Looking for information about you Flexible Choice plan? View, download, or print commonly used forms, FAQs, reference guides, and other documents here.
Links to important forms and documents.
Provider Options by Location:
Kaiser Permanente States: The PHCS and Multiplan Networks provides access to care in the Kaiser Permanente states of CA, CO, GA, HI, MD, OR, VA, WA, and DC.
Non-Kaiser Permanente States: The CignaPPONetwork* only provides access to care in non-Kaiser Permanente states
*Disclaimer: The Cigna PPO Network refers to providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
Quick Documents
Flexible Choice and Out-of-Area PPO Formulary
Precertification Request Form
Medical Claim Form
Pharmacy Claim Form
Nominate a PHCS and/or MultiPlan Provider
Member Care Transition Form
Flexible Choice Information for Physicians
Prepare for Your non-KP Appointment Flyer
Your Rights and Protection Against Surprise Medical Bills – Maryland
Your Rights and Protection Against Surprise Medical Bills – District of Columbia
Your Rights and Protection Against Surprise Medical Bills – Virginia
Flexible Choice Reference Guide
Flexible Choice Overview Flyer
Deductible Flex Choice Reference Guide
Deductible Flex Choice Flyer
HSA Qualified Flex Choice Reference Guide
HSA Qualified Flyer