Plan Name | Enrollment Code(s) | PDF Version | Accessible Version |
Advantage Health Plan, Inc. |
6Y |
PDF |
Accessible |
Aetna Health Inc. |
JN |
PDF |
Accessible |
Aetna Health Inc. |
2U, 2X, 6J, 7D, 8J, JC, P3, RD, UB, WQ |
PDF |
Accessible |
Alliance Health Benefit Plan |
1R |
PDF |
Accessible |
Altius Health Plans |
9K |
PDF |
Accessible |
AmeriHealth HMO, Inc. |
FK |
PDF |
Accessible |
APWU Health Plan |
47 |
PDF |
Accessible |
Arnett HMO Health Plan |
G2 |
PDF |
Accessible |
Association Benefit Plan |
42 |
PDF |
Accessible |
Avera Health Plan |
AV |
PDF |
Accessible |
AultCare HMO |
3A |
PDF |
Accessible |
Av-Med Health Plan |
EM |
PDF |
Accessible |
Av-Med Health Plan (South Florida) |
ML |
PDF |
Accessible |
Blue Care Network |
G7, K5, KF, KN, KR, LN, LX |
PDF |
Accessible |
Blue Chip, Coordinated Health Partners, |
DA |
PDF |
Accessible |
Blue Choice |
MK |
PDF |
Accessible |
BlueCHOICE |
9G |
PDF |
Accessible |
Blue Cross and Blue Shield Service Benefit Plan |
10, 11 |
PDF |
Accessible |
Blue Cross- HMO |
M5 |
PDF |
Accessible |
Blue HMO (formerly Health Maintenance Plan-HMP) |
R5 |
PDF |
Accessible |
Blue Shield of California Access+ |
SJ |
PDF |
Accessible |
Capital District Physicians' Health Plan, Inc. |
PW, QB, SG |
PDF |
Accessible |
Capital Health Plan |
EA |
PDF |
Accessible |
CareFirst BlueChoice |
2G |
PDF |
Accessible |
CIGNA HealthCare of California |
9T |
PDF |
Accessible |
Cimarron Health Plan |
PX |
PDF |
Accessible |
ConnectiCare, Inc. |
TE |
PDF |
Accessible |
Coventry Health Care of Iowa, Inc. |
SV |
PDF |
Accessible |
Coventry Health Care of Kansas (Kansas City) |
HA |
PDF |
Accessible |
Coventry Health Care of Kansas, Inc. |
7W |
PDF |
Accessible |
Coventry Health Care of Louisiana |
BJ, JA |
PDF |
Accessible |
Dean Health Plan |
WD |
PDF |
Accessible |
Fallon Community Health Plan |
JV |
PDF |
Accessible |
FIRSTCARE |
6U, CK |
PDF |
Accessible |
Foreign Service Benefit Plan |
40 |
PDF |
Accessible |
Foundation Health, A Florida Health Plan |
5E |
PDF |
Accessible |
GHI HMO Select, Inc. |
6V, X4 |
PDF |
Accessible |
Government Employees Hospital Association (GEHA) Benefit Plan |
31 |
PDF |
Accessible |
Grand Valley Health Plan |
RL |
PDF |
Accessible |
Group Health Cooperative of Eau Claire |
WT |
PDF |
Accessible |
Group Health Cooperative of Puget Sound |
54, VR |
PDF |
Accessible |
Group Health Cooperative of South Central Wisconsin |
WJ |
PDF |
Accessible |
Group Health Incorporated |
80 |
PDF |
Accessible |
Group Health Plan, Inc. |
MM |
PDF |
Accessiblel |
Hawaii Medical Service Association Plan |
87 |
PDF |
Accessible |
Health Alliance HMO |
FX |
PDF |
Accessible |
Health Alliance Plan |
52 |
PDF |
Accessible |
Health Insurance Plan of Greater New York (HIP/HMO) |
51 |
PDF |
Accessible |
Health Net |
LB |
PDF |
Accessible |
Health Net of Arizona (formerly Intergroup of Arizona, Inc.) |
A7 |
PDF |
Accessible |
Health Net of Pennsylvania (formerly PHS Health Plans, QualMed Plans for Health, and Greater Atlantic Health Service) |
27, 2K |
PDF |
Accessible |
Health Plan of Nevada, Inc. |
NM |
PDF |
Accessible |
HealthAmerica Pennsylvania |
26, SW |
PDF |
Accessible |
HealthGuard |
NQ |
PDF |
Accessible |
HealthPartners Classic |
53 |
PDF |
Accessible |
HealthPartners Primary Clinic Plan |
HQ |
PDF |
Accessible |
Health Plan of the Upper Ohio Valley, Inc., The |
U4 |
PDF |
Accessible |
Healthplan Southeast |
RK |
PDF |
Accessible |
HealthPlus of Michigan |
X5 |
PDF |
Accessible |
Healthspring |
6K |
PDF |
Accessible |
Heart of America HMO Health Plan |
RU |
PDF |
Accessible |
HMO Blue |
AH |
PDF |
Accessible |
HMO Blue Texas |
YM, YX |
PDF |
Accessible |
HMO-CNY, Inc. |
EB |
PDF |
Accessible |
HMO Health Ohio |
L4 |
PDF |
Accessible |
Humana Medical Plan, Inc. |
EE |
PDF |
Accessible |
Humana Health Plan, Inc. |
MS |
PDF |
Accessible |
Humana Health Plan, Inc. |
D2 |
PDF |
Accessible |
Humana Health Plan Inc. - Chicago |
75 |
PDF |
Accessible |
Humana Health Plans of Puerto Rico |
ZJ |
PDF |
Accessible |
Humana Health Plan of Texas |
UR |
PDF |
Accessible |
Independent Health Association |
QA |
PDF |
Accessible |
JMH Health Plan |
J8 |
PDF |
Accessible |
John Deere Health Plan, Inc. |
YH |
PDF |
Accessible |
Kaiser Foundation Health Plan Inc., Hawaii Region |
63 |
PDF |
Accessible |
Kaiser Foundation Health Plan of Colorado |
65 |
PDF |
Accessible |
Kaiser Foundation Health Plan of Georgia, Inc. |
F8 |
PDF |
Accessible |
Kaiser Foundation Health Plan of Ohio |
64 |
PDF |
Accessible |
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. |
E3 |
PDF |
Accessible |
Kaiser Foundation Health Plan of the Northwest |
57 |
PDF |
Accessible |
Kaiser Foundation Health Plan, Inc., Northern California Region |
59 |
PDF |
Accessible |
Kaiser Foundation Health Plan, Inc., Southern California Region |
62 |
PDF |
Accessible |
Keystone Health Plan Central |
S4 |
PDF |
Accessible |
Keystone Health Plan East |
ED |
PDF |
Accessible |
KPS Health Plans |
VT |
PDF |
Accessible |
Lovelace Health Plan |
Q1 |
PDF |
Accessible |
M*Plan, Inc. |
IN |
PDF |
Accessible |
Mail Handlers Benefit Plan |
45 |
PDF |
Accessible |
M.D. IPA: The Quality Care Health Plan |
JP |
PDF |
Accessible |
M-Care |
EG |
PDF |
Accessible |
Mercy Health Plans/Premier Health Plans |
7M, HM |
PDF |
Accessible |
Michigan Health Maintenance Organization Plans,Inc |
KA |
PDF |
Accessible |
MVP Health Plan |
GA, M9, MX, VW |
PDF |
Accessible |
NALC Health Benefit Plan |
32 |
PDF |
Accessible |
National Rural Carriers Association |
38 |
PDF |
Accessible |
New West Health Plan |
NV |
PDF |
Accessible |
Optima Health Plan |
9R |
PDF |
Accessible |
OSF HealthPlans, Inc. |
9F |
PDF |
Accessible |
PacifiCare Asia Pacific |
JK |
PDF |
Accessible |
PacifiCare of Colorado, Inc. |
D6 |
PDF |
Accessible |
PacifiCare Health Plans |
2N, 7Z, A3, CY, GF, K9, WB |
PDF |
Accessible |
Panama Canal Area Benefit Plan |
43 |
PDF |
Accessible |
Paramount Health Care |
U2 |
PDF |
Accessible |
PersonalCare's HMO Health Plan |
GE |
PDF |
Accessible |
Physicians Health Plan of Northern Indiana |
DQ |
PDF |
Accessible |
Piedmont Community Healthcare (Virginia) |
2C |
PDF |
Accessible |
Postmasters Benefit Plan |
36 |
PDF |
Accessible |
Preferred Care |
GV |
PDF |
Accessible |
Preferred Plus of Kansas |
VA |
PDF |
Accessible |
Presbyterian Health Plan |
P2 |
PDF |
Accessible |
PrimeHealth of Alabama, Inc. |
AA |
PDF |
Accessible |
SAMBA Health Benefit Plan |
44 |
PDF |
Accessible |
Sioux Valley Health Plan |
AU |
PDF |
Accessible |
SummaCare Health Plan |
5W |
PDF |
Accessible |
SuperMed HMO |
5M |
PDF |
Accessible |
The Oath - A Health Plan for Alabama, Inc. |
DF |
PDF |
Accessible |
Total Health Care |
N2 |
PDF |
Accessible |
Total Health Choice |
4A |
PDF |
Accessible |
Triple - S, Inc. |
89 |
PDF |
Accessible |
UHP Healthcare |
C4 |
PDF |
Accessible |
Unicare Health Plan (formerly Rush Prudential) |
17 |
PDF |
Accessible |
Union Health Service |
76 |
PDF |
Accessible |
United Healthcare of Ohio, Inc. |
3U |
PDF |
Accessible |
Univera Healthcare |
KQ, Q8 |
PDF |
Accessible |
Universal Care |
6Q |
PDF |
Accessible |
UPMC Health Plan |
8W |
PDF |
Accessible |
U.S. Secret Service Employees Health Assoc. |
Y7 |
PDF |
Accessible |
Vantage Health Plan |
AQ, MV |
PDF |
Accessible |
Vista Healthplan |
3N |
PDF |
Accessible |
Vytra Health Plans |
J6 |
PDF |
Accessible |
Wellness Plan, The |
K3 |
PDF |
Accessible |
WinHealth Partners |
PV |
PDF |
Accessible |