1700-55 (7-16)
HMO 6/17/2016 Download
Off Ex Silver Trio ACO HMO 1700/55 (1-16)
HMO 6/21/2016 Download
Pediatric Dental HMO - 2015
HMO 1/9/2015 Download
Mirror Bronze 60 PPO - 2016
PPO 6/17/2016 Download
Off Ex Bronze Full PPO 3500/60 (1-16)
PPO 6/21/2016 Download
Off Ex Bronze Full PPO 3500/60 (7-16)
PPO 6/17/2016 Download
Off Ex Bronze Full PPO 4500/30 (1-16)
PPO 6/21/2016 Download
Off Ex Bronze Full PPO 4500/45 (1-16)
PPO 6/21/2016 Download
Off Ex Bronze Full PPO 4500/45 (7-16)
PPO 6/17/2016 Download
Off Ex Bronze Full PPO 5500/40 (1-16)
PPO 6/21/2016 Download
Off Ex Bronze Full PPO 5500/40 (1-16)
PPO 6/21/2016 Download
Off Ex Bronze Full PPO HSA 4500/30 (7-16)
PPO 6/17/2016 Download
Off Ex Bronze Full PPO HSA 5500/40 (7-16)
PPO 6/17/2016 Download
Off Ex Gold Full PPO 0/20 (1-16)
PPO 6/21/2016 Download
Off Ex Gold Full PPO 0/20 (7-16)
PPO 6/17/2016 Download
Off Ex Gold Full PPO 1000/35 (1-16)
PPO 6/21/2016 Download
Off Ex Gold Full PPO 1000/35 (7-16)
PPO 6/17/2016 Download
Off Ex Gold Full PPO 250/20 (1-16)
PPO 6/21/2016 Download
Off Ex Gold Full PPO 250/20 (7-16)
PPO 6/17/2016 Download
Off Ex Gold Full PPO 750/20 (1-16)
PPO 6/21/2016 Download
Off Ex Gold Full PPO 750/20 (7-16)
PPO 6/17/2016 Download
Off Ex Platinum Full PPO 0/10 (1-16)
PPO 6/21/2016 Download
Off Ex Platinum Full PPO 0/10 (7-16)
PPO 6/17/2016 Download
Off Ex Platinum Full PPO 150/15 (1-16)
PPO 6/21/2016 Download
Off Ex Platinum Full PPO 150/15 (7-16)
PPO 6/17/2016 Download
Off Ex Silver Full PPO 1250/40 (1-16)
PPO 6/21/2016 Download
Off Ex Silver Full PPO 1250/40 (7-16)
PPO 6/17/2016 Download
Off Ex Silver Full PPO 1700/40 (1-16)
PPO 6/21/2016 Download
Off Ex Silver Full PPO 1700/40 (7-16)
PPO 6/17/2016 Download
Off Ex Silver Full PPO 2000/20 (1-16)
PPO 6/21/2016 Download
Off Ex Silver Full PPO HSA 2000/20 (7-16)
PPO 6/17/2016 Download
Chiropractic & Acupuncture Benefits

Description:
For HMO and POS plans. A12114 (07/03)

Riders 12/21/2002 Download
Chiropractic Benefits

Description:
For HMO and POS plans. A11343 (07/03)

Riders 12/21/2002 Download
Eyewear Only Plan

Description:
HMO plan Memebers. Administered by Medical Eye Services (MES) using The Eye Care Network A11343 (07/01)

Riders 12/21/2002 Download
Infertility Benefits

Description:
A11918 (01/02)

Riders 12/21/2002 Download
Substance Abuse Treatment Benefits

Description:
HMO plans. A12137 (01/02)

Riders 12/21/2002 Download
Vision Benefits

Description:
Administered by Medical Eye Services (MES) using The Eye Care Network A11398 (07/03)

Riders 12/21/2002 Download
Dental Plans
DHMO Dental HMO Basic - 2016
DHMO 6/17/2016 Download
DHMO Dental HMO Deluxe - 2016
DHMO 6/17/2016 Download
DHMO Dental HMO Plus - 2016
DHMO 6/17/2016 Download
DHMO Dental HMO VOL - 2016
DHMO 6/17/2016 Download
DPPO Smile 50/1500/No Ortho/Mac - 2016
PPO 6/17/2016 Download
DPPO Smile Basic 75/1000/No Ortho/Mac - 2016
PPO 6/17/2016 Download
DPPO Smile Basic Vol 75/1000/No Ortho/MAC - 2016
PPO 6/17/2016 Download
DPPO Smile Deluxe 2000 50/2000/No Ortho/Mac - 2016
PPO 6/17/2016 Download
DPPO Smile Deluxe 50/1500/Ortho/Mac - 2016
PPO 6/17/2016 Download
DPPO Smile Deluxe Gold 50/1500/Ortho - 2016
PPO 6/17/2016 Download
DPPO Smile Deluxe Plus 2000 50/2000/Ortho/Mac-2016
PPO 6/17/2016 Download
DPPO Smile Plus 50/1500/Ortho/Mac - 2016
PPO 6/17/2016 Download
DPPO Smile Plus Gold 50/1500/Ortho - 2016
PPO 6/17/2016 Download
DPPO Smile Value 50/1500/No Ortho MAC - 2016
PPO 6/17/2016 Download
DPPO Ultimate Dental Plus PPO 50/2000 - 2016
PPO 6/17/2016 Download
DPPO Ultimate Dental PPO 50/2000 - 2016
PPO 6/17/2016 Download
INO Smile 50/1500/Endo-Perio 80%/No Ortho - 2016
PPO 6/17/2016 Download
INO Smile 50/1500/Endo-Perio 80%/Ortho - 2016
PPO 6/17/2016 Download
INO Smile 50/2500/Endo-Perio 80%/Ortho - 2016
PPO 6/17/2016 Download
INO Smile 50/2500/Endo-Period 80%/No Ortho - 2016
PPO 6/17/2016 Download
INO Smile VOL 50/1500/Endo-Perio 50%/No Ortho-2016
PPO 6/17/2016 Download
INO Smile VOL 50/1500/Endo-Perio 50%/Ortho - 2016
PPO 6/17/2016 Download
INO Smile VOL 50/2500/Endo-Perio 50%/No Ortho-2016
PPO 6/17/2016 Download
INO Smile VOL 50/2500/Endo-Perio 50%/Ortho - 2016
PPO 6/17/2016 Download
Life Plans
Blue Shield Life 100K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 150K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 15K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 20K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 25K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 50K - 2016
Basic Life 6/17/2016 Download
Blue Shield Life 75K - 2016
Basic Life 6/17/2016 Download
Vision Plans
Enhanced 0/0/120 - 2016
N/A 6/17/2016 Download
Enhanced 0/0/150 - 2016
N/A 6/17/2016 Download
Enhanced 15/25/120 – 2016
N/A 6/17/2016 Download
Enhanced 15/25/150 - 2016
N/A 6/17/2016 Download
Enhanced Plus 15/25/150/120 - 2016
N/A 6/17/2016 Download
Enhanced VOL 15/25/120 - 2016
N/A 6/17/2016 Download
Preferred 0/0/120 - 2016
N/A 6/17/2016 Download
Preferred 0/0/150 - 2016
N/A 6/17/2016 Download
Preferred 15/25/120 - 2016
N/A 6/17/2016 Download
Preferred 15/25/150 - 2016
N/A 6/17/2016 Download
Preferred 15/25/150/120 - 2016
N/A 6/17/2016 Download
Preferred Plus 0/0/150/120 - 2016
N/A 6/17/2016 Download
Preferred VOL 15/25/120 - 2016
N/A 6/17/2016 Download
Ultimate 0/0/120 - 2016
N/A 6/17/2016 Download
Ultimate 15/25/120 - 2016
N/A 6/17/2016 Download
Ultimate 15/25/150 - 2016
N/A 6/17/2016 Download
Ultimate Plus 0/0/150/120 - 2016
N/A 6/17/2016 Download
Ultimate Plus 15/25/150/120 - 2016
N/A 6/17/2016 Download
Ultimate VOL 15/25/150 - 2016
N/A 6/17/2016 Download
Other Plans
How to Find a Provider
N/A 1/13/2015 Download
Lifepath Advisers

Description:
Summary A12183-E (07/02)

N/A 12/27/2002 Download
Lifepath Advisers

Description:
Frequently asked questions.

N/A 11/26/2002 Download
NurseHelp Flyer
N/A 1/23/2012 Download
Premium Only Plan (POP)

Description:
Provided by Ceridian Benefits Services as a service to contract holders of Blue Shield of California.

N/A 11/26/2002 Download
Why Not-for-Profit Status Makes a Difference


N/A 11/27/2002 Download