Employer and Producer Information
Annual Notices & Disclosures
Broker of Record Change Form
BSwift Online Enrollment Access
CalCPA Society Membership (Enroll / Renew)
COBRA Administration
DE9 Insurance Code Notice
Medicare Secondary Payer Exception Form
Subscription and Producer Agreements
- Producer Agreements
- Subscription Agreement
Enrollment / Waiver Form
Enrollment and Change Form (All employees must complete the form. Employees waiving coverage must complete the waiver section.)
Benefits and Formularies
2026 Benefits
2026 Rx Formularies
2025 Benefits
- Benefit Changes
- Creditable Coverage
- Plan Comparisons
2025 Rx Formularies
Summary of Benefits and Coverage (SBC) and Plan Documents
To view Summary of Benefits and Coverage (SBCs) and Plan Documents, click on the buttons below.
Member Forms & Flyers
CalCPA Health
Dental: Delta Forms
Dental: Delta Flyers
HSA Banking: HealthEquity Flyers
Life/LTD: Lincoln Forms
Life/LTD: Lincoln Flyers
Medical: Anthem/Coupe Health Forms
Medical: Anthem/Coupe Health Flyers
- Autism Program
- Global Program
- Building Healthy Families
- ConditionCare
- Estimate Your Cost
- Flu Shot
- LiveHealth Online
- HMO Guest Membership
- How To Find A Doctor
- Mobile App Sydney
- NurseLine
- Preventive Guide Brochure
- Special Offers
- Wellness Tools
- Coupe Tiering
- Understanding Select PPO
- Where To Go For Care
Prescription Rx Forms
- ESI Rx for non-HMO members
- Carelon Rx for HMO members
Prescription Rx Flyers
- ESI Rx for non-HMO members
- EncircleRx Weight Loss GLP-1
- ESI How to Locate a Pharmacy
- ESI How to Register
- Extended Payment Program Flyer
- Carelon Rx
- Good Rx (Price Assurance)