Individual and family document library
We try to minimize paperwork. But sometimes you need a form or other information. And when you need it, you want it to be convenient. We have created a document library to give you easy access to the most requested documents.
If you’re a Security Health Plan member, simply log in to your My Security Health Plan account and view your specific plan documents, in the “Coverage and benefits” section.
2021 Individual and Family Health Insurance Application
Complete this form to apply for health coverage
2021 Individual and Family Policy
Provides specific coverage details for your policy
2021 Select Customer Guide
Brochure outlining our Select plan, including the service area, provider network and plan options. Helpful for Marketplace plan shopping
2021 Select Member Handbook
A quick-start guide for Select members to understand their health plan and find the information they need
2021 SimplyOne Customer Guide
Brochure outlining our SimplyOne plan, including the service area, provider network and plan options. Helpful for Marketplace plan shopping
2021 SimplyOne Member Handbook
A quick-start guide for SimplyOne members to understand their health plan and find the information they need
HIPAA Authorization to Use and Disclose Protected Health Information
Use this form to designate individuals you choose to have access to your health information
Member Prescription Drug Reimbursement Request
Complete this form to submit a prescription drug reimbursement claim
Póliza Individual y Familiar de 2021
Proporciona detalles de cobertura específicos de su póliza
Security Health Plan is a Qualified Health Plan (QHP) issuer through the Federally-facilitated Exchange. Pediatric dental services, as required under the Affordable Care Act, are not included in this policy. Stand-alone dental plans are available for purchase with the Marketplace. Please contact Security Health Plan or the Federally-facilitated Exchange if you are interested in purchasing pediatric dental or stand-alone dental coverage.
For our Qualified Health Plans, Security Health Plan does not use quality measures, member experience measures or cost-related measures to select practitioners or hospitals.