Enroll and get quotes with Oscar - No extra charge for broker support
Enroll and get quotes with Oscar – No extra charge for broker support

Oscar Insurance Forms and Notices

Here’s where you can find Oscar’s policies, plan benefits, coverage information, certificates, appeals, drug formulary, clinical guidelines, HIPAA authorization forms, member rights, privacy practices, and many other important notices. Need help finding something? Contact us at 1-855-672-2788

On Exchange Plan Contract

Subscriber Agreement and Combined Evidence of Coverage and Disclosure Form

Subscriber Agreement and Combined Evidence of Coverage and Disclosure Form HDHP

Off Exchange Plan Contract

Standard Off Exchange Plan Contract

Standard Off Exchange HDHP Plan Contract

Non-Standard Off Exchange Plan Contract

Non-Standard Off Exchange HDHP Plan Contract

On-Exchange Summaries of Benefits and Coverage

Oscar $0 Cost Share EPO AI-AN

Oscar Minimum Coverage EPO

Oscar Bronze 60 HDHP EPO

Oscar Bronze 60 HDHP EPO AI-AN

Oscar Bronze 60 EPO

Oscar Bronze 60 EPO AI-AN

Oscar Silver 70 EPO

Oscar Silver 70 EPO AI-AN

Oscar Silver 73 EPO

Oscar Silver 87 EPO

Oscar Silver 94 EPO

Oscar Gold 80 EPO

Oscar Gold 80 EPO AI-AN

Oscar Platinum 90 EPO

Oscar Platinum 90 EPO AI-AN

Off-Exchange Summaries of Benefits and Coverage

Oscar Minimum Coverage EPO

Oscar Bronze 60 HDHP EPO

Oscar Bronze 60 EPO

Oscar Silver 70 EPO Off Exchange

Oscar Gold 80 EPO

Oscar Platinum 90 EPO

Oscar Simple Bronze EPO

Oscar Saver Silver HSA HDHP EPO

Oscar Simple Silver EPO

Oscar Simple Gold EPO

On Exchange Schedules of Benefits

Oscar $0 Cost Share EPO AI-AN

Oscar Minimum Coverage EPO

Oscar Bronze 60 HDHP EPO

Oscar Bronze 60 HDHP EPO AI-AN

Oscar Bronze 60 EPO

Oscar Bronze 60 EPO AI-AN

Oscar Silver 70 EPO

Oscar Silver 70 EPO AI-AN

Oscar Silver 73 EPO

Oscar Silver 87 EPO

Oscar Silver 94 EPO

Oscar Gold 80 EPO

Oscar Gold 80 EPO AI-AN

Oscar Platinum 90 EPO

Oscar Platinum 90 EPO AI-AN

Off Exchange Schedules of Benefits

Oscar Minimum Coverage EPO

Oscar Bronze 60 HDHP EPO

Oscar Bronze 60 EPO

Oscar Silver 70 EPO Off Exchange

Oscar Saver Silver HSA HDHP EPO

Oscar Gold 80 EPO

Oscar Platinum 90 EPO

Oscar Simple Bronze EPO

Oscar Simple Silver EPO

Oscar Simple Gold EPO

Appeals & Grievances

Drug and Formulary Information

Enroll and get quotes with Oscar - No extra charge for broker support
Enroll and get quotes with Oscar – No extra charge for broker support

2018 CA Forms

On-Exchange Summaries of Benefits and Coverage

Bronze 60 EPO   English PDF

Bronze 60 HDHP EPO  English PDF

Silver 70 EPO  English PDF

Silver 73 EPO  English PDF

Silver 87 EPO  English PDF

Silver 94 EPO  English PDF

Gold 80 EPO  English PDF

Platinum 90 EPO  English PDF

Minimum Coverage EPO  English PDF

AI-AN EPO  English PDF

Off-Exchange Summaries of Benefits and Coverage

Bronze 60 EPO  English PDF

 Bronze 60 HDHP EPO  English PDF

Silver 70 EPO  English PDF

Gold 80 EPO  English PDF

Platinum 90 EPO   English PDF

Minimum Coverage EPO  English PDF

Simple Bronze  English PDF

Simple Silver  English PDF

Simple Gold  English PDF

Saver Silver  English PDF

Saver Gold   English PDF