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Information from your health plan about COVID-19 (coronavirus disease)

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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

    Download

  • 2021 Individual and Family Policy

    Provides specific coverage details for your policy

    Download

  • 2021 Select Customer Guide

    Brochure outlining our Select plan, including the service area, provider network and plan options. Helpful for Marketplace plan shopping

    Download

  • 2021 Select Member Handbook

    A quick-start guide for Select members to understand their health plan and find the information they need

    Download

  • 2021 SimplyOne Customer Guide

    Brochure outlining our SimplyOne plan, including the service area, provider network and plan options. Helpful for Marketplace plan shopping

    Download

  • 2021 SimplyOne Member Handbook

    A quick-start guide for SimplyOne members to understand their health plan and find the information they need

    Download

  • HIPAA Authorization to Use and Disclose Protected Health Information

    Use this form to designate individuals you choose to have access to your health information

    Download

  • Member Prescription Drug Reimbursement Request

    Complete this form to submit a prescription drug reimbursement claim

    Download

  • Póliza Individual y Familiar de 2021

    Proporciona detalles de cobertura específicos de su póliza

    Download

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.