Point-of-service plans

We offer employers flexible plans to meet their employees' needs. 

Individual and family resources

These resources will come in handy as you start the enrollment process with your clients.



If your small group of 100 or fewer employees is ready to sign up for coverage, you’ve come to the right place. Here you'll find plans, rates, applications and brochures. We’re here to help make the enrollment process as convenient and seamless as possible. 

You are our specialty

Choose convenience, care and support.

Using CVS specialty™ allows our members the choice of receiving their specialty medications by mail or pick up at any of the over 100 CVS and Target® pharmacies in San Diego County.

Forms for Medicare members

Here are the forms you need to care for Medicare-eligible
members of Sharp Health Plan.

Choose a formulary based on how you obtained your healthcare coverage.

Choose high-quality, affordable coverage from Sharp Health Plan. San Diego’s own health insurance.

Early childhood education immunizations

At Sharp Health Plan, we believe in providing the best care possible for our community. We understand that the decision to immunize your child may be difficult due to confounding news reports. This is why we at Sharp Health Plan, in partnership with our community pediatricians, would like to provide you with information to help you feel comfortable with this important decision.
  
Parents make tough choices every day—immunizing against deadly or debilitating disease should not be one of them. 

Questions about health insurance and Covered California?

Sharp Health Plan is hosting free community meetings and personalized enrollment workshops.

From choosing the right plan to understanding the enrollment process, our Certified Enrollment Counselors will help you select the right plan and make enrolling as simple as possible.

To register for a personalized enrollment workshop or community information meeting click below. You can also call us at 1-800-827-4277 (1-800-82-SHARP).

Can’t make a meeting? Visit sharphealthplan.com/workshops to learn more about quality, affordable coverage from Sharp Health Plan.

Ready to enroll? Visit sharphealthplan.com/get-a-quote to receive a quote in 5 minutes or less

Mail-order prescription update

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Out-of-town coverage for children

If your dependent child is traveling for less than 90 consecutive days in the coming year, or is enrolling in college as full-time student, he or she may continue on your health insurance policy. In situations where your child is expected to be out of the service area, we want to be sure you know the options for accessing health care services.

Children must maintain their primary residence or work within Sharp Health Plan’s service area unless they are full-time students or in cases where coverage is provided under a medical support order. A child’s residence will no longer be considered a primary residence if: (a) the child moves out of the service area without intent to return or, (b) the child is absent from the residence for more than 90 consecutive days in any 12-month period and is not a full-time student.

TEST SYNC 6/18

Just testing the sync.

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Report incorrect provider information

Let us know if you find incorrect information in our provider directories so we can fix it. You can use the online form below, call us at 858.499.8300 or email us at shp.directory@sharp.com (For your protection, we don't recommend using email to send personal medical information.)

Welcome, City of San Diego retirees!

Whether you are eligible for Medicare or are an early retiree, you can find more information here to help you get the most out of your health care dollar and still keep the Sharp providers you know and trust.

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Your statement, simplified.

At Sharp Health Plan, we’re committed to making your health care experience simple.
We’ve created this quick guide to help you understand key points on your monthly statement.


How did you purchase your health plan? Choose the button for you..


Direct from Sharp Health Plan Through Covered California

Sharp Advantage disclaimer

Sharp Advantage is offered by Sharp Health Plan. Sharp Advantage is an HMO plan with a Medicare contract. Enrollment in Sharp Advantage depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change each year. The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B premium.


This information is available for free in other languages. Please call our Customer Care number at 1-855-820-2112 for additional information. (TTY users should call 711.) Hours are 8:00 a.m. to 6:00 p.m., Monday to Friday. Customer Care also has free language interpreter services available for non-English speakers. Please contact Sharp Advantage if you need information in another format.


Esta información puede obtenerse sin cargo en otros idiomas. Si desea más información, llame a nuestro servicio de atención a los miembros al 1-855-820-2112. (Los usuarios de TTY deben llamar al 711.) El horario es de 8:00 de la mañana a 6:00 de la tarde de lunes a viernes. Alguien que hable español le podrá ayudar. Este es un servicio gratuito. Por favor, póngase en contacto con Sharp Advantage si usted necesita información en otro forma.

Preparation is key

Browse through our checklists and resources to make sure you have what you need for your clients.

Marketing materials request form

Need marketing materials in bulk? Put in a request here.

Understanding IRS 1095 tax forms

Tax season is here and Sharp Health Plan wants to help in making this challenging time easier for you.

In your mailbox, you may have received or will soon receive an IRS 1095 tax form. This form verifies you had the minimum essential health coverage during 2016. Under the Affordable Care Act, you are required to verify your health care coverage when you file your federal tax return; this form fulfills that requirement. Although you are not required to submit your 1095 form to the IRS when you file your taxes, we encourage you to keep it as part of your tax records.  

We recommend you consult your tax adviser and refer to the IRS website for more information.

Broker contact us form

We appreciate your partnership with us and are here to support you in any way we can. Use the form below to send us a message, we’re here to help.

Member contact us form

Have questions? Fill out the form below and a Sharp Health Plan representative will contact you.

 

For your protection, we do not recommend the use of emails to convey medical information. If you have questions that would involve such information, please call your provider directly.

Public Policy Committee

Public Policy Committee

We want to hear from you. Join our committee to help us serve you better and improve member satisfaction overall.

LEARN MORE
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Get a small group quote

We've teamed up with Health Connect to offer small group quotes. You can also give us a call to get a quote at 858.499.8229 or email commercial.sales@sharp.com.

TAKE ME THERE
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Preventive care

You can make your health a priority and we’re here to help. To get started, visit our preventive care page that highlights some of the exams, vaccines and screenings that can help you and your loved ones stay healthy. 

TAKE ME THERE
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Make the most of our portal

Log in to SharpConnect and get the details and instruction you need to determine client eligibility, enrollment requirements and more.

DOWNLOAD SHARPCONNECT USER GUIDE FOR BROKERS
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Helpful tips for overseeing your group’s benefits

Find answers to questions on everything from enrollment to termination of coverage. As you get the hang of administering benefits, you’ll need the manual less and less, but for now, it should come in handy.

DOWNLOAD THE GROUP ADMINISTRATION MANUAL
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We're here to help

We invite you to a phone orientation with a personal healthcare assistant from Customer Care. They’re standing by ready to help. Schedule yours today or call us at 1.800.359.2002, 8 a.m. – 6 p.m., Monday to Friday.

SCHEDULE MY PHONE ORIENTATION
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Are you a Sharp Advantage Medicare plan member?

Your mail order pharmacy is Postal Prescription Services. Visit PPSRx.com to order your prescriptions online or call 1.800.552.6694.  

VISIT POSTAL PRESCRIPTION SERVICES
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Prevention matters for children

Right from the start, prevention goes a long way in helping your child grow up healthy, happy and strong. During the years your child is developing and changing the most, be sure they receive timely exams, vaccines and screenings at every stage.

DOWNLOAD THE CHECKLIST
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For every woman, at any stage of health

Getting care early is your best defense against serious illnesses like breast, cervical, and colon cancers. Discuss this checklist with your doctor so that you can develop a preventative care plan together that's right for you.

DOWNLOAD THE CHECKLIST
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Your gateway to the care you need

We’re here to make using your plan just as simple as enrolling. From helping you understand your benefits to finding the right doctor, we’re here for you. Find out how to get care under your plan.

SEE GET CARE
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Log in to your account to see plan coverage details

Maximize your membership by registering with our secure member portal SharpConnect. Here you can view your covered benefits and see your cost-sharing financial responsibilities, e.g., copays, coinsurance, deductible, maximum out of pocket, etc.

LOG IN OR SIGN UP
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Log in to your account to renew, change or cancel coverage

Open enrollment is around the corner, running from November 1, 2015 to January 31, 2016. During open enrollment, you can make a change to your plan by logging into your account or calling Customer Care at  1.800.359.2002If you need health coverage before January 1, 2016, you can still make a change if you or a loved one has had a qualifying event like getting married or having a baby in the past 60 days.

LOG IN
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Your health is important

Part of taking care of yourself means finding a pharmacy that works with your lifestyle and is there when you need it. Use our pharmacy search to browse all pharmacies covered by your insurance plan. You can see which locations are open 24 hours a day or offer up to 90-day prescription supplies.

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Log in to your SharpConnect account for accurate pricing based on your benefit plan.

The costs shown in the drug list search tool below are estimates only. 

LOG IN TO MY ACCOUNT
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Start the new year strong

Best Health is our free wellness and coaching program, available to all Sharp Health Plan members. Sign up and get a Personal Health Assessment that you can share with your doctor. Plus, you'll find helpful tools and resources to help you feel better and live better. 

LEARN MORE
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Request delivery online

You can register for mail order pharmacy services online on the Wellpartner website. Your doctor can fax your prescriptions directly to WellPartner at 1.866.624.5797.

REGISTER ONLINE

Sharp Advantage for Medicare-eligible employees

If you have employees over age 65, we offer Sharp Advantage, a Medicare plan that has no cost to your business. It provides cost savings for your Medicare-eligible employees and their spouses unlike typical small group plans, along with extra benefits like a free gym membership or chiropractic care. Businesses must have less than 20 total employees to qualify.

 

Call for details 858.499.8229

LEARN MORE
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Most-used resources at your fingertips

From information on healthcare reform and renewal to language assistance and group administration manuals, here are the resources you’ll need to help your employees make the most of their benefit plan.

GO TO EMPLOYER RESOURCES
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Why choose Sharp Health Plan?

We’re the only commercial not-for-profit health insurance provider in San Diego. We’re proud to connect over 3,000 local companies and their employees to award-winning care. Meet the heart behind the health care.

EXPLORE NOW
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Health Care Reform and your health

By law, your coverage can’t be dropped or denied if you have a pre-existing medical condition or if you get sick. Because of the Health Care Reform, you can get health insurance regardless of the current state of your health, and you can’t be charged more because of your existing health or medical condition. When you get care for your pre-existing condition or a new health condition, you’ll still need to pay any deductibles, copayments, and coinsurance your plan requires.

LEARN MORE

2017 Large group information

Coverage for large groups

101 or more employees

Effective January 1, 2015

Large group HMO brochure
Large group POS overview

 

 

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Helpful tips for overseeing your group’s benefits

Find answers to questions on everything from enrollment to termination of coverage. As you get the hang of administering benefits, you’ll need the manual less and less, but for now, it should come in handy.

DOWNLOAD THE GROUP ADMINISTRATION MANUAL

Large group master application

Thanks for choosing us. We’re glad you’re ready to get your group covered with us. First, we’ll need some information about your company, employee eligibility, and your plan preferences. Then, we can start getting your group the care they need.

DOWNLOAD APPLICATION ➜

Enrolling employees

When employees are ready to start getting coverage, they’ll need to fill out this form. This helps us organize and keep track of their benefits so that they can maximize their coverage and care.

DOWNLOAD APPLICATION ➜

Enrolling employees (Spanish)

Here's the employee enrollment form for our Spanish-speaking members.

DOWNLOAD APPLICATION ➜

Need marketing materials for your next client visit? We're here to help.

Large group benefit comparison brochure

Here’s a simple guide to choosing the right plan for your business. Find out what makes us unique, see explanations of benefits and more.

DOWNLOAD GUIDE ➜

Point-of-service plans

Members with POS plans can choose the providers and level of coverage that work best for them. If they choose an out-of-network provider, their out-of-pocket costs will be higher. Members don’t need a referral from their primary care physician, but some services require pre-certification.

LEARN MORE ➜

Point of Service (POS) plan overview

Guide your customers through Sharp Health Plan's POS benefit with this helpful brochure.

DOWNLOAD FLYER ➜

Assist America

Medical issues can happen when we're working, traveling or studying outside of the San Diego area. Our members always have coverage through Assist America® no matter where life takes them. Share the brochure.  

DOWNLOAD BROCHURE ➜

2017 Member resource guide

Help your clients get the most out of their benefits with helpful information on how to use their plans.

DOWNLOAD GUIDE ➜
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Make the most of our portal

Log in to SharpConnect and get the details and instruction you need to determine client eligibility, enrollment requirements and more.

DOWNLOAD SHARPCONNECT USER GUIDE FOR BROKERS

Page Last Updated: 12/18/2016

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