pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_a_vbid_indicator	pbp_a_snp_pct	pbp_a_contract_partd_flag	pbp_a_platino_flag	pbp_a_last_data_entry_date	pbpver	pbp_a_ready_for_upload_date_tm	pbp_a_BPT_MA_date_time	pbp_a_BPT_PD_date_time	pbp_a_BPT_MSA_date_time	pbp_a_BPT_ESRD_date_time	pbp_a_upload_date_time	pbp_a_org_name	pbp_a_org_marketing_name	pbp_a_org_website	pbp_a_plan_name	pbp_a_org_type	pbp_a_plan_type	pbp_a_network_flag	pbp_a_ben_cov	pbp_a_hospice_care_yn	pbp_a_service_area	pbp_a_contract_number	pbp_a_plan_identifier	pbp_a_segment_id	pbp_a_contract_period	pbp_a_plan_geog_name	pbp_a_segment_name	pbp_a_eghp_yn	pbp_a_est_memb	pbp_a_continue_yn	pbp_a_continue_costshare_yn	pbp_a_platino_yn	pbp_a_special_need_flag	pbp_a_special_need_plan_type	pbp_a_snp_institutional_type	pbp_a_dsnp_zerodollar	pbp_a_snp_cond	pbp_a_snp_state_cvg_yn	pbp_a_pharmacy_website	pbp_a_formulary_web_addr	pbp_a_phys_web_addr	pbp_a_curmbr_phone	pbp_a_curmbr_phone_ext	pbp_a_curmbr_loc_phone	pbp_a_curmbr_loc_phone_ext	pbp_a_prombr_phone	pbp_a_prombr_phone_ext	pbp_a_prombr_loc_phone	pbp_a_prombr_loc_phone_ext	pbp_a_pd_curmbr_phone	pbp_a_pd_curmbr_phone_ext	pbp_a_pd_curmbr_loc_phone	pbp_a_pd_curmbr_loc_phone_ext	pbp_a_pd_prombr_phone	pbp_a_pd_prombr_phone_ext	pbp_a_pd_prombr_loc_phone	pbp_a_pd_prombr_loc_phone_ext	pbp_a_ttytdd_curmbr_phone	pbp_a_ttytdd_curmbr_phone_ext	pbp_a_ttytdd_cur_loc_phone	pbp_a_ttytdd_cur_loc_phone_ext	pbp_a_ttytdd_prombr_phone	pbp_a_ttytdd_prombr_phone_ext	pbp_a_ttytdd_pro_loc_phone	pbp_a_ttytdd_pro_loc_phone_ext	pbp_a_pd_ttytdd_curmbr_phone	pbp_a_pd_ttytdd_curmbr_phn_ext	pbp_a_pd_ttytdd_cur_loc_phone	pbp_a_pd_ttytdd_cur_loc_phn_ex	pbp_a_pd_ttytdd_prombr_phone	pbp_a_pd_ttytdd_prombr_phn_ext	pbp_a_pd_ttytdd_pro_loc_phone	pbp_a_pd_ttytdd_pro_loc_phn_ex	pbp_a_ffs_bid_b_yn	pbp_a_ffs_bid_b_auth_yn	pbp_a_ffs_bid_b_auth_cats	pbp_a_ffs_bid_b_ref_yn	pbp_a_ffs_bid_b_ref_cats	pbp_a_ffs_bid_c_yn	pbp_a_ffs_bid_c_auth_yn	pbp_a_ffs_bid_c_auth_cats	pbp_a_ffs_bid_c_ref_yn	pbp_a_ffs_bid_c_ref_cats	pbp_a_ffs_bid_d_yn	pbp_a_tier_yn	pbp_a_tier_bendesc_bens	pbp_a_tier_mc_bendesc_cats	pbp_a_tier_nmc_bendesc_cats
E0654	801	0		30	13	E0654_801_0	1			1		05/23/2017	2018.03	05/23/2017 12:21:17 PM Eastern Daylight Time					05/23/2017 12:46:50 PM Eastern Daylight Time	IBT VOLUNTARY EMPLOYEE BENEFITS TRUST	TEAMStar Medicare Part D Prescription Drug Program	www.teamstarpartd.com	IBT Voluntary Employee Benefits Trust (Employer PDP)	13	30					E0654	801	0	2018	National		1					2						www.Optum.com	www.teamstarpartd.com										(866)524-4173		(866)524-4173		(866)524-4173		(866)524-4173										(866)524-4174		(866)524-4174		(866)524-4174		(866)524-4174																
E3014	801	0		30	13	E3014_801_0	1			1		06/02/2017	2018.03	06/02/2017 11:36:56 AM Eastern Daylight Time					06/02/2017 11:39:39 AM Eastern Daylight Time	PSERS HOP PROGRAM	Pennsylvania Public School Employees Retirement Sy	www.hopbenefits.com	PSERS Health Options Program (Employer PDP)	13	30					E3014	801	0	2018	National		1					2						www.hopbenefits.com	www.hopbenefits.com										(888)239-1301		(888)239-1301		(800)773-7725		(800)773-7725										(800)498-5428		(800)498-5428		(800)498-5428		(800)498-5428																
E4744	801	0		30	13	E4744_801_0	1			1		06/01/2017	2018.03	06/01/2017 09:26:40 AM Mountain Daylight Time					06/01/2017 10:17:58 AM Mountain Daylight Time	MODOT/MSHP MEDICAL AND LIFE INSURANCE PLAN	MISSOURI DEPARTMENT OF TRANSPORTATION	http://www.modot.org/newsandinfo/GeneralInfo.htm	Missouri Department of Transportatio/ Highway Patr (Employer PDP)	13	30					E4744	801	0	2018	National		1					2						https://mp.medimpact.com/pharmacyportal/public/Login.jsp	http://www.modot.org/newsandinfo/GeneralInfo/documents/Formulary.htm										(844)513-6006		(844)513-6006		(877)863-9406		(573)751-2551										(711)-		(711)-		(711)-		(711)-																
H0022	001	0	1	48	05	H0022_001_0	3			1		08/24/2017	2018.03	08/24/2017 04:35:26 PM Eastern Daylight Time					08/25/2017 11:07:36 AM Pacific Daylight Time	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Buckeye Health Plan - MyCare Ohio	http://mmp.buckeyehealthplan.com	Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)	05	48		1			H0022	001	0	2018	Cleveland, Dayton, Toledo and surrounding counties		2	10156	2			2						http://mmp.buckeyehealthplan.com/home/provider-directory/	http://mmp.buckeyehealthplan.com/home/prescription-drug-part-d-formulary-2/	http://mmp.buckeyehealthplan.com/home/provider-directory/	(866)549-8289		(866)549-8289		(866)549-8289		(866)549-8289		(866)549-8289		(866)549-8289		(866)549-8289		(866)549-8289		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0028	004	0	1	01	01	H0028_004_0	4			1		08/02/2017	2018.03	08/02/2017 03:17:20 PM Eastern Daylight Time	08/05/2017 10:37:34 AM Eastern Daylight Time	08/04/2017 09:51:05 AM Eastern Daylight Time			08/06/2017 08:53:33 AM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana-medicare.com	Humana Gold Plus H0028-004 (HMO)	01	01		1			H0028	004	0	2018	Honolulu, Kauai and Maui counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0028	007	0	1	01	01	H0028_007_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 09:58:20 AM Eastern Daylight Time	08/04/2017 04:36:26 PM Eastern Daylight Time	08/04/2017 09:51:06 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H0028-007 (HMO SNP)	01	01		1			H0028	007	0	2018	Douglas County		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0028	008	1	1	01	01	H0028_008_1	2			1		08/02/2017	2018.03	08/02/2017 01:41:46 PM Eastern Daylight Time	08/04/2017 04:35:33 PM Eastern Daylight Time	08/04/2017 09:51:06 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Gold Plus H0028-008 (HMO)	01	01		1			H0028	008	1	2018	Heartland	Heartland	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0028	008	2	1	01	01	H0028_008_2	2			1		05/27/2017	2018.03	05/27/2017 03:25:11 PM Eastern Daylight Time	08/04/2017 04:36:00 PM Eastern Daylight Time	08/04/2017 09:51:07 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Gold Plus H0028-008 (HMO)	01	01		1			H0028	008	2	2018	Heartland	Cedar Rapids	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0028	009	0	1	01	01	H0028_009_0	2			1		05/27/2017	2018.03	05/27/2017 03:25:45 PM Eastern Daylight Time	08/04/2017 04:36:52 PM Eastern Daylight Time	08/04/2017 09:51:07 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Value Plus H0028-009 (HMO)	01	01		1			H0028	009	0	2018	Select Counties in Iowa, and South Dakota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0028	801	0	1	01	01	H0028_801_0	4			1		06/13/2017	2018.03	06/13/2017 10:09:16 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H0028	801	0	2018	Select Counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0028	802	0	1	01	01	H0028_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:09:34 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	CHA HMO, INC.	CHA HMO, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H0028	802	0	2018	Select Counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0029	001	0	1	01	01	H0029_001_0	3			1		08/02/2017	2018.03	08/02/2017 04:44:21 PM Pacific Daylight Time	08/04/2017 04:49:49 PM Pacific Daylight Time	08/04/2017 04:49:26 PM Pacific Daylight Time			08/04/2017 07:27:31 PM Pacific Daylight Time	COORDINATED CARE OF WASHINGTON, INC.	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H0029	001	0	2018	Pierce		2	1000	2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888	888	(888)888-8888		(888)888-8888	888	(888)888-8888		(888)888-8888	888	(888)888-8888		(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	(888)888-8888	888	2					2					2	2			
H0029	004	0	1	01	01	H0029_004_0	4			1		08/02/2017	2018.03	08/02/2017 04:32:06 PM Pacific Daylight Time	08/04/2017 04:49:49 PM Pacific Daylight Time	08/04/2017 04:49:26 PM Pacific Daylight Time			08/04/2017 07:27:31 PM Pacific Daylight Time	COORDINATED CARE OF WASHINGTON, INC.	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H0029	004	0	2018	Spokane		2		2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0029	006	0	1	01	01	H0029_006_0	2			1		06/29/2017	2018.03	06/29/2017 10:20:08 AM Pacific Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/06/2017 09:35:23 AM Pacific Daylight Time	COORDINATED CARE OF WASHINGTON, INC.	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H0029	006	0	2018	Spokane		2		2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0062	001	0	1	01	01	H0062_001_0	4			1		08/02/2017	2018.03	08/02/2017 01:10:29 PM Pacific Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Allwell	https://advantage.superiorhealthplan.com	Allwell Medicare (HMO)	01	01		1			H0062	001	0	2018	Bexar County		2		2			2						https://advantage.superiorhealthplan.com/findadoctor	https://advantage.superiorhealthplan.com/partdformulary	https://advantage.superiorhealthplan.com/findadoctor	(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0062	002	0	1	01	01	H0062_002_0	3			1		08/02/2017	2018.03	08/02/2017 01:11:01 PM Pacific Daylight Time	08/04/2017 04:35:07 PM Pacific Daylight Time	08/04/2017 04:35:30 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Allwell	https://advantage.superiorhealthplan.com	Allwell Medicare (HMO)	01	01		1			H0062	002	0	2018	Dallas, Collin, Denton, Smith and Tarrant Counties		2		2			2						https://advantage.superiorhealthplan.com/findadoctor	https://advantage.superiorhealthplan.com/partdformulary	https://advantage.superiorhealthplan.com/findadoctor	(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0062	003	0	1	01	01	H0062_003_0	4			1		08/02/2017	2018.03	08/02/2017 01:14:37 PM Pacific Daylight Time	08/04/2017 04:34:58 PM Pacific Daylight Time	08/04/2017 04:35:24 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Allwell	https://advantage.superiorhealthplan.com	Allwell Medicare (HMO)	01	01		1			H0062	003	0	2018	Hidalgo and Cameron Counties		2		2			2						https://advantage.superiorhealthplan.com/findadoctor	https://advantage.superiorhealthplan.com/partdformulary	https://advantage.superiorhealthplan.com/findadoctor	(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(844)796-6811		(844)796-6811		(877)826-5520		(877)826-5520		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0062	004	0	1	01	01	H0062_004_0	4			1		08/04/2017	2018.03	08/04/2017 12:28:18 PM Pacific Daylight Time	08/04/2017 04:34:58 PM Pacific Daylight Time	08/04/2017 04:35:24 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Allwell	www.allwell.superiorhealthplan.com	Allwell Medicare (HMO)	01	01		1			H0062	004	0	2018	El Paso County		2		2			2						http://advantage.superiorhealthplan.com/home/find-a-provider-or-pharmacy/	http://advantage.superiorhealthplan.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0062	005	0	1	01	01	H0062_005_0	4			1		08/02/2017	2018.03	08/02/2017 01:17:05 PM Pacific Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:24 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	Allwell	www.allwell.superiorhealthplan.com	Allwell Medicare (HMO)	01	01		1			H0062	005	0	2018	Nueces County		2		2			2						http://advantage.superiorhealthplan.com/home/find-a-provider-or-pharmacy/	http://advantage.superiorhealthplan.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0088	001	0	1	04	01	H0088_001_0	4			1		08/04/2017	2018.03	08/04/2017 10:28:07 AM Eastern Daylight Time	08/04/2017 02:38:11 PM Eastern Daylight Time	07/31/2017 06:44:19 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H0088	001	0	2018	Select Counties in NY		2	1878	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fap_search	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						1	01	3-1;3-2;7a;7c;7d;7e1;7e2;7f;7g;7h1;7h2;7i;8a1;8a2;8b1;8b3;9a;9b;9c;9d;16b;17a;18a;	
H0104	012	0	1	04	01	H0104_012_0	6			1		08/07/2017	2018.03	08/07/2017 12:17:34 PM Central Daylight Time	08/04/2017 10:01:03 AM Central Daylight Time	08/04/2017 10:01:03 AM Central Daylight Time			08/07/2017 12:27:11 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	012	0	2018	Alabama		2	28574	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0104	014	0	1	04	01	H0104_014_0	7			1		08/07/2017	2018.03	08/07/2017 12:17:22 PM Central Daylight Time	08/04/2017 10:01:04 AM Central Daylight Time	08/04/2017 10:01:04 AM Central Daylight Time			08/07/2017 12:27:11 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	014	0	2018	Birmingham/Mobile		2	27939	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0104	015	0	1	04	01	H0104_015_0	4			1		08/04/2017	2018.03	08/04/2017 01:40:07 PM Central Daylight Time	08/04/2017 01:32:42 PM Central Daylight Time	08/04/2017 01:32:42 PM Central Daylight Time			08/04/2017 01:42:57 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	015	0	2018	Alabama		2	8795	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0104	801	0	1	04	01	H0104_801_0	2			1		05/15/2017	2018.03	05/15/2017 10:21:10 AM Central Daylight Time					06/02/2017 01:39:15 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 801 (PPO)	01	04		1			H0104	801	0	2018	State of Alabama		1	0	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0104	802	0	1	04	01	H0104_802_0	2			1		06/14/2017	2018.03	06/14/2017 01:51:26 PM Central Daylight Time					06/14/2017 01:51:39 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 802 (PPO)	01	04		1			H0104	802	0	2018	State of Alabama		1	264000	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0104	804	0	1	04	01	H0104_804_0	2			1		05/15/2017	2018.03	05/15/2017 10:31:52 AM Central Daylight Time					06/02/2017 01:39:15 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Advantage (PPO)	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 804 (PPO)	01	04		1			H0104	804	0	2018	State of Alabama		1	0	2			2						www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com/sales/plans/blueadvantage/tools.html	www.bcbsalmedicare.com	(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(888)234-8266		(888)234-8266		(888)873-4707		(888)873-4707		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0105	001	0	1	20	08	H0105_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:55:37 PM Eastern Daylight Time		05/24/2017 01:49:55 PM Eastern Daylight Time			05/24/2017 01:58:14 PM Eastern Daylight Time	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	http://www.theoakspace.com	The Methodist Oaks d.b.a. The Oaks PACE (PACE)	08	20		1			H0105	001	0	2018	Rural South Carolina		2		2			2						http://www.theoakspace.com	www.groveparkpharmacy.com	http://www.theoakspace.com									(855)268-5300		(803)268-5300		(803)268-5300		(803)268-5300										(855)268-5300		(803)535-1561		(803)268-5300		(803)535-1561																
H0105	002	0	1	20	08	H0105_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:56:14 PM Eastern Daylight Time		05/24/2017 01:49:37 PM Eastern Daylight Time			05/24/2017 01:58:14 PM Eastern Daylight Time	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	http://www.theoakspace.com	The Methodist Oaks d.b.a. The Oaks PACE (PACE)	08	20		1			H0105	002	0	2018	Rural South Carolina		2		2			2						http://www.theoakspace.com	www.groveparkpharmacy.com	http://www.theoakspace.com									(855)268-5300		(803)268-5300		(803)268-5300		(803)268-5300										(855)268-5300		(803)535-1561		(803)268-5300		(803)535-1561																
H0107	003	0	1	04	01	H0107_003_0	7			1		08/04/2017	2018.03	08/04/2017 01:52:19 PM Central Daylight Time	08/04/2017 03:39:40 PM Central Daylight Time	08/01/2017 03:44:06 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of Montana	www.getbluemt.com/mapd	Blue Cross Medicare Advantage Classic (PPO)	01	04		1			H0107	003	0	2018	Montana		2	77865	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0107	004	0	1	04	01	H0107_004_0	7			1		08/04/2017	2018.03	08/04/2017 01:53:21 PM Central Daylight Time	08/07/2017 11:23:11 AM Central Daylight Time	08/01/2017 03:44:37 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of Montana	www.getbluemt.com/mapd	Blue Cross Medicare Advantage Optimum (PPO)	01	04		1			H0107	004	0	2018	Montana		2	51981	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0107	801	0	1	04	01	H0107_801_0	1			1		05/23/2017	2018.03	05/23/2017 11:04:38 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of Montana	www.getbluemt.com/mapd	Blue Cross Medicare Advantage Employer Ideal (PPO)	01	04		1			H0107	801	0	2018	Montana		1	2875	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H0107	802	0	1	04	01	H0107_802_0	2			1		05/30/2017	2018.03	05/30/2017 12:45:52 PM Mountain Daylight Time					05/30/2017 12:46:53 PM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of Montana	www.getbluemt.com/mapd	Blue Cross Medicare Advantage Employer Expanded (PPO)	01	04		1			H0107	802	0	2018	Montana		1	1	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H0107	803	0	1	04	01	H0107_803_0	2			1		05/30/2017	2018.03	05/30/2017 12:46:01 PM Mountain Daylight Time					05/30/2017 12:46:53 PM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of Montana	www.getbluemt.com/mapd	Blue Cross Medicare Advantage (PPO)	01	04		1			H0107	803	0	2018	State of Montana		1	1	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H0111	001	0	1	04	01	H0111_001_0	4			1		08/04/2017	2018.03	08/04/2017 10:41:35 AM Eastern Daylight Time	08/04/2017 02:40:21 PM Eastern Daylight Time	07/31/2017 06:44:43 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H0111	001	0	2018	Selected GA Counties		2	40024	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H0111	002	0	1	04	01	H0111_002_0	4			1		08/04/2017	2018.03	08/04/2017 10:46:05 AM Eastern Daylight Time	08/03/2017 03:06:35 PM Eastern Daylight Time	07/31/2017 06:45:05 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Prime (PPO)	01	04		1			H0111	002	0	2018	Selected GA Counties		2	5638	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H0112	001	0	1	20	08	H0112_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:20:44 PM Eastern Daylight Time		05/24/2017 01:30:38 PM Eastern Daylight Time			05/24/2017 01:37:19 PM Eastern Daylight Time	MORSE LIFE HOME CARE, INC.	Palm Beach PACE	www.MorseLife.org	Palm Beach PACE (PACE)	08	20		1			H0112	001	0	2018	Palm Beach County (partial)		2		2			2						MorseLife.org	N/A										(855)572-7223		(561)687-5745		(855)572-7223		(561)687-5745										(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771																
H0112	002	0	1	20	08	H0112_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:21:19 PM Eastern Daylight Time		05/24/2017 01:30:56 PM Eastern Daylight Time			05/24/2017 01:37:19 PM Eastern Daylight Time	MORSE LIFE HOME CARE, INC.	Palm Beach PACE	www.MorseLife.org	Palm Beach PACE (PACE)	08	20		1			H0112	002	0	2018	Palm Beach County (partial)		2		2			2						MorseLife.org	N/A										(855)572-7223		(561)687-5745		(855)572-7223		(561)687-5745										(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771																
H0137	001	0	1	48	05	H0137_001_0	4			1		08/10/2017	2018.03	08/10/2017 02:11:28 PM Eastern Daylight Time					08/10/2017 02:12:00 PM Eastern Daylight Time	COMMONWEALTH CARE ALLIANCE, INC.	Commonwealth Care Alliance, Inc.	www.commonwealthonecare.org	Commonwealth Care Alliance (Medicare-Medicaid Plan)	05	48		1			H0137	001	0	2018	ESS, FRA, HMD, HMP, MID, NOR, PLY, SUF, WOR.		2	219986	2			2						www.commonwealthonecare.org/pharmacy-program/overview	www.commonwealthonecare.org/pharmacy-program/formulary	www.commonwealthcare.org	(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0148	001	0	1	48	05	H0148_001_0	6			1		09/18/2017	2018.03	09/18/2017 12:36:54 PM Pacific Daylight Time					09/18/2017 12:37:19 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1st.com/ca/calmediconnect	Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H0148	001	0	2018	Care1st Health Plan San Diego County		2	2500	2			2						www.care1st.com/ca/	www.care1st.com/ca/	www.care1st.com/ca/calmediconnect	(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0148	002	0	1	48	05	H0148_002_0	6			1		09/18/2017	2018.03	09/18/2017 12:29:51 PM Pacific Daylight Time					09/18/2017 12:37:19 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1st.com/ca/calmediconnect	Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H0148	002	0	2018	Care1st Health Plan Los Angeles County		2	5000	2			2						www.care1st.com/ca/	www.care1st.com/ca/	www.care1st.com/ca/calmediconnect	(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(855)905-3825		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0150	007	0	1	01	01	H0150_007_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:12:14 PM Central Daylight Time	08/03/2017 10:25:10 AM Central Daylight Time	08/01/2017 01:58:28 PM Central Daylight Time			08/04/2017 03:17:49 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H0150	007	0	2018	Select Alabama Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0150	012	0	1	01	01	H0150_012_0	3			1		05/22/2017	2018.03	05/22/2017 04:08:56 PM Central Daylight Time	05/26/2017 02:25:56 PM Central Daylight Time				06/01/2017 04:31:52 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H0150	012	0	2018	Select Alabama Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0150	024	1	1	01	01	H0150_024_1	4			1		08/02/2017	2018.03	08/02/2017 12:53:19 PM Central Daylight Time	08/03/2017 10:25:31 AM Central Daylight Time	08/01/2017 01:58:48 PM Central Daylight Time			08/04/2017 03:17:49 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0150	024	1	2018	Select Alabama Counties	Alabama Preferred	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0150	024	2	1	01	01	H0150_024_2	4			1		08/04/2017	2018.03	08/04/2017 11:44:58 AM Central Daylight Time	08/03/2017 10:25:53 AM Central Daylight Time	08/01/2017 01:59:07 PM Central Daylight Time			08/04/2017 03:17:49 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0150	024	2	2018	Select Alabama Counties	Alabama Preferred Select Counties	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0150	804	0	1	01	01	H0150_804_0	3			1		05/22/2017	2018.03	05/22/2017 08:30:13 PM Central Daylight Time					06/01/2017 04:31:52 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H0150	804	0	2018	Alabama		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H0154	008	0	1	01	01	H0154_008_0	9			1		06/30/2017	2018.03	06/30/2017 03:28:53 PM Central Daylight Time	06/04/2017 08:34:22 PM Central Daylight Time				06/30/2017 04:17:10 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Select (HMO)	01	01		1			H0154	008	0	2018	Northwest Alabama, Central Alabama and Mobile Area		2	7320	2			2						http://www.vivamedicaremember.com/Download.aspx?ID=992&Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=1326&Type=doc	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0154	011	0	1	01	01	H0154_011_0	10			1		08/03/2017	2018.03	08/03/2017 03:31:45 PM Central Daylight Time	08/05/2017 02:22:28 PM Central Daylight Time	08/05/2017 02:22:28 PM Central Daylight Time			08/05/2017 02:25:17 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Premier (HMO)	01	01		1			H0154	011	0	2018	Northwest Alabama, Central Alabama and Mobile Area		2	35196	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0154	012	0	1	01	01	H0154_012_0	10		1	1	2	08/03/2017	2018.03	08/03/2017 03:33:19 PM Central Daylight Time	08/05/2017 02:22:29 PM Central Daylight Time	08/05/2017 02:22:29 PM Central Daylight Time			08/05/2017 02:25:17 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Extra Value (HMO SNP)	01	01		1			H0154	012	0	2018	Northwest Alabama, Central Alabama and Mobile Area		2	220785	2			1	3		2		2	www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0154	014	0	1	01	01	H0154_014_0	11			1		08/03/2017	2018.03	08/03/2017 03:38:09 PM Central Daylight Time	08/05/2017 02:22:29 PM Central Daylight Time	08/05/2017 02:22:43 PM Central Daylight Time			08/05/2017 02:25:17 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Me (HMO)	01	01		1			H0154	014	0	2018	Central Alabama		2	55206	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0154	015	1	1	01	01	H0154_015_1	11			1		08/04/2017	2018.03	08/04/2017 10:47:02 AM Central Daylight Time	08/05/2017 02:22:44 PM Central Daylight Time	08/05/2017 02:22:44 PM Central Daylight Time			08/05/2017 02:25:17 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com	VIVA Medicare Plus (HMO)	01	01		1			H0154	015	1	2018	Northwest Alabama, Central Alabama and Mobile Area	Northwest Alabama, Central Alabama and Mobile Area	2	242807	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0154	015	2	1	01	01	H0154_015_2	11			1		08/04/2017	2018.03	08/04/2017 10:50:10 AM Central Daylight Time	08/05/2017 02:22:44 PM Central Daylight Time	08/05/2017 02:22:45 PM Central Daylight Time			08/05/2017 02:25:17 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com	VIVA Medicare Plus (HMO)	01	01		1			H0154	015	2	2018	Northwest Alabama, Central Alabama and Mobile Area	Ft. Payne, Gadsden,Troy, Jasper, Russellville Area	2	20143	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0154	801	0	1	01	01	H0154_801_0	4			1		06/01/2017	2018.03	06/01/2017 06:23:35 PM Central Daylight Time					06/04/2017 05:02:12 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Group Plan with Rx (CY) (HMO)	01	01		1			H0154	801	0	2018	State of Alabama		1	2100	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;9a;9b;9c;9d;10a;11a;11b;11c;12;15;16b;	1	7d;	1					2				
H0154	802	0	1	01	01	H0154_802_0	4			1		06/01/2017	2018.03	06/01/2017 06:30:53 PM Central Daylight Time					06/04/2017 05:02:12 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Group Plan (no Rx) (HMO)	01	01		1			H0154	802	0	2018	State of Alabama		1	1080	2			2						http://www.vivamedicaremember.com/Download.aspx?ID=992&Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=1326&Type=doc	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;9a;9b;9c;9d;10a;11a;11b;11c;12;15;16b;	1	7d;	1					2				
H0154	803	0	1	01	01	H0154_803_0	4			1		06/01/2017	2018.03	06/01/2017 06:35:26 PM Central Daylight Time					06/04/2017 05:02:12 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare	www.vivamedicaremember.com/	VIVA Medicare Plus Group Plan with Rx (not CY) (HMO)	01	01		1			H0154	803	0	2018	State of Alabama		1	1200	2			2						www.vivamedicaremember.com/Resource/Current/Pharmacy.aspx	www.vivamedicaremember.com/Resource/Current/Formulary.aspx	www.vivamedicaremember.com/MemberResources/	(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(800)633-1542		(205)918-2067		(888)830-8482		(205)933-8482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;9a;9b;9c;9d;10a;11a;11b;11c;12;15;16b;	1	7d;	1					2				
H0169	001	0	1	01	01	H0169_001_0	4		1	1	2	07/05/2017	2018.03	07/05/2017 02:09:20 PM Central Daylight Time	08/03/2017 01:57:22 PM Central Daylight Time	08/01/2017 08:42:11 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0169	001	0	2018	Select Counties in IA		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0169	002	0	1	01	01	H0169_002_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:32:26 PM Central Daylight Time	08/03/2017 01:58:08 PM Central Daylight Time	08/01/2017 08:42:38 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0169	002	0	2018	Select Counties in MO		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0169	003	0	1	01	01	H0169_003_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:33:15 PM Central Daylight Time	08/03/2017 01:58:53 PM Central Daylight Time	08/01/2017 08:43:04 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0169	003	0	2018	Select Counties in NE		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0174	001	0	1	01	01	H0174_001_0	6		1	1	2	06/05/2017	2018.03	06/05/2017 04:14:58 PM Central Daylight Time	08/01/2017 09:39:52 AM Central Daylight Time	07/31/2017 03:33:01 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	TODAY'S OPTIONS OF TEXAS, INC.	Universal American Corp.	www.TexanPlusSNP.com	TexanPlus Star (HMO SNP)	01	01		1			H0174	001	0	2018	Select counties in Southeast Texas		2	10721	2			1	3		2		2	www.TexanPlusSNP.com	www.TexanPlusSNP.com	www.TexanPlusSNP.com	(844)879-4367		(844)879-4367		(866)556-4607		(866)556-4607		(844)879-4367		(844)879-4367		(866)556-4607		(866)556-4607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0192	001	0	1	48	05	H0192_001_0	4			1		08/24/2017	2018.03	08/24/2017 07:42:39 AM Central Daylight Time					08/24/2017 12:59:37 PM Central Daylight Time	AMERIHEALTH MICHIGAN, INC.	AmeriHealth Caritas VIP Care Plus	www.amerihealthcaritasvipcareplus.com	AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan)	05	48		1			H0192	001	0	2018	Wayne and Macomb Counties		2		2			2						www.amerihealthcaritasvipcareplus.com	www.amerihealthcaritasvipcareplus.com	www.amerihealthcaritasvipcareplus.com	(888)667-0318		(888)667-0318		(877)694-2316		(877)694-2316		(888)667-0318		(888)667-0318		(877)694-2316		(877)694-2316		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0216	001	0	1	20	08	H0216_001_0	1			1		06/03/2017	2018.03	06/03/2017 08:34:18 AM Central Daylight Time		06/03/2017 08:29:32 AM Central Daylight Time			06/03/2017 08:37:56 AM Central Daylight Time	PACE IOWA	Immanuel Pathways Iowa	Immanuelpathways.org	PACE Iowa (PACE)	08	20		1			H0216	001	0	2018	Mills, Harrison, and Pottawatomie Counties		2		2			2						www.immanuelcommunities.com	www.immanuelcommunities.com										(000)000-0000		(712)256-7284		(000)000-0000		(712)256-7284										(180)073-5294		(712)256-7284		(180)073-5294		(712)256-7284																
H0216	002	0	1	20	08	H0216_002_0	1			1		06/03/2017	2018.03	06/03/2017 08:35:02 AM Central Daylight Time		06/03/2017 08:29:32 AM Central Daylight Time			06/03/2017 08:37:56 AM Central Daylight Time	PACE IOWA	Immanuel Pathways Iowa	Immanuelpathways.org	PACE Iowa (PACE)	08	20		1			H0216	002	0	2018	Mills, Harrison, and Pottawatomie Counties		2		2			2						www.immanuelcommunities.com	www.immanuelcommunities.com										(000)000-0000		(712)256-7284		(000)000-0000		(712)256-7284										(180)073-5294		(712)256-7284		(180)073-5294		(712)256-7284																
H0251	002	0	1	01	01	H0251_002_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:47:22 AM Central Daylight Time	08/03/2017 12:54:43 PM Central Daylight Time	08/01/2017 08:43:31 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0251	002	0	2018	Select counties in Tennessee		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0251	004	0	1	01	01	H0251_004_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 09:51:25 AM Central Daylight Time	08/03/2017 12:57:13 PM Central Daylight Time	08/01/2017 08:43:57 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete ONE (HMO SNP)	01	01		1			H0251	004	0	2018	Select Counties in TN		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0281	001	0	1	48	05	H0281_001_0	3			1		09/18/2017	2018.03	09/18/2017 10:14:51 AM Pacific Daylight Time					09/18/2017 03:48:32 PM Pacific Daylight Time	ILLINICARE HEALTH PLAN	IlliniCare Health	http://mmp.illinicare.com	IlliniCare Health - MMAI (Medicare-Medicaid Plan)	05	48		1			H0281	001	0	2018	Cook, DuPage, Kane, Kankakee, Lake & Will Counties		2	66000	2			2						http://mmp.illinicare.com/home/prescription-drug-part-d-formulary-2	http://mmp.illinicare.com/home/prescription-drug-part-d-formulary-2/formulary-2/	http://apps.illinicare.com/findadoc/changeNetwork?prodId=1078	(877)941-0482		(877)941-0482		(877)941-0482		(877)941-0482		(877)941-0482		(877)941-0482		(877)941-0482		(877)941-0482		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0294	002	0	1	04	01	H0294_002_0	3		1	1		07/19/2017	2018.03	07/19/2017 02:18:24 PM Central Daylight Time	08/03/2017 01:15:45 PM Central Daylight Time	08/01/2017 08:44:23 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0294	002	0	2018	Various Counties in Wisconsin		2		2			1	4			00000000000000000010		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0294	004	0	1	04	01	H0294_004_0	3			1		06/28/2017	2018.03	06/28/2017 09:33:12 AM Central Daylight Time	08/03/2017 01:16:21 PM Central Daylight Time	08/01/2017 08:44:49 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0294	004	0	2018	Various Counties in Wisconsin		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0294	010	0	1	04	01	H0294_010_0	4		1	1		06/28/2017	2018.03	06/28/2017 09:34:21 AM Central Daylight Time	08/03/2017 01:16:57 PM Central Daylight Time	08/01/2017 08:45:15 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0294	010	0	2018	Select Counties in Lacrosse and Central WI		2		2			1	4			00000000000000000010		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0294	011	0	1	04	01	H0294_011_0	4			1		06/28/2017	2018.03	06/28/2017 09:34:57 AM Central Daylight Time	08/03/2017 01:17:34 PM Central Daylight Time	08/01/2017 08:45:41 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0294	011	0	2018	Select Counites in Central WI		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0294	012	0	1	04	01	H0294_012_0	4			1		06/28/2017	2018.03	06/28/2017 09:41:54 AM Central Daylight Time	08/03/2017 01:18:09 PM Central Daylight Time	08/01/2017 08:46:06 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage Premier (PPO)	01	04		1			H0294	012	0	2018	Select counties in central WI		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0302	001	0	1	01	01	H0302_001_0	8			1		08/03/2017	2018.03	08/03/2017 05:19:27 PM US Mountain Standard Time	08/02/2017 02:49:08 PM US Mountain Standard Time	08/03/2017 05:28:52 AM US Mountain Standard Time			08/07/2017 02:40:07 PM US Mountain Standard Time	MEDISUN, INC.	Blue Cross Blue Shield of Arizona Advantage	azbluemedicare.com	Blue Medicare Advantage Plus (HMO)	01	01		1			H0302	001	0	2018	Central and Southern Arizona		2	274609	2			2						azbluemedicare.com	azbluemedicare.com	azbluemedicare.com	(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0302	006	0	1	01	01	H0302_006_0	8			1		08/03/2017	2018.03	08/03/2017 07:42:19 PM US Mountain Standard Time	08/02/2017 03:21:23 PM US Mountain Standard Time	08/03/2017 05:29:13 AM US Mountain Standard Time			08/07/2017 02:40:07 PM US Mountain Standard Time	MEDISUN, INC.	Blue Cross Blue Shield of Arizona Advantage	azbluemedicare.com	Blue Medicare Advantage Classic (HMO)	01	01		1			H0302	006	0	2018	Phoenix Metro area		2	360915	2			2						azbluemedicare.com	azbluemedicare.com	azbluemedicare.com	(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0302	008	0	1	01	01	H0302_008_0	7			1		08/03/2017	2018.03	08/03/2017 07:40:09 PM US Mountain Standard Time	08/02/2017 03:25:41 PM US Mountain Standard Time	08/03/2017 05:29:35 AM US Mountain Standard Time			08/07/2017 02:40:07 PM US Mountain Standard Time	MEDISUN, INC.	Blue Cross Blue Shield of Arizona Advantage	azbluemedicare.com	Blue Medicare Advantage Classic (HMO)	01	01		1			H0302	008	0	2018	Pima County		2	149074	2			2						azbluemedicare.com	azbluemedicare.com	azbluemedicare.com	(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0302	801	0	1	01	01	H0302_801_0	3			1		06/05/2017	2018.03	06/05/2017 09:56:26 AM US Mountain Standard Time					06/05/2017 11:21:35 AM US Mountain Standard Time	MEDISUN, INC.	Blue Cross Blue Shield of Arizona Advantage	azbluemedicare.com	Blue Medicare Advantage Employer Plan (HMO)	01	01		1			H0302	801	0	2018	Arizona		1	60000	2			2						azbluemedicare.com	azbluemedicare.com	azbluemedicare.com	(800)446-8331		(800)446-8331		(888)274-0142		(888)274-0142										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7g;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;16b;	1	1a;5;6;7b;7c;7d;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;14d;14e1;14e2;14e3;16b;18a;	1					1				
H0321	002	0	1	01	01	H0321_002_0	4		1	1	2	07/25/2017	2018.03	07/25/2017 01:04:32 PM Central Daylight Time	08/03/2017 01:18:46 PM Central Daylight Time	08/01/2017 08:46:33 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	ARIZONA PHYSICIANS IPA, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0321	002	0	2018	Select counties in Arizona		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)614-0623		(877)614-0623		(888)834-3721		(888)834-3721		(877)614-0623		(877)614-0623		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0321	004	0	1	01	01	H0321_004_0	4		1	1	2	07/25/2017	2018.03	07/25/2017 01:04:27 PM Central Daylight Time	08/03/2017 01:19:24 PM Central Daylight Time	08/01/2017 08:47:13 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	ARIZONA PHYSICIANS IPA, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete ONE (HMO SNP)	01	01		1			H0321	004	0	2018	Select counties in Arizona		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)614-0623		(877)614-0623		(888)834-3721		(888)834-3721		(877)614-0623		(877)614-0623		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0332	001	0	1	01	01	H0332_001_0	4			1		06/30/2017	2018.03	06/30/2017 10:26:29 AM Central Daylight Time	06/05/2017 12:53:40 PM Central Daylight Time				06/30/2017 03:45:27 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential (HMO)	01	01		1			H0332	001	0	2018	Harris, Ft Bend, Galveston and Montgomery counties		2	24252	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										2					2					2	2			
H0332	002	0	1	01	01	H0332_002_0	6			1		08/06/2017	2018.03	08/06/2017 12:13:24 PM Central Daylight Time	08/06/2017 11:46:07 AM Central Daylight Time	08/06/2017 11:51:16 AM Central Daylight Time			08/07/2017 08:51:41 AM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx (HMO)	01	01		1			H0332	002	0	2018	Harris, Ft Bend, Galveston and Montgomery counties		2	264324	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646		(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		2					2					2	2			
H0332	003	0	1	02	01	H0332_003_0	4			1		06/30/2017	2018.03	06/30/2017 10:28:35 AM Central Daylight Time	06/05/2017 12:58:20 PM Central Daylight Time				06/30/2017 03:45:27 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential+Choice (HMO-POS)	01	02		1			H0332	003	0	2018	Harris, Ft Bend, Galveston and Montgomery counties		2	11022	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										2					2					2	2			
H0332	004	0	1	02	01	H0332_004_0	5			1		08/06/2017	2018.03	08/06/2017 12:13:51 PM Central Daylight Time	08/06/2017 11:49:33 AM Central Daylight Time	08/06/2017 11:52:55 AM Central Daylight Time			08/07/2017 08:51:41 AM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx+Choice (HMO-POS)	01	02		1			H0332	004	0	2018	Harris, Ft Bend, Galveston and Montgomery counties		2	17886	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646		(866)535-8343		(713)442-2273		(800)663-7146		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		2					2					2	2			
H0332	801	0	1	01	01	H0332_801_0	1			1		05/31/2017	2018.03	05/31/2017 05:17:56 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential Retiree (HMO)	01	01		1			H0332	801	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										1	2		2		1					1				
H0332	803	0	1	01	01	H0332_803_0	1			1		05/31/2017	2018.03	05/31/2017 05:24:02 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	803	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	804	0	1	01	01	H0332_804_0	1			1		05/31/2017	2018.03	05/31/2017 05:22:57 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential+Choice Retiree (HMO)	01	01		1			H0332	804	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										1	2		2		1					1				
H0332	805	0	1	01	01	H0332_805_0	1			1		05/31/2017	2018.03	05/31/2017 05:23:47 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx+Choice Retiree (HMO)	01	01		1			H0332	805	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	806	0	1	01	01	H0332_806_0	1			1		05/31/2017	2018.03	05/31/2017 05:24:57 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential Retiree (HMO)	01	01		1			H0332	806	0	2018	Texas		1	18432	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(877)853-9075		(713)442-2377		(877)853-9075		(713)442-2377										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										1	2		2		1					1				
H0332	807	0	1	01	01	H0332_807_0	1			1		05/31/2017	2018.03	05/31/2017 05:25:52 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	807	0	2018	Texas		1	744	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	808	0	1	01	01	H0332_808_0	1			1		05/31/2017	2018.03	05/31/2017 05:26:33 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential+Choice Retiree (HMO)	01	01		1			H0332	808	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										1	2		2		1					1				
H0332	809	0	1	01	01	H0332_809_0	1			1		05/31/2017	2018.03	05/31/2017 05:28:57 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx+Choice Retiree (HMO)	01	01		1			H0332	809	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	810	0	1	01	01	H0332_810_0	1			1		05/31/2017	2018.03	05/31/2017 05:30:59 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	810	0	2018	Texas		1	684	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	811	0	1	01	01	H0332_811_0	1			1		05/31/2017	2018.03	05/31/2017 05:30:16 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	811	0	2018	Texas		1	51234	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	812	0	1	01	01	H0332_812_0	1			1		05/31/2017	2018.03	05/31/2017 05:30:55 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	812	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	813	0	1	01	01	H0332_813_0	1			1		05/31/2017	2018.03	05/31/2017 05:31:36 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage RX Retiree (HMO)	01	01		1			H0332	813	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537		1	2		2		1					1				
H0332	814	0	1	01	01	H0332_814_0	1			1		05/31/2017	2018.03	05/31/2017 05:32:17 PM Central Daylight Time					06/03/2017 03:45:58 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential Retiree (HMO)	01	01		1			H0332	814	0	2018	Texas		1	108	2			2						www.kelseycareadvantage.com	www.kelseycareadvantage.com	www.Kelseycareadvantage.com	(866)534-0554		(713)442-2273		(866)534-0554		(713)442-5646										(866)302-9336		(713)442-9537		(866)302-9336		(713)442-9537										1	2		2		1					1				
H0336	001	0	1	48	05	H0336_001_0	5			1		09/18/2017	2018.03	09/18/2017 01:01:00 PM Eastern Daylight Time					09/18/2017 01:13:23 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Gold Plus Integrated	www.humana.com/medicare/medicaid-dual/illinois/	Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)	05	48		1			H0336	001	0	2018	Chicago Metro Area		2	70524	2			2						www.humana.com/medicare/medicaid-dual/illinois/pharmacy/	www.humana.com/medicare/medicaid-dual/illinois/pharmacy/	www.humana.com/medicare/medicaid-dual/illinois/help/	(800)787-3311		(800)787-3311		(855)635-9561		(855)635-9561		(800)787-3311		(800)787-3311		(855)635-9561		(855)635-9561		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0351	030	0	1	01	01	H0351_030_0	5			1		07/06/2017	2018.03	07/06/2017 02:09:08 PM Pacific Daylight Time	07/13/2017 11:56:24 AM Pacific Daylight Time				07/14/2017 05:51:07 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Complement (HMO)	01	01		1			H0351	030	0	2018	Maricopa, Pinal, Santa Cruz, Cochise		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0351	038	0	1	01	01	H0351_038_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:25:04 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:26 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell CHF/Diabetes Medicare (HMO SNP)	01	01		1			H0351	038	0	2018	Maricopa and Pinal Counties		2		2			1	4			00000000000000000100		https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	041	0	1	01	01	H0351_041_0	4			1		08/02/2017	2018.03	08/02/2017 12:32:25 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Select (HMO)	01	01		1			H0351	041	0	2018	Pima County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	042	0	1	01	01	H0351_042_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:25:11 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Cardio Medicare (HMO SNP)	01	01		1			H0351	042	0	2018	Maricopa and Pinal Counties		2		2			1	4			00010000000000000000		https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	043	1	1	01	01	H0351_043_1	5			1		08/02/2017	2018.03	08/02/2017 01:37:05 PM Pacific Daylight Time	08/06/2017 01:14:02 AM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Premier (HMO)	01	01		1			H0351	043	1	2018	Maricopa and Pinal Counties, AZ	Maricopa County, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	043	4	1	01	01	H0351_043_4	5			1		08/02/2017	2018.03	08/02/2017 01:48:21 PM Pacific Daylight Time	08/06/2017 01:15:02 AM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Premier (HMO)	01	01		1			H0351	043	4	2018	Maricopa and Pinal Counties, AZ	Pinal County, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	044	1	1	01	01	H0351_044_1	4			1		05/29/2017	2018.03	05/29/2017 02:13:21 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare (HMO)	01	01		1			H0351	044	1	2018	Pima, Cochise, Santa Cruz, AZ	Pima, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	044	2	1	01	01	H0351_044_2	6			1		06/01/2017	2018.03	06/01/2017 12:28:47 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare (HMO)	01	01		1			H0351	044	2	2018	Pima, Cochise, Santa Cruz, AZ	Cochise, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	044	3	1	01	01	H0351_044_3	4			1		06/01/2017	2018.03	06/01/2017 12:29:03 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:03:17 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare (HMO)	01	01		1			H0351	044	3	2018	Pima, Cochise, Santa Cruz, AZ	Santa Cruz, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	049	1	1	01	01	H0351_049_1	5			1		08/02/2017	2018.03	08/02/2017 02:01:53 PM Pacific Daylight Time	08/06/2017 01:16:10 AM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Essentials II (HMO)	01	01		1			H0351	049	1	2018	Maricopa and Pinal	Maricopa, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	049	2	1	01	01	H0351_049_2	5			1		08/02/2017	2018.03	08/02/2017 02:07:20 PM Pacific Daylight Time	08/06/2017 01:17:10 AM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Essentials II (HMO)	01	01		1			H0351	049	2	2018	Maricopa and Pinal	Pinal, AZ	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0351	801	0	1	01	01	H0351_801_0	3			1		06/08/2017	2018.03	06/08/2017 03:09:11 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell CoCare (HMO)	01	01		1			H0351	801	0	2018	All AZ Counties		1	660	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0351	803	0	1	01	01	H0351_803_0	3			1		06/08/2017	2018.03	06/08/2017 03:09:28 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell CoCare (HMO)	01	01		1			H0351	803	0	2018	All AZ Counties		1	240	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0351	804	0	1	01	01	H0351_804_0	3			1		06/08/2017	2018.03	06/08/2017 03:42:27 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell CoCare (HMO)	01	01		1			H0351	804	0	2018	All AZ Counties		1	240	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0354	001	0	1	01	01	H0354_001_0	6			1		08/02/2017	2018.03	08/02/2017 01:23:59 PM Central Daylight Time	08/03/2017 01:46:02 PM Central Daylight Time	08/01/2017 01:59:27 PM Central Daylight Time			08/04/2017 11:16:26 AM Central Daylight Time	CIGNA HEALTHCARE OF ARIZONA, INC.	Cigna	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0354	001	0	2018	Maricopa Co. and Select Zip Codes in Pinal Co.		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0354	024	0	1	01	01	H0354_024_0	6			1		08/02/2017	2018.03	08/02/2017 01:23:40 PM Central Daylight Time	08/03/2017 01:46:22 PM Central Daylight Time	08/01/2017 01:59:47 PM Central Daylight Time			08/04/2017 11:16:26 AM Central Daylight Time	CIGNA HEALTHCARE OF ARIZONA, INC.	Cigna	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0354	024	0	2018	Pima County		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)627-7534		(800)627-7534		(855)836-8905		(855)836-8905		(800)627-7534		(800)627-7534		(855)836-8905		(855)836-8905		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0354	027	0	1	01	01	H0354_027_0	6		1	1		08/02/2017	2018.03	08/02/2017 01:22:57 PM Central Daylight Time	08/03/2017 01:46:43 PM Central Daylight Time	08/01/2017 02:00:06 PM Central Daylight Time			08/04/2017 11:16:26 AM Central Daylight Time	CIGNA HEALTHCARE OF ARIZONA, INC.	Cigna	www.cignahealthspring.com	Cigna-HealthSpring Achieve Plus (HMO SNP)	01	01		1			H0354	027	0	2018	Maricopa Co. and Select Zip Codes in Pinal Co.		2		2			1	4			00000010000000000000		www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0354	804	0	1	01	01	H0354_804_0	3			1		05/23/2017	2018.03	05/23/2017 03:34:18 PM Central Daylight Time					06/01/2017 04:48:20 PM Central Daylight Time	CIGNA HEALTHCARE OF ARIZONA, INC.	Cigna	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H0354	804	0	2018	All Counties in Arizona		1	9156	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;17b;	1	3-1;3-2;3-3;6;7c;7d;7f;7g;7i;8b1;8b2;8b3;9a;9d;12;14a;14d;14e2;16b;17a;18a;	1					1				
H0354	805	0	1	01	01	H0354_805_0	3			1		05/23/2017	2018.03	05/23/2017 03:36:10 PM Central Daylight Time					06/01/2017 04:48:20 PM Central Daylight Time	CIGNA HEALTHCARE OF ARIZONA, INC.	Cigna	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx FY (HMO)	01	01		1			H0354	805	0	2018	All Counties in Arizona		1	744	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(800)627-7534		(800)627-7534		(855)561-3811		(855)561-3811		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;17b;	1	3-1;3-2;3-3;6;7c;7d;7f;7g;7i;8b1;8b2;8b3;9a;9d;12;14a;14d;14e2;16b;17a;18a;	1					1				
H0390	001	0	1	20	08	H0390_001_0	1			1		05/24/2017	2018.03	05/24/2017 10:28:59 AM Eastern Daylight Time		05/24/2017 10:24:32 AM Eastern Daylight Time			05/24/2017 10:30:36 AM Eastern Daylight Time	PACE OF SOUTHWEST MICHIGAN, INC.	PACE of Southwest Michigan	http://www.paceswmi.org/	PACE of Southwest Michigan - Dual (PACE)	08	20		1			H0390	001	0	2018	PACE of Southwest Michigan - Dual		2		2			2						www.seniorscript.com	theresesaggau@paceswmi.org										(855)243-8876		(269)408-4322		(855)243-8876		(269)408-4322										(855)243-8876		(269)408-4322		(855)243-8876		(269)408-4322																
H0390	002	0	1	20	08	H0390_002_0	1			1		05/24/2017	2018.03	05/24/2017 10:29:15 AM Eastern Daylight Time		05/24/2017 10:24:33 AM Eastern Daylight Time			05/24/2017 10:30:36 AM Eastern Daylight Time	PACE OF SOUTHWEST MICHIGAN, INC.	PACE of Southwest Michigan	http://www.paceswmi.org/	PACE of Southwest Michigan - Medicare Only (PACE)	08	20		1			H0390	002	0	2018	PACE of Southwest Michigan - Medicare Only		2		2			2						www.seniorscript.com	theresesaggau@paceswmi.org										(855)243-8876		(269)408-4322		(855)243-8876		(269)408-4322										(855)243-8876		(269)408-4322		(855)243-8876		(269)408-4322																
H0423	001	0	1	01	01	H0423_001_0	6		1	1	2	08/08/2017	2018.03	08/08/2017 11:39:35 AM Eastern Daylight Time	08/08/2017 10:55:42 AM Eastern Daylight Time	08/01/2017 02:03:02 PM Eastern Daylight Time			08/08/2017 12:01:48 PM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Advantage Plan (HMO SNP)	01	01		1			H0423	001	0	2018	NYC - The Bronx, Brooklyn, Manhattan, Queens		2	8637	2			1	3		2		2	www.caremark.com	https://www.metroplus.org/CMSPages/GetFile.aspx?guid=3ee42e68-06ac-4431-8445-a77d6a8e117e	www.metroplusmedicare.org	(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0423	004	0	1	01	01	H0423_004_0	7			1		08/04/2017	2018.03	08/04/2017 03:50:46 PM Eastern Daylight Time	08/01/2017 02:04:22 PM Eastern Daylight Time	08/01/2017 01:56:32 PM Eastern Daylight Time			08/04/2017 03:55:07 PM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Platinum (HMO)	01	01		1			H0423	004	0	2018	NYC - The Bronx, Brooklyn, Manhattan, Queens		2	603	2			2						www.caremark.com	https://www.metroplus.org/CMSPages/GetFile.aspx?guid=3ee42e68-06ac-4431-8445-a77d6a8e117e	www.metroplusmedicare.org	(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(866)986-0356		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	001	0	1	01	01	H0432_001_0	6			1		08/04/2017	2018.03	08/04/2017 08:48:48 AM Central Daylight Time	08/03/2017 01:20:00 PM Central Daylight Time	08/01/2017 08:47:40 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0432	001	0	2018	Northern Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	002	0	1	01	01	H0432_002_0	6			1		08/02/2017	2018.03	08/02/2017 03:08:44 PM Central Daylight Time	08/03/2017 01:20:36 PM Central Daylight Time	08/01/2017 08:48:06 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0432	002	0	2018	Northern Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	003	0	1	01	01	H0432_003_0	6			1		08/02/2017	2018.03	08/02/2017 01:58:36 PM Central Daylight Time	08/03/2017 01:21:12 PM Central Daylight Time	08/01/2017 08:48:32 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0432	003	0	2018	Southern Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	004	0	1	01	01	H0432_004_0	6			1		06/28/2017	2018.03	06/28/2017 09:38:22 AM Central Daylight Time	08/03/2017 01:21:47 PM Central Daylight Time	08/01/2017 08:48:58 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0432	004	0	2018	Southern Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	005	0	1	01	01	H0432_005_0	6			1		08/02/2017	2018.03	08/02/2017 01:59:08 PM Central Daylight Time	08/04/2017 08:29:09 AM Central Daylight Time	08/01/2017 08:49:27 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0432	005	0	2018	West Central Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	006	0	1	01	01	H0432_006_0	6			1		06/28/2017	2018.03	06/28/2017 09:38:53 AM Central Daylight Time	08/04/2017 08:29:42 AM Central Daylight Time	08/01/2017 08:49:53 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0432	006	0	2018	West Central Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	007	0	1	01	01	H0432_007_0	6			1		08/02/2017	2018.03	08/02/2017 01:59:30 PM Central Daylight Time	08/04/2017 08:30:15 AM Central Daylight Time	08/01/2017 08:50:19 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0432	007	0	2018	East Central Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	008	0	1	01	01	H0432_008_0	6			1		06/28/2017	2018.03	06/28/2017 09:40:15 AM Central Daylight Time	08/04/2017 08:30:49 AM Central Daylight Time	08/01/2017 08:50:45 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0432	008	0	2018	East Central Alabama		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0432	009	0	1	01	01	H0432_009_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 08:30:48 AM Central Daylight Time	08/03/2017 01:24:52 PM Central Daylight Time	08/01/2017 08:51:11 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0432	009	0	2018	Select Counties in Alabama		2		2			1	3		2		2	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0439	002	0	1	01	01	H0439_002_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 09:11:38 PM Central Daylight Time	08/03/2017 10:26:14 AM Central Daylight Time	08/01/2017 02:00:28 PM Central Daylight Time			08/04/2017 02:58:34 PM Central Daylight Time	CIGNA HEALTHCARE OF GEORGIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H0439	002	0	2018	Select Georgia Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0439	003	1	1	01	01	H0439_003_1	3			1		08/02/2017	2018.03	08/02/2017 01:59:29 PM Central Daylight Time	08/03/2017 10:26:36 AM Central Daylight Time	08/01/2017 02:00:47 PM Central Daylight Time			08/04/2017 02:58:34 PM Central Daylight Time	CIGNA HEALTHCARE OF GEORGIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0439	003	1	2018	Georgia	Georgia Preferred	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0439	003	2	1	01	01	H0439_003_2	3			1		08/02/2017	2018.03	08/02/2017 02:00:01 PM Central Daylight Time	08/03/2017 10:26:58 AM Central Daylight Time	08/01/2017 02:01:10 PM Central Daylight Time			08/04/2017 02:58:34 PM Central Daylight Time	CIGNA HEALTHCARE OF GEORGIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H0439	003	2	2018	Georgia	Georgia Preferred Select Counties	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0439	801	0	1	01	01	H0439_801_0	2			1		05/22/2017	2018.03	05/22/2017 08:37:18 PM Central Daylight Time					05/31/2017 10:36:20 PM Central Daylight Time	CIGNA HEALTHCARE OF GEORGIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H0439	801	0	2018	Georgia		1	792	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H0477	001	0	1	20	08	H0477_001_0	1			1		05/31/2017	2018.03	05/31/2017 02:30:19 PM Eastern Daylight Time		05/31/2017 11:19:54 AM Eastern Daylight Time			05/31/2017 02:41:12 PM Eastern Daylight Time	SERENITY CARE, INC.	Serenity Care PACE	http://www.serenitypace.org	Serenity PACE Dual (PACE)	08	20		1			H0477	001	0	2018	Serenity Pace Dual		2		2			2						www.omnicare.com	www.pharmastarpbm.com										(413)241-6265		(413)241-6265		(413)241-6265		(413)241-6265										(413)241-6265		(413)241-6265		(413)241-6265		(413)241-6265																
H0477	002	0	1	20	08	H0477_002_0	1			1		05/31/2017	2018.03	05/31/2017 02:30:55 PM Eastern Daylight Time		05/31/2017 11:19:39 AM Eastern Daylight Time			05/31/2017 02:41:12 PM Eastern Daylight Time	SERENITY CARE, INC.	Serenity Care PACE	http://www.serenitypace.org	Serenity PACE Medicare only (PACE)	08	20		1			H0477	002	0	2018	Serenity PACE Medicare only		2		2			2						www.omnicare.com	www.pharmastarpbm.com										(413)241-6265		(413)241-6265		(413)304-3977		(413)304-3977										(413)241-6265		(413)241-6265		(413)304-3977		(413)304-3977																
H0480	001	0	1	48	05	H0480_001_0	5			1		08/25/2017	2018.03	08/25/2017 01:53:02 PM Eastern Daylight Time					08/25/2017 01:55:00 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Meridian Complete	www.mhplan.com	Meridian Complete (Medicare-Medicaid Plan)	05	48		1			H0480	001	0	2018	Southwestern Michigan		2	68964	2			2						www.mhplan.com	www.mhplan.com	www.mhplan.com	(855)323-4578		(855)323-4578		(855)647-0075		(855)647-0075		(855)323-4578		(855)323-4578		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H0490	004	0	1	01	01	H0490_004_0	5		1	1	2	07/05/2017	2018.03	07/05/2017 04:40:51 PM Pacific Daylight Time	08/03/2017 03:33:50 PM Pacific Daylight Time	08/01/2017 08:59:28 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF OHIO, INC.	Molina Healthcare of Ohio	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H0490	004	0	2018	Ohio		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(866)472-4584		(866)472-4584		(866)403-8293		(866)403-8293		(866)472-4584		(866)472-4584		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	015	0	1	01	01	H0504_015_0	3			1		08/03/2017	2018.03	08/03/2017 10:37:20 AM Pacific Daylight Time	08/02/2017 12:06:46 PM Pacific Daylight Time	08/02/2017 11:29:42 AM Pacific Daylight Time			08/03/2017 12:26:45 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	015	0	2018	Los Angeles (Partial)/Orange Counties		2	541415	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	017	0	1	01	01	H0504_017_0	3			1		08/03/2017	2018.03	08/03/2017 10:46:43 AM Pacific Daylight Time	08/02/2017 12:07:46 PM Pacific Daylight Time	08/02/2017 11:30:31 AM Pacific Daylight Time			08/03/2017 12:31:39 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	017	0	2018	San Bernardino County (Partial)		2	65847	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	021	0	1	01	01	H0504_021_0	3			1		08/03/2017	2018.03	08/03/2017 10:38:22 AM Pacific Daylight Time	08/02/2017 12:11:19 PM Pacific Daylight Time	08/02/2017 11:31:11 AM Pacific Daylight Time			08/03/2017 12:33:21 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus Choice Plan (HMO)	01	01		1			H0504	021	0	2018	Los Angeles (Partial)/Orange Counties CP		2	263317	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	026	0	1	01	01	H0504_026_0	4			1		08/03/2017	2018.03	08/03/2017 10:48:00 AM Pacific Daylight Time	08/02/2017 12:11:55 PM Pacific Daylight Time	08/02/2017 11:31:56 AM Pacific Daylight Time			08/03/2017 12:36:04 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	026	0	2018	Riverside County (Partial)		2	36492	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	028	0	1	01	01	H0504_028_0	4			1		08/03/2017	2018.03	08/03/2017 10:50:23 AM Pacific Daylight Time	08/02/2017 12:13:21 PM Pacific Daylight Time	08/02/2017 11:34:29 AM Pacific Daylight Time			08/03/2017 12:38:38 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	028	0	2018	San Diego County		2	73556	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	029	0	1	01	01	H0504_029_0	4			1		08/03/2017	2018.03	08/03/2017 10:52:19 AM Pacific Daylight Time	08/02/2017 12:14:18 PM Pacific Daylight Time	08/02/2017 11:45:03 AM Pacific Daylight Time			08/03/2017 12:39:58 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	029	0	2018	Ventura County (Partial)		2	62102	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	031	0	1	01	01	H0504_031_0	4			1		08/03/2017	2018.03	08/03/2017 10:54:36 AM Pacific Daylight Time	08/02/2017 12:16:20 PM Pacific Daylight Time	08/02/2017 11:45:55 AM Pacific Daylight Time			08/03/2017 12:41:42 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	031	0	2018	Fresno County		2	21759	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	037	0	1	01	01	H0504_037_0	4			1		08/03/2017	2018.03	08/03/2017 10:49:07 AM Pacific Daylight Time	08/02/2017 12:17:23 PM Pacific Daylight Time	08/02/2017 11:33:51 AM Pacific Daylight Time			08/03/2017 12:43:01 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Trio Medicare (HMO)	01	01		1			H0504	037	0	2018	Sacramento County (partial)		2	99339	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	038	0	1	01	01	H0504_038_0	4			1		08/03/2017	2018.03	08/03/2017 10:55:49 AM Pacific Daylight Time	08/02/2017 12:18:10 PM Pacific Daylight Time	08/02/2017 11:48:51 AM Pacific Daylight Time			08/03/2017 12:44:03 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	038	0	2018	Kern County (partial)		2	70617	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H0504	039	0	1	01	01	H0504_039_0	5			1		08/03/2017	2018.03	08/03/2017 10:56:56 AM Pacific Daylight Time	08/02/2017 12:19:10 PM Pacific Daylight Time	08/02/2017 11:49:21 AM Pacific Daylight Time			08/03/2017 12:45:16 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	039	0	2018	San Luis Obispo/Santa Barbara Counties (partial)		2	14232	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(800)776-4466		(800)776-4466		(800)488-8000		(800)488-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0504	803	0	1	01	01	H0504_803_0	1			1		06/01/2017	2018.03	06/01/2017 09:34:13 AM Pacific Daylight Time					06/02/2017 10:06:11 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	803	0	2018	MA-PD Employer Group Plan		1	18624	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;2;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;18a;	2					2				
H0504	804	0	1	01	01	H0504_804_0	1			1		06/01/2017	2018.03	06/01/2017 09:34:23 AM Pacific Daylight Time					06/02/2017 10:07:37 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	804	0	2018	MA-PD Employer Group Plan		1	6716	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;2;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;18a;	2					2				
H0504	805	0	1	01	01	H0504_805_0	1			1		06/01/2017	2018.03	06/01/2017 09:34:36 AM Pacific Daylight Time					06/02/2017 10:11:05 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	805	0	2018	MA-Only Employer Group Plan		1	0	2			2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary	www.blueshieldca.com/find-a-doctor	(800)776-4466		(800)776-4466		(800)776-4466		(800)776-4466										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;18a;	2					2				
H0523	002	0	1	01	01	H0523_002_0	6			1		08/02/2017	2018.03	08/02/2017 02:50:39 PM Mountain Daylight Time	08/03/2017 02:49:27 PM Eastern Daylight Time	07/31/2017 05:28:26 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	002	0	2018	Los Angeles and Orange Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	022	0	1	01	01	H0523_022_0	3			1		08/02/2017	2018.03	08/02/2017 08:19:24 AM Mountain Daylight Time	08/03/2017 02:50:14 PM Eastern Daylight Time	07/31/2017 05:28:56 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	http://www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	022	0	2018	Riverside and San Bernardino Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	031	0	1	01	01	H0523_031_0	3			1		08/02/2017	2018.03	08/02/2017 08:21:58 AM Mountain Daylight Time	08/03/2017 02:51:31 PM Eastern Daylight Time	07/31/2017 05:29:25 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	031	0	2018	Kern County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	052	0	1	01	01	H0523_052_0	3			1		08/02/2017	2018.03	08/02/2017 08:23:59 AM Mountain Daylight Time	08/03/2017 02:52:29 PM Eastern Daylight Time	07/31/2017 05:29:54 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	052	0	2018	San Diego County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	060	0	1	01	01	H0523_060_0	3			1		08/02/2017	2018.03	08/02/2017 02:52:32 PM Mountain Daylight Time	08/03/2017 02:53:17 PM Eastern Daylight Time	07/31/2017 05:30:23 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H0523	060	0	2018	Orange County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	061	0	1	01	01	H0523_061_0	3			1		08/02/2017	2018.03	08/02/2017 02:55:17 PM Mountain Daylight Time	08/03/2017 02:54:22 PM Eastern Daylight Time	07/31/2017 05:30:52 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H0523	061	0	2018	Los Angeles County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	063	0	1	01	01	H0523_063_0	3			1		08/02/2017	2018.03	08/02/2017 12:32:02 PM Mountain Daylight Time	08/03/2017 02:55:40 PM Eastern Daylight Time	07/31/2017 05:31:21 PM Eastern Daylight Time			08/04/2017 05:19:29 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H0523	063	0	2018	San Bernardino County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0523	801	0	1	01	01	H0523_801_0	2			1		06/02/2017	2018.03	06/02/2017 01:25:52 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H0523	801	0	2018	California		1	6590	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H0523	805	0	1	01	01	H0523_805_0	2			1		06/02/2017	2018.03	06/02/2017 01:26:22 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA INC.	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H0523	805	0	2018	California		1	8780	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H0524	002	0	2	01	01	H0524_002_0	8			1		08/04/2017	2018.03	08/04/2017 10:27:03 AM Pacific Daylight Time	08/02/2017 05:09:12 PM Pacific Daylight Time	08/02/2017 04:44:52 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage B Only South (HMO)	01	01		2	1		H0524	002	0	2018	Part B Only Southern California Area		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	003	0	1	01	01	H0524_003_0	6			1		08/04/2017	2018.03	08/04/2017 10:25:22 AM Pacific Daylight Time	08/02/2017 05:10:12 PM Pacific Daylight Time	08/02/2017 04:45:46 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)	01	01		1			H0524	003	0	2018	Los Angeles and Orange Counties Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	008	0	1	01	01	H0524_008_0	6			1		08/04/2017	2018.03	08/04/2017 10:23:48 AM Pacific Daylight Time	08/02/2017 04:55:12 PM Pacific Daylight Time	08/02/2017 04:32:44 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Solano (HMO)	01	01		1			H0524	008	0	2018	Solano County Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	010	0	2	01	01	H0524_010_0	7			1		08/04/2017	2018.03	08/04/2017 10:25:04 AM Pacific Daylight Time	08/02/2017 04:56:11 PM Pacific Daylight Time	08/02/2017 04:33:37 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage B Only North (HMO)	01	01		2	1		H0524	010	0	2018	Part B Only Northern California Area		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	013	0	1	01	01	H0524_013_0	6			1		08/04/2017	2018.03	08/04/2017 10:23:34 AM Pacific Daylight Time	08/02/2017 04:57:11 PM Pacific Daylight Time	08/02/2017 04:34:29 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Sr Adv Enhanced Sac., Sonoma (HMO)	01	01		1			H0524	013	0	2018	Greater Sac and Sonoma County Plan - Enhanced		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	015	0	1	01	01	H0524_015_0	6			1		08/04/2017	2018.03	08/04/2017 10:25:44 AM Pacific Daylight Time	08/02/2017 05:11:12 PM Pacific Daylight Time	08/02/2017 04:46:40 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Inland Empire (HMO)	01	01		1			H0524	015	0	2018	Inland Empire Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	029	0	1	01	01	H0524_029_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:26:57 AM Pacific Daylight Time	08/04/2017 09:35:10 AM Pacific Daylight Time	08/02/2017 04:51:56 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)	01	01		1			H0524	029	0	2018	Southern California Plan		2		2			1	3		1		2	kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	030	0	1	01	01	H0524_030_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:24:56 AM Pacific Daylight Time	08/04/2017 09:32:37 AM Pacific Daylight Time	08/02/2017 04:51:02 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Senior Advantage Medicare Medi-Cal Plan North (HMO SNP)	01	01		1			H0524	030	0	2018	Northern California Plan		2		2			1	3		1		2	kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	031	0	1	01	01	H0524_031_0	6			1		08/04/2017	2018.03	08/04/2017 10:24:02 AM Pacific Daylight Time	08/02/2017 04:58:11 PM Pacific Daylight Time	08/02/2017 04:35:21 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Marin San Mateo (HMO)	01	01		1			H0524	031	0	2018	Marin and San Mateo Counties Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	032	0	1	01	01	H0524_032_0	6			1		08/04/2017	2018.03	08/04/2017 10:24:15 AM Pacific Daylight Time	08/02/2017 04:59:12 PM Pacific Daylight Time	08/02/2017 04:36:13 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Alam., SF, Napa (HMO)	01	01		1			H0524	032	0	2018	Alameda, Napa, and SF Counties Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	033	0	1	01	01	H0524_033_0	6			1		08/04/2017	2018.03	08/04/2017 10:24:25 AM Pacific Daylight Time	08/02/2017 05:00:12 PM Pacific Daylight Time	08/02/2017 04:37:04 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Contra Costa (HMO)	01	01		1			H0524	033	0	2018	Contra Costa County Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	034	0	1	01	01	H0524_034_0	6			1		08/04/2017	2018.03	08/04/2017 10:26:00 AM Pacific Daylight Time	08/02/2017 05:12:11 PM Pacific Daylight Time	08/02/2017 04:47:33 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Ventura (HMO)	01	01		1			H0524	034	0	2018	Ventura County Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	035	0	1	01	01	H0524_035_0	6			1		08/04/2017	2018.03	08/04/2017 10:26:15 AM Pacific Daylight Time	08/02/2017 05:13:11 PM Pacific Daylight Time	08/02/2017 04:48:27 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Kern (HMO)	01	01		1			H0524	035	0	2018	Kern County Plan - Enhanced		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	036	0	1	01	01	H0524_036_0	6			1		08/04/2017	2018.03	08/04/2017 10:26:29 AM Pacific Daylight Time	08/02/2017 05:14:10 PM Pacific Daylight Time	08/02/2017 04:49:19 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Kern (HMO)	01	01		1			H0524	036	0	2018	Kern County Plan - Basic		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	037	0	1	01	01	H0524_037_0	6			1		08/04/2017	2018.03	08/04/2017 10:26:43 AM Pacific Daylight Time	08/02/2017 05:15:10 PM Pacific Daylight Time	08/02/2017 04:50:08 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage San Diego (HMO)	01	01		1			H0524	037	0	2018	San Diego County Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	038	0	1	01	01	H0524_038_0	6			1		08/04/2017	2018.03	08/04/2017 10:22:58 AM Pacific Daylight Time	08/02/2017 05:01:13 PM Pacific Daylight Time	08/02/2017 04:37:59 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Fresno (HMO)	01	01		1			H0524	038	0	2018	Greater Fresno Area Plan - Enhanced		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	039	0	1	01	01	H0524_039_0	6			1		08/04/2017	2018.03	08/04/2017 10:24:42 AM Pacific Daylight Time	08/02/2017 05:02:13 PM Pacific Daylight Time	08/02/2017 04:38:50 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Santa Clara (HMO)	01	01		1			H0524	039	0	2018	Santa Clara County Plan		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	040	0	1	01	01	H0524_040_0	6			1		08/04/2017	2018.03	08/04/2017 10:21:45 AM Pacific Daylight Time	08/02/2017 05:03:14 PM Pacific Daylight Time	08/02/2017 04:39:43 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Stanis (HMO)	01	01		1			H0524	040	0	2018	Stanislaus County Plan - Enhanced		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	041	0	1	01	01	H0524_041_0	6			1		08/04/2017	2018.03	08/04/2017 10:20:59 AM Pacific Daylight Time	08/02/2017 05:04:13 PM Pacific Daylight Time	08/02/2017 04:40:31 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Stanis (HMO)	01	01		1			H0524	041	0	2018	Stanislaus County Plan - Basic		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	042	0	1	01	01	H0524_042_0	6			1		08/04/2017	2018.03	08/04/2017 10:22:21 AM Pacific Daylight Time	08/02/2017 05:05:13 PM Pacific Daylight Time	08/02/2017 04:41:25 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced SnJoaq (HMO)	01	01		1			H0524	042	0	2018	San Joaquin County Plan - Enhanced		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	043	0	1	01	01	H0524_043_0	6			1		08/04/2017	2018.03	08/04/2017 10:22:05 AM Pacific Daylight Time	08/02/2017 05:06:13 PM Pacific Daylight Time	08/02/2017 04:42:15 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic SnJoaq (HMO)	01	01		1			H0524	043	0	2018	San Joaquin County Plan - Basic		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	046	0	1	01	01	H0524_046_0	6			1		08/04/2017	2018.03	08/04/2017 10:22:42 AM Pacific Daylight Time	08/02/2017 05:07:13 PM Pacific Daylight Time	08/02/2017 04:43:07 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Fresno (HMO)	01	01		1			H0524	046	0	2018	Greater Fresno Area Plan - Basic		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	051	0	1	01	01	H0524_051_0	6			1		08/04/2017	2018.03	08/04/2017 10:23:18 AM Pacific Daylight Time	08/02/2017 05:08:12 PM Pacific Daylight Time	08/02/2017 04:43:58 PM Pacific Daylight Time			08/04/2017 05:01:45 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO)	01	01		1			H0524	051	0	2018	Greater Sac and Sonoma County Plan - Basic		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0524	801	0	1	01	01	H0524_801_0	2			1		05/30/2017	2018.03	05/30/2017 09:19:54 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	801	0	2018	Southern California Group Part A B		1	38321	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	802	0	1	01	01	H0524_802_0	2			1		05/30/2017	2018.03	05/30/2017 09:25:29 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	802	0	2018	Northern California Group Part A B		1	106553	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	803	0	2	01	01	H0524_803_0	2			1		05/30/2017	2018.03	05/30/2017 09:26:37 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	803	0	2018	Southern California Group B Only		1	36	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	804	0	2	01	01	H0524_804_0	2			1		05/30/2017	2018.03	05/30/2017 09:26:57 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	804	0	2018	Northern California Group B Only		1	84	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	805	0	1	01	01	H0524_805_0	2			1		05/30/2017	2018.03	05/30/2017 09:27:47 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	805	0	2018	Southern California Group Part A B Part D		1	2039723	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	806	0	1	01	01	H0524_806_0	2			1		05/30/2017	2018.03	05/30/2017 09:28:10 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	806	0	2018	Northern California Group Part A B Part D		1	2186313	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	807	0	2	01	01	H0524_807_0	2			1		05/30/2017	2018.03	05/30/2017 09:28:30 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	807	0	2018	Southern California Group Part B only  Part D		1	23936	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	808	0	2	01	01	H0524_808_0	2			1		05/30/2017	2018.03	05/30/2017 09:28:52 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	808	0	2018	Northern California Group Part B only Part D		1	5290	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	809	0	1	01	01	H0524_809_0	2			1		05/30/2017	2018.03	05/30/2017 09:29:13 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB Part AB with D (HMO)	01	01		1			H0524	809	0	2018	Southern California Plan		1	127695	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	810	0	1	01	01	H0524_810_0	2			1		05/30/2017	2018.03	05/30/2017 09:29:33 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB Part AB with D (HMO)	01	01		1			H0524	810	0	2018	Northern California Plan		1	136562	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	811	0	2	01	01	H0524_811_0	2			1		05/30/2017	2018.03	05/30/2017 09:29:54 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB Part B Only with D (HMO)	01	01		2	1		H0524	811	0	2018	Southern California Plan		1	432	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0524	812	0	2	01	01	H0524_812_0	2			1		05/30/2017	2018.03	05/30/2017 09:30:18 PM Pacific Daylight Time					06/02/2017 06:17:18 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB Part B Only with D (HMO)	01	01		2	1		H0524	812	0	2018	Northern California Plan		1	128	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(800)443-0815		(800)443-0815		(800)777-1238		(800)777-1238		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;11a;11b;11c;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;14a;14d;14e3;16b;17a;18a;	1					2				
H0542	001	0	1	20	08	H0542_001_0	1			1		05/23/2017	2018.03	05/23/2017 02:03:49 PM Pacific Daylight Time		05/23/2017 01:59:00 PM Pacific Daylight Time			05/23/2017 02:05:47 PM Pacific Daylight Time	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Health Services Corporation	www.altamed.org	AltaMed Health Services Corporation (PACE)	08	20		1			H0542	001	0	2018	Los Angeles County		2		2			2						http://www.altamed.org/	http://www.altamed.org/										(877)462-2582		(323)728-0411		(877)462-2582		(323)728-0411										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H0542	002	0	1	20	08	H0542_002_0	1			1		05/23/2017	2018.03	05/23/2017 02:04:16 PM Pacific Daylight Time		05/23/2017 01:59:25 PM Pacific Daylight Time			05/23/2017 02:05:47 PM Pacific Daylight Time	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Health Services Corporation	www.altamed.org	AltaMed Health Services Corporation (PACE)	08	20		1			H0542	002	0	2018	Los Angeles County		2		2			2						http://www.altamed.org/	http://www.altamed.org/										(877)462-2582		(323)728-0411		(877)462-2582		(323)728-0411										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H0543	001	0	1	01	01	H0543_001_0	4			1		08/03/2017	2018.03	08/03/2017 11:38:26 AM Central Daylight Time	08/03/2017 12:58:45 PM Central Daylight Time	08/04/2017 03:20:09 PM Central Daylight Time			08/04/2017 03:29:13 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	001	0	2018	Los Angeles county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	004	0	1	01	01	H0543_004_0	3			1		08/02/2017	2018.03	08/02/2017 02:36:59 PM Central Daylight Time	08/03/2017 12:59:18 PM Central Daylight Time	08/01/2017 08:52:28 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	004	0	2018	Orange County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	007	0	1	01	01	H0543_007_0	3			1		08/02/2017	2018.03	08/02/2017 02:41:32 PM Central Daylight Time	08/03/2017 12:59:51 PM Central Daylight Time	08/01/2017 08:53:01 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	007	0	2018	Riverside and San Bernardino counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	013	0	1	01	01	H0543_013_0	3			1		06/28/2017	2018.03	06/28/2017 03:01:43 PM Central Daylight Time	08/03/2017 01:00:24 PM Central Daylight Time	08/01/2017 08:53:28 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Value (HMO)	01	01		1			H0543	013	0	2018	San Diego county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	019	0	1	01	01	H0543_019_0	3			1		08/02/2017	2018.03	08/02/2017 02:42:21 PM Central Daylight Time	08/03/2017 01:00:57 PM Central Daylight Time	08/01/2017 08:53:58 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	019	0	2018	Kern county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	022	0	1	01	01	H0543_022_0	3			1		06/28/2017	2018.03	06/28/2017 10:03:26 AM Central Daylight Time	08/03/2017 01:01:30 PM Central Daylight Time	08/01/2017 08:54:25 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	022	0	2018	Ventura county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	028	0	1	01	01	H0543_028_0	3			1		05/30/2017	2018.03	05/30/2017 02:24:19 PM Central Daylight Time	08/03/2017 01:02:04 PM Central Daylight Time	08/01/2017 08:54:51 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	028	0	2018	San Mateo county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	029	0	1	01	01	H0543_029_0	3			1		06/28/2017	2018.03	06/28/2017 10:04:16 AM Central Daylight Time	08/03/2017 01:02:37 PM Central Daylight Time	08/01/2017 08:55:17 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	029	0	2018	Santa Clara county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	032	0	1	01	01	H0543_032_0	3			1		05/25/2017	2018.03	05/25/2017 11:12:29 AM Central Daylight Time	08/03/2017 01:03:11 PM Central Daylight Time	08/01/2017 08:55:43 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	032	0	2018	Santa Barbara and San Luis Obispo counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	035	0	1	01	01	H0543_035_0	3			1		05/25/2017	2018.03	05/25/2017 11:12:42 AM Central Daylight Time	08/03/2017 01:03:44 PM Central Daylight Time	08/01/2017 08:56:09 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	035	0	2018	Fresno and Madera counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	036	0	1	01	01	H0543_036_0	3			1		05/30/2017	2018.03	05/30/2017 02:24:49 PM Central Daylight Time	08/03/2017 01:04:16 PM Central Daylight Time	08/01/2017 08:56:36 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	036	0	2018	Stanislaus county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	060	0	1	01	01	H0543_060_0	3			1		06/28/2017	2018.03	06/28/2017 03:02:13 PM Central Daylight Time	08/03/2017 01:04:49 PM Central Daylight Time	08/01/2017 08:57:03 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	060	0	2018	San Diego county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	070	0	1	01	01	H0543_070_0	3			1		06/28/2017	2018.03	06/28/2017 10:07:40 AM Central Daylight Time	08/03/2017 01:05:22 PM Central Daylight Time	08/01/2017 08:57:31 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	070	0	2018	Alameda and Contra Costa counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	086	0	1	01	01	H0543_086_0	3			1		05/25/2017	2018.03	05/25/2017 11:13:58 AM Central Daylight Time	08/03/2017 01:05:55 PM Central Daylight Time	08/01/2017 08:57:58 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	086	0	2018	Nevada county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	089	0	1	01	01	H0543_089_0	3			1		05/30/2017	2018.03	05/30/2017 02:27:32 PM Central Daylight Time	08/03/2017 01:06:28 PM Central Daylight Time	08/01/2017 08:58:26 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	089	0	2018	Placer, Sacramento, and Yolo counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	121	0	1	01	01	H0543_121_0	4			1		05/11/2017	2018.03	05/11/2017 07:17:50 PM Central Daylight Time	06/01/2017 02:24:05 PM Central Daylight Time				07/06/2017 03:14:18 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0543	121	0	2018	Kern,LA,Orange,Riverside,San Bernardino,San Diego		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0543	138	0	1	01	01	H0543_138_0	3			1		08/02/2017	2018.03	08/02/2017 02:42:41 PM Central Daylight Time	08/03/2017 01:07:01 PM Central Daylight Time	08/01/2017 08:58:52 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	138	0	2018	Orange county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	140	0	1	01	01	H0543_140_0	3			1		05/25/2017	2018.03	05/25/2017 11:14:53 AM Central Daylight Time	08/03/2017 01:07:35 PM Central Daylight Time	08/01/2017 08:59:19 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	140	0	2018	Amador, El Dorado, Mendocino,Merced,Tulare		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	144	0	1	01	01	H0543_144_0	3			1		08/02/2017	2018.03	08/02/2017 02:43:28 PM Central Daylight Time	08/03/2017 01:08:08 PM Central Daylight Time	08/01/2017 08:59:47 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	144	0	2018	Riverside and San Bernardino counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	145	0	1	01	01	H0543_145_0	3			1		08/02/2017	2018.03	08/02/2017 02:47:46 PM Central Daylight Time	08/03/2017 01:08:41 PM Central Daylight Time	08/01/2017 09:00:14 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.UHCMedicareSolutions.com	Sharp SecureHorizons Plan by UnitedHealthcare (HMO)	01	01		1			H0543	145	0	2018	San Diego county		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	146	0	1	01	01	H0543_146_0	3			1		05/25/2017	2018.03	05/25/2017 11:15:43 AM Central Daylight Time	08/03/2017 01:09:14 PM Central Daylight Time	08/01/2017 09:00:50 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	146	0	2018	Placer, Sacramento, and Yolo counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	147	0	1	01	01	H0543_147_0	3			1		07/05/2017	2018.03	07/05/2017 02:05:18 PM Central Daylight Time	08/03/2017 01:09:47 PM Central Daylight Time	08/01/2017 09:01:36 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	147	0	2018	Stanislaus county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	148	0	1	01	01	H0543_148_0	3			1		05/25/2017	2018.03	05/25/2017 11:16:29 AM Central Daylight Time	08/03/2017 01:10:20 PM Central Daylight Time	08/01/2017 09:02:02 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	148	0	2018	Sonoma county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	151	0	1	01	01	H0543_151_0	3			1		08/03/2017	2018.03	08/03/2017 11:39:02 AM Central Daylight Time	08/03/2017 01:10:53 PM Central Daylight Time	08/01/2017 09:02:28 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	151	0	2018	Los Angeles county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	152	0	1	01	01	H0543_152_0	3			1		08/02/2017	2018.03	08/02/2017 02:51:07 PM Central Daylight Time	08/03/2017 01:11:26 PM Central Daylight Time	08/01/2017 09:03:31 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 4 (HMO)	01	01		1			H0543	152	0	2018	San Diego county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	153	0	1	01	01	H0543_153_0	4			1		06/02/2017	2018.03	06/02/2017 11:35:43 AM Central Daylight Time	08/03/2017 01:11:59 PM Central Daylight Time	08/01/2017 09:03:57 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 3 (HMO)	01	01		1			H0543	153	0	2018	Los Angeles, Orange, Riverside, and San Bernardino		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	158	0	1	01	01	H0543_158_0	4			1		06/01/2017	2018.03	06/01/2017 10:06:49 AM Central Daylight Time	08/03/2017 01:12:33 PM Central Daylight Time	08/01/2017 09:04:26 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	158	0	2018	San Mateo County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	163	0	1	01	01	H0543_163_0	4			1		06/01/2017	2018.03	06/01/2017 10:07:27 AM Central Daylight Time	08/03/2017 01:13:06 PM Central Daylight Time	08/01/2017 09:04:53 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	163	0	2018	Contra Costa County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	164	0	1	01	01	H0543_164_0	4			1		06/28/2017	2018.03	06/28/2017 03:02:39 PM Central Daylight Time	08/03/2017 01:13:39 PM Central Daylight Time	08/01/2017 09:05:19 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	164	0	2018	Los Angeles County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	165	0	1	01	01	H0543_165_0	4			1		06/28/2017	2018.03	06/28/2017 03:02:51 PM Central Daylight Time	08/03/2017 01:14:13 PM Central Daylight Time	08/01/2017 09:05:45 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	165	0	2018	Orange County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	166	0	1	01	01	H0543_166_0	4			1		06/28/2017	2018.03	06/28/2017 03:03:18 PM Central Daylight Time	08/03/2017 01:14:46 PM Central Daylight Time	08/01/2017 09:06:12 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	166	0	2018	Riverside and San Bernardino Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	167	0	1	01	01	H0543_167_0	4			1		06/01/2017	2018.03	06/01/2017 10:13:07 AM Central Daylight Time	08/03/2017 01:15:19 PM Central Daylight Time	08/01/2017 09:06:38 AM Central Daylight Time			08/04/2017 01:16:16 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	167	0	2018	San Luis Obispo County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0543	802	0	1	01	01	H0543_802_0	3			1		06/08/2017	2018.03	06/08/2017 11:15:49 AM Central Daylight Time					08/07/2017 04:17:26 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	802	0	2018	CA Employer Sponsored Plan Service Area		1	82716	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0543	805	0	1	01	01	H0543_805_0	3			1		06/08/2017	2018.03	06/08/2017 11:16:18 AM Central Daylight Time					08/07/2017 04:17:26 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	805	0	2018	CA Employer Sponsored Plan Service Area		1	205584	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0543	806	0	1	01	01	H0543_806_0	3			1		06/08/2017	2018.03	06/08/2017 11:16:39 AM Central Daylight Time					08/07/2017 04:17:26 PM Central Daylight Time	UHC OF CALIFORNIA	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	806	0	2018	CA Employer Sponsored Plan Service Area		1	52104	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0544	002	0	1	01	01	H0544_002_0	5			1		08/03/2017	2018.03	08/03/2017 11:39:44 AM Pacific Daylight Time	08/03/2017 02:52:49 PM Pacific Daylight Time	08/02/2017 12:19:02 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Value Plus (HMO)	01	01		1			H0544	002	0	2018	Los Angeles and Orange Counties		2	250119	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	003	0	1	01	01	H0544_003_0	5		1	1	2	08/03/2017	2018.03	08/03/2017 11:44:19 AM Pacific Daylight Time	08/03/2017 02:54:25 PM Pacific Daylight Time	08/02/2017 12:19:30 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Connect (HMO SNP)	01	01		1			H0544	003	0	2018	Los Angeles County		2	954	2			1	3		2		2	www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3146		(800)589-3146		(866)622-2820		(866)622-2820		(800)589-3146		(800)589-3146		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	004	0	1	01	01	H0544_004_0	7		1	1		08/02/2017	2018.03	08/02/2017 04:34:20 PM Pacific Daylight Time	08/03/2017 02:56:01 PM Pacific Daylight Time	08/02/2017 12:19:57 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Diabetes (HMO SNP)	01	01		1			H0544	004	0	2018	Los Angeles and Orange Counties		2	124217	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3145		(800)589-3145		(866)622-2820		(866)622-2820		(800)589-3145		(800)589-3145		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	005	0	1	01	01	H0544_005_0	7		1	1		08/02/2017	2018.03	08/02/2017 04:34:53 PM Pacific Daylight Time	08/03/2017 02:55:13 PM Pacific Daylight Time	08/02/2017 12:20:25 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Touch (HMO SNP)	01	01		1			H0544	005	0	2018	Los Angeles and Orange Counties		2	28762	2			1	1	3				www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	007	0	1	01	01	H0544_007_0	5			1		08/02/2017	2018.03	08/02/2017 04:36:27 PM Pacific Daylight Time	08/03/2017 02:53:38 PM Pacific Daylight Time	08/02/2017 12:20:52 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem StartSmart Plus (HMO)	01	01		1			H0544	007	0	2018	L.A., Orange, San Bernardino Counties		2	12976	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	008	0	1	01	01	H0544_008_0	5			1		08/03/2017	2018.03	08/03/2017 02:16:04 PM Pacific Daylight Time	08/03/2017 03:02:30 PM Pacific Daylight Time	08/02/2017 12:21:20 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Value Plus (HMO)	01	01		1			H0544	008	0	2018	San Bernardino County		2	29724	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	010	0	1	01	01	H0544_010_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:46:50 PM Pacific Daylight Time	08/03/2017 03:03:17 PM Pacific Daylight Time	08/02/2017 12:21:47 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Diabetes (HMO SNP)	01	01		1			H0544	010	0	2018	San Bernardino County		2	21717	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3145		(800)589-3145		(866)622-2820		(866)622-2820		(800)589-3145		(800)589-3145		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	012	0	1	01	01	H0544_012_0	5			1		08/03/2017	2018.03	08/03/2017 02:36:51 PM Pacific Daylight Time	08/03/2017 03:08:04 PM Pacific Daylight Time	08/02/2017 12:22:15 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Value Plus (HMO)	01	01		1			H0544	012	0	2018	Santa Clara County, San Benito County		2	21103	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	013	0	1	01	01	H0544_013_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:53:39 PM Pacific Daylight Time	08/03/2017 02:57:34 PM Pacific Daylight Time	08/02/2017 12:22:43 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Heart (HMO SNP)	01	01		1			H0544	013	0	2018	Los Angeles and Orange Counties		2	19740	2			1	4			00000000000000010000		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	014	0	1	01	01	H0544_014_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:54:03 PM Pacific Daylight Time	08/03/2017 02:56:48 PM Pacific Daylight Time	08/02/2017 12:23:11 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Breathe (HMO SNP)	01	01		1			H0544	014	0	2018	Los Angeles and Orange Counties		2	15422	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	015	0	1	01	01	H0544_015_0	7		1	1		08/03/2017	2018.03	08/03/2017 02:46:31 PM Pacific Daylight Time		08/02/2017 12:23:36 PM Pacific Daylight Time		08/03/2017 03:31:39 PM Pacific Daylight Time	08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem ESRD (HMO SNP)	01	01		1			H0544	015	0	2018	Los Angeles and Orange Counties		2	16212	2			1	4			00000000100000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4177		(888)357-4177		(866)622-2820		(866)622-2820		(888)357-4177		(888)357-4177		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	019	0	1	01	01	H0544_019_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:56:24 PM Pacific Daylight Time	08/03/2017 03:04:04 PM Pacific Daylight Time	08/02/2017 12:24:03 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Breathe (HMO SNP)	01	01		1			H0544	019	0	2018	San Bernardino County		2	5821	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	020	0	1	01	01	H0544_020_0	5		1	1		08/03/2017	2018.03	08/03/2017 02:47:52 PM Pacific Daylight Time		08/02/2017 12:24:30 PM Pacific Daylight Time		08/03/2017 03:32:19 PM Pacific Daylight Time	08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem ESRD (HMO SNP)	01	01		1			H0544	020	0	2018	San Bernardino County		2	2773	2			1	4			00000000100000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4177		(888)357-4177		(866)622-2820		(866)622-2820		(888)357-4177		(888)357-4177		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	021	0	1	01	01	H0544_021_0	5			1		08/03/2017	2018.03	08/03/2017 12:05:48 PM Pacific Daylight Time	08/03/2017 03:08:51 PM Pacific Daylight Time	08/02/2017 12:24:57 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem StartSmart Plus (HMO)	01	01		1			H0544	021	0	2018	Santa Clara, Stanislaus, San Benito		2	40344	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	024	0	1	01	01	H0544_024_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:58:58 PM Pacific Daylight Time	08/03/2017 03:11:57 PM Pacific Daylight Time	08/02/2017 12:25:24 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Breathe (HMO SNP)	01	01		1			H0544	024	0	2018	Santa Clara, San Benito County		2	1816	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	025	0	1	01	01	H0544_025_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:59:30 PM Pacific Daylight Time	08/03/2017 03:11:14 PM Pacific Daylight Time	08/02/2017 12:25:52 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Diabetes (HMO SNP)	01	01		1			H0544	025	0	2018	Santa Clara, San Benito County		2	9849	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	027	0	1	01	01	H0544_027_0	5			1		08/02/2017	2018.03	08/02/2017 05:00:03 PM Pacific Daylight Time	08/03/2017 03:23:01 PM Pacific Daylight Time	08/02/2017 12:26:19 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Value Plus (HMO)	01	01		1			H0544	027	0	2018	Stanislaus County		2	20813	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	031	0	1	01	01	H0544_031_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:00:35 PM Pacific Daylight Time	08/03/2017 03:24:35 PM Pacific Daylight Time	08/02/2017 12:26:46 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Breathe (HMO SNP)	01	01		1			H0544	031	0	2018	Stanislaus County		2	2377	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	032	0	1	01	01	H0544_032_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:00:58 PM Pacific Daylight Time	08/03/2017 03:23:48 PM Pacific Daylight Time	08/02/2017 12:27:13 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Diabetes (HMO SNP)	01	01		1			H0544	032	0	2018	Stanislaus County		2	11491	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	036	0	1	01	01	H0544_036_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:01:20 PM Pacific Daylight Time	08/03/2017 03:25:22 PM Pacific Daylight Time	08/02/2017 12:27:41 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem Heart (HMO SNP)	01	01		1			H0544	036	0	2018	Stanislaus County		2	1860	2			1	4			00000000000000010000		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	037	0	1	01	01	H0544_037_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:01:47 PM Pacific Daylight Time	08/03/2017 03:12:45 PM Pacific Daylight Time	08/02/2017 12:28:08 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem Heart (HMO SNP)	01	01		1			H0544	037	0	2018	Santa Clara, San Benito County		2	1659	2			1	4			00000000000000010000		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	038	0	1	01	01	H0544_038_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:02:33 PM Pacific Daylight Time	08/03/2017 03:04:52 PM Pacific Daylight Time	08/02/2017 12:28:35 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem Heart (HMO SNP)	01	01		1			H0544	038	0	2018	San Bernardino County		2	4104	2			1	4			00000000000000010000		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	041	0	1	01	01	H0544_041_0	5		1	1	2	08/03/2017	2018.03	08/03/2017 01:29:13 PM Pacific Daylight Time	08/03/2017 03:09:39 PM Pacific Daylight Time	08/02/2017 12:29:00 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Connect (HMO SNP)	01	01		1			H0544	041	0	2018	Santa Clara County		2	155	2			1	3		2		2	www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3146		(800)589-3146		(866)622-2820		(866)622-2820		(800)589-3146		(800)589-3146		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	049	0	1	01	01	H0544_049_0	5			1		08/02/2017	2018.03	08/02/2017 05:03:28 PM Pacific Daylight Time	08/03/2017 03:05:42 PM Pacific Daylight Time	08/02/2017 01:08:37 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.caremore.com	Anthem Connect Plus (HMO)	01	01		1			H0544	049	0	2018	Counties: LA, Orange, San Bern., SC, San Benito		2	41803	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	050	0	1	01	01	H0544_050_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:04:13 PM Pacific Daylight Time	08/03/2017 03:10:27 PM Pacific Daylight Time	08/02/2017 12:29:30 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem Touch (HMO SNP)	01	01		1			H0544	050	0	2018	Santa Clara County		2	3361	2			1	1	3				www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	052	0	1	01	01	H0544_052_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 09:59:26 AM Pacific Daylight Time	08/07/2017 05:49:34 AM Pacific Daylight Time	08/06/2017 12:03:55 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H0544	052	0	2018	Fresno, Kings, Madera and Tulare Counties		2	13973	2			1	3		1		1	www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)398-0642		(844)398-0642		(888)230-7338		(888)230-7338		(844)799-9866		(844)799-9866		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	053	0	1	01	01	H0544_053_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 10:06:43 AM Pacific Daylight Time	08/07/2017 05:49:35 AM Pacific Daylight Time	08/06/2017 12:03:56 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H0544	053	0	2018	Kern County		2	13993	2			1	3		1		1	www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)398-0642		(844)398-0642		(888)230-7338		(888)230-7338		(844)799-9866		(844)799-9866		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	054	0	1	01	01	H0544_054_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 10:10:41 AM Pacific Daylight Time	08/07/2017 05:49:35 AM Pacific Daylight Time	08/06/2017 12:03:56 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H0544	054	0	2018	San Francisco and Sacramento Counties		2	50775	2			1	3		1		1	www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)398-0642		(844)398-0642		(888)230-7338		(888)230-7338		(844)799-9866		(844)799-9866		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	055	0	1	01	01	H0544_055_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 11:38:15 AM Pacific Daylight Time	08/07/2017 05:49:36 AM Pacific Daylight Time	08/06/2017 12:03:56 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H0544	055	0	2018	Ventura County		2	13250	2			1	3		1		1	www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)398-0642		(844)398-0642		(888)230-7338		(888)230-7338		(844)799-9866		(844)799-9866		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	056	0	1	01	01	H0544_056_0	6			1		08/04/2017	2018.03	08/04/2017 11:46:16 AM Pacific Daylight Time	08/07/2017 05:49:36 AM Pacific Daylight Time	08/06/2017 12:03:57 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	056	0	2018	Fresno, Kings, Madera and Tulare Counties		2	13298	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	057	0	1	01	01	H0544_057_0	6			1		08/04/2017	2018.03	08/04/2017 11:59:01 AM Pacific Daylight Time	08/07/2017 05:49:37 AM Pacific Daylight Time	08/06/2017 12:03:57 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	057	0	2018	San Francisco County		2	43581	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	058	0	1	01	01	H0544_058_0	7			1		08/04/2017	2018.03	08/04/2017 12:01:18 PM Pacific Daylight Time	08/07/2017 05:49:37 AM Pacific Daylight Time	08/06/2017 12:03:57 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Select (HMO)	01	01		1			H0544	058	0	2018	Los Angeles County		2	51080	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	059	0	1	01	01	H0544_059_0	7			1		08/04/2017	2018.03	08/04/2017 12:06:56 PM Pacific Daylight Time	08/07/2017 05:49:38 AM Pacific Daylight Time	08/06/2017 12:03:58 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Select (HMO)	01	01		1			H0544	059	0	2018	Orange County		2	14676	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	060	3	1	01	01	H0544_060_3	6			1		08/04/2017	2018.03	08/04/2017 06:21:11 PM Pacific Daylight Time	08/07/2017 05:49:38 AM Pacific Daylight Time	08/06/2017 12:03:58 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	060	3	2018	San Bernardino and Riverside Counties	San Bernardino County	2	5425	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	060	4	1	01	01	H0544_060_4	6			1		08/04/2017	2018.03	08/04/2017 06:22:47 PM Pacific Daylight Time	08/07/2017 05:49:39 AM Pacific Daylight Time	08/06/2017 12:03:58 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	060	4	2018	San Bernardino and Riverside Counties	Riverside County	2	8045	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	061	0	1	01	01	H0544_061_0	6			1		08/04/2017	2018.03	08/04/2017 12:19:58 PM Pacific Daylight Time	08/07/2017 05:49:39 AM Pacific Daylight Time	08/06/2017 12:03:59 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	061	0	2018	Orange and Los Angeles Counties		2	18725	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	062	0	1	01	01	H0544_062_0	7			1		08/04/2017	2018.03	08/04/2017 12:22:40 PM Pacific Daylight Time	08/07/2017 05:49:39 AM Pacific Daylight Time	08/06/2017 12:03:59 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	062	0	2018	Kern County		2	37039	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	063	0	1	01	01	H0544_063_0	7			1		08/04/2017	2018.03	08/04/2017 12:25:28 PM Pacific Daylight Time	08/07/2017 05:49:40 AM Pacific Daylight Time	08/06/2017 12:03:59 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	063	0	2018	Ventura County		2	30007	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	064	0	1	01	01	H0544_064_0	6			1		08/04/2017	2018.03	08/04/2017 12:32:18 PM Pacific Daylight Time	08/07/2017 05:49:40 AM Pacific Daylight Time	08/06/2017 12:04:00 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	064	0	2018	Sacramento County		2	42355	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	065	0	1	01	01	H0544_065_0	7			1		08/04/2017	2018.03	08/04/2017 12:41:49 PM Pacific Daylight Time	08/07/2017 05:49:41 AM Pacific Daylight Time	08/06/2017 12:04:00 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	065	0	2018	San Diego County		2	17819	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	066	0	1	01	01	H0544_066_0	7			1		08/04/2017	2018.03	08/04/2017 12:45:31 PM Pacific Daylight Time	08/07/2017 05:49:41 AM Pacific Daylight Time	08/06/2017 12:04:00 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Select (HMO)	01	01		1			H0544	066	0	2018	San Bernardino County		2	8616	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	067	0	1	01	01	H0544_067_0	7			1		08/04/2017	2018.03	08/04/2017 01:13:18 PM Pacific Daylight Time	08/07/2017 05:49:42 AM Pacific Daylight Time	08/06/2017 12:04:00 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Select (HMO)	01	01		1			H0544	067	0	2018	Riverside County		2	22148	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	069	0	1	01	01	H0544_069_0	7			1		08/04/2017	2018.03	08/04/2017 01:15:29 PM Pacific Daylight Time	08/07/2017 05:49:42 AM Pacific Daylight Time	08/06/2017 12:03:54 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Select (HMO)	01	01		1			H0544	069	0	2018	San Francisco County		2	22082	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	070	0	1	01	01	H0544_070_0	7			1		08/04/2017	2018.03	08/04/2017 01:16:50 PM Pacific Daylight Time	08/07/2017 05:49:43 AM Pacific Daylight Time	08/06/2017 12:03:54 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Coordination Plus (HMO)	01	01		1			H0544	070	0	2018	San Diego County		2	15767	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)799-9862		(844)799-9862		(888)230-7338		(888)230-7338		(844)799-9863		(844)799-9863		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	071	0	1	01	01	H0544_071_0	7			1		08/04/2017	2018.03	08/04/2017 01:19:23 PM Pacific Daylight Time	08/07/2017 05:49:43 AM Pacific Daylight Time	08/06/2017 12:03:54 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Coordination Plus (HMO)	01	01		1			H0544	071	0	2018	Riverside and San Bernardino Counties		2	9930	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)799-9862		(844)799-9862		(888)230-7338		(888)230-7338		(844)799-9863		(844)799-9863		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	072	0	1	01	01	H0544_072_0	7			1		08/04/2017	2018.03	08/04/2017 01:21:20 PM Pacific Daylight Time	08/07/2017 05:49:44 AM Pacific Daylight Time	08/06/2017 12:03:55 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Coordination Plus (HMO)	01	01		1			H0544	072	0	2018	Los Angeles and Orange Counties		2	35401	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)799-9862		(844)799-9862		(888)230-7338		(888)230-7338		(844)799-9863		(844)799-9863		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	074	0	1	01	01	H0544_074_0	6			1		08/04/2017	2018.03	08/04/2017 01:33:29 PM Pacific Daylight Time	08/07/2017 05:49:33 AM Pacific Daylight Time	08/06/2017 12:03:55 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/shop	Anthem MediBlue Plus (HMO)	01	01		1			H0544	074	0	2018	Yolo County		2	895	2			2						www.caremore.com	www.caremore.com	www.anthem.com/ca/shop	(888)230-7338		(888)230-7338		(844)316-0357		(844)316-0357		(888)230-7338		(888)230-7338		(844)364-2108		(844)364-2108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	801	0	1	01	01	H0544_801_0	2			1		05/30/2017	2018.03	05/30/2017 09:58:15 AM Pacific Daylight Time					06/05/2017 06:21:25 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem EGWP (HMO)	01	01		1			H0544	801	0	2018	California		1	165	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0544	802	0	1	01	01	H0544_802_0	2			1		05/30/2017	2018.03	05/30/2017 09:58:47 AM Pacific Daylight Time					06/05/2017 06:21:25 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem EGWP MAPD (HMO)	01	01		1			H0544	802	0	2018	California		1	2065	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	804	0	1	01	01	H0544_804_0	2			1		05/30/2017	2018.03	05/30/2017 09:59:05 AM Pacific Daylight Time					06/05/2017 06:21:25 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	caremore.com	Anthem EGWP MAPD (HMO)	01	01		1			H0544	804	0	2018	California		1	65	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0544	805	0	1	01	01	H0544_805_0	8			1		06/03/2017	2018.03	06/03/2017 12:40:12 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		1			H0544	805	0	2018	California, select counties		1	5878	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;14d;14e1;14e2;14e3;	1					1				
H0544	806	0	1	01	01	H0544_806_0	7			1		06/03/2017	2018.03	06/03/2017 12:40:21 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		1			H0544	806	0	2018	California, select counties		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;14d;14e1;14e2;14e3;	1					1				
H0544	807	0	1	02	01	H0544_807_0	7			1		06/03/2017	2018.03	06/03/2017 12:40:43 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.anthem.com/ca/medicare	Senior Secure (HMO-POS)	01	02		1			H0544	807	0	2018	California, select counties		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;14d;14e1;14e2;14e3;	1	2		2		1				
H0544	808	0	2	01	01	H0544_808_0	7			1		06/03/2017	2018.03	06/03/2017 12:41:02 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	Blue Cross of California	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		2	1		H0544	808	0	2018	Select counties in California		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(800)225-2273		(800)225-2273		(877)826-1831		(877)826-1831		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;14d;14e1;14e2;14e3;	1					1				
H0545	001	0	1	01	01	H0545_001_0	7			1		06/30/2017	2018.03	06/30/2017 02:37:37 PM Pacific Daylight Time	08/01/2017 05:12:50 PM Pacific Daylight Time	08/02/2017 09:50:18 AM Pacific Daylight Time			08/04/2017 01:23:11 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Service To Seniors (HMO)	01	01		1			H0545	001	0	2018	Counties: LA, RV, OC and SB		2	232312	2			2						http://www.ivhp.com	www.ivhp.com	http://www.ivhp.com	(800)251-8191		(909)623-6333		(800)500-7018		(800)500-7018		(800)523-3142		(800)523-3142		(800)500-7018		(800)500-7018		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0545	012	0	1	01	01	H0545_012_0	7			1		06/23/2017	2018.03	06/23/2017 03:28:14 PM Pacific Daylight Time	08/03/2017 11:12:58 AM Pacific Daylight Time	08/02/2017 09:47:04 AM Pacific Daylight Time			08/04/2017 01:23:11 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Desert Preferred Choice (HMO)	01	01		1			H0545	012	0	2018	Riverside County		2	76944	2			2						http://www.ivhp.com	www.ivhp.com	http://www.ivhp.com	(800)251-8191		(800)251-8191		(800)500-7018		(800)500-7018		(800)523-3142		(800)523-3142		(800)500-7018		(800)500-7018		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		2					2					2	2			
H0545	014	0	1	01	01	H0545_014_0	6			1		06/23/2017	2018.03	06/23/2017 03:28:50 PM Pacific Daylight Time	08/01/2017 05:22:00 PM Pacific Daylight Time	08/02/2017 09:51:24 AM Pacific Daylight Time			08/04/2017 01:23:11 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Value Preferred Choice (HMO)	01	01		1			H0545	014	0	2018	Counties: LA, SB and Orange		2	3726	2			2						http://www.ivhp.com	www.ivhp.com	http://www.ivhp.com	(800)251-8191		(909)623-6333		(800)500-7018		(800)500-7018		(800)523-3142		(800)523-3142		(800)500-7018		(800)500-7018		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		2					2					2	2			
H0545	801	0	1	01	01	H0545_801_0	1			1		05/11/2017	2018.03	05/11/2017 04:15:46 PM Pacific Daylight Time					06/02/2017 02:57:10 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Active Plus I (HMO)	01	01		1			H0545	801	0	2018	Counties: LA, OC, RV SB		1	500	2			2						http://www.ivhp.com	www.ivhp.com	http://www.ivhp.com	(800)251-8191		(909)623-6333		(800)500-7018		(800)500-7018		(800)523-3142		(800)523-3142		(800)500-7018		(800)500-7018		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;17a;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;17a;18a;	2					1				
H0545	802	0	1	01	01	H0545_802_0	1			1		05/11/2017	2018.03	05/11/2017 04:17:28 PM Pacific Daylight Time					06/02/2017 02:57:10 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Active Plus II (HMO)	01	01		1			H0545	802	0	2018	Counties: LA, OC, RV SB		1	500	2			2						http://www.ivhp.com	www.ivhp.com	http://www.ivhp.com	(800)251-8191		(909)623-6333		(800)500-7018		(800)500-7018		(800)523-3142		(800)523-3142		(800)500-7018		(800)500-7018		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		(800)505-7150		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;17a;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;17a;18a;	2					1				
H0562	009	0	1	01	01	H0562_009_0	5			1		07/06/2017	2018.03	07/06/2017 02:17:00 PM Pacific Daylight Time	08/04/2017 04:34:09 PM Pacific Daylight Time	08/04/2017 04:34:09 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	009	0	2018	San Francisco County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4736		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	012	0	1	01	01	H0562_012_0	4			1		08/03/2017	2018.03	08/03/2017 10:17:04 AM Pacific Daylight Time	08/04/2017 04:34:09 PM Pacific Daylight Time	08/04/2017 04:34:09 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	012	0	2018	San Diego County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	039	0	1	01	01	H0562_039_0	4			1		08/03/2017	2018.03	08/03/2017 10:37:38 AM Pacific Daylight Time	08/07/2017 09:34:30 AM Pacific Daylight Time	08/04/2017 04:44:51 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	039	0	2018	Yolo county		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	044	0	1	01	01	H0562_044_0	3			1		07/06/2017	2018.03	07/06/2017 02:29:24 PM Pacific Daylight Time	07/13/2017 11:56:25 AM Pacific Daylight Time				07/14/2017 02:46:13 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Green (HMO)	01	01		1			H0562	044	0	2018	L.A., Riverside, S.Bern. Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0562	045	0	1	01	01	H0562_045_0	3			1		07/12/2017	2018.03	07/12/2017 04:25:12 PM Pacific Daylight Time	07/13/2017 11:56:25 AM Pacific Daylight Time				07/13/2017 02:10:25 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Green (HMO)	01	01		1			H0562	045	0	2018	No. CA Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0562	055	0	1	01	01	H0562_055_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:13:37 AM Pacific Daylight Time	08/04/2017 04:34:09 PM Pacific Daylight Time	08/04/2017 04:34:10 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Amber I (HMO SNP)	01	01		1			H0562	055	0	2018	L.A., Kern, Org, Riv, SB, Fresno, SD, SF, Tulare		2		2			1	3		2		2	https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	068	0	1	01	01	H0562_068_0	4			1		08/03/2017	2018.03	08/03/2017 10:39:46 AM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	068	0	2018	Alameda and Stanislaus Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	079	0	1	01	01	H0562_079_0	4			1		08/03/2017	2018.03	08/03/2017 10:41:23 AM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	079	0	2018	Kern County, CA		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	084	0	1	01	01	H0562_084_0	4			1		08/03/2017	2018.03	08/03/2017 10:42:28 AM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time	08/04/2017 04:34:03 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	084	0	2018	Placer, Sacramento Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	090	0	1	01	01	H0562_090_0	4			1		08/03/2017	2018.03	08/03/2017 10:43:52 AM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	090	0	2018	Fresno County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	092	0	1	01	01	H0562_092_0	4		1	1		08/03/2017	2018.03	08/03/2017 10:32:04 AM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Jade (HMO SNP)	01	01		1			H0562	092	0	2018	Kern, L. A. and Orange Counties		2		2			1	4			00000000000000000010		https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	095	0	1	01	01	H0562_095_0	4			1		08/03/2017	2018.03	08/03/2017 10:52:08 AM Pacific Daylight Time	08/06/2017 01:09:12 AM Pacific Daylight Time	08/04/2017 04:44:52 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	095	0	2018	Santa Clara County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	097	0	1	01	01	H0562_097_0	4			1		08/03/2017	2018.03	08/03/2017 10:21:49 AM Pacific Daylight Time	08/06/2017 01:10:06 AM Pacific Daylight Time	08/04/2017 04:44:52 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Ruby Select (HMO)	01	01		1			H0562	097	0	2018	San Francisco, CA		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	100	1	1	01	01	H0562_100_1	5			1		07/12/2017	2018.03	07/12/2017 04:26:25 PM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	100	1	2018	LA, Orange, Riverside and San Bernardino Counties	Los Angeles and Orange Counties	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	100	2	1	01	01	H0562_100_2	4			1		07/12/2017	2018.03	07/12/2017 04:26:36 PM Pacific Daylight Time	08/04/2017 04:34:04 PM Pacific Daylight Time	08/04/2017 04:34:05 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Healthy Heart (HMO)	01	01		1			H0562	100	2	2018	LA, Orange, Riverside and San Bernardino Counties	Riverside and San Bernardino Counties	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	101	1	1	01	01	H0562_101_1	4			1		08/03/2017	2018.03	08/03/2017 10:34:03 AM Pacific Daylight Time	08/04/2017 04:34:05 PM Pacific Daylight Time	08/04/2017 04:34:05 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Gold Select (HMO)	01	01		1			H0562	101	1	2018	LA, Orange, Riverside and San Bernardino Counties	Los Angeles and Orange Counties	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	101	2	1	01	01	H0562_101_2	4			1		08/03/2017	2018.03	08/04/2017 06:40:27 PM Pacific Daylight Time	08/04/2017 04:34:05 PM Pacific Daylight Time	08/04/2017 04:34:05 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Gold Select (HMO)	01	01		1			H0562	101	2	2018	LA, Orange, Riverside and San Bernardino Counties	Riverside and San Bernardino Counties	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	103	0	1	01	01	H0562_103_0	5			1		08/03/2017	2018.03	08/03/2017 10:29:25 AM Pacific Daylight Time	08/06/2017 01:10:58 AM Pacific Daylight Time	08/04/2017 04:44:52 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Ruby Select (HMO)	01	01		1			H0562	103	0	2018	Yolo County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	110	1	1	01	01	H0562_110_1	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:17:11 AM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Amber II (HMO SNP)	01	01		1			H0562	110	1	2018	Parts of Southern and Northern California	Fresno, L.A., Orange, S.D., San Francisco	2		2			1	3		2		2	https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	110	2	1	01	01	H0562_110_2	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:17:28 AM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Amber II (HMO SNP)	01	01		1			H0562	110	2	2018	Parts of Southern and Northern California	Kern and Tulare Counties	2		2			1	3		2		2	https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	110	3	1	01	01	H0562_110_3	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:17:53 AM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Amber II (HMO SNP)	01	01		1			H0562	110	3	2018	Parts of Southern and Northern California	Riverside and San Bernardino Counties	2		2			1	3		2		2	https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	111	1	1	01	01	H0562_111_1	4			1		08/03/2017	2018.03	08/03/2017 10:36:09 AM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time	08/04/2017 04:34:06 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Sapphire (HMO)	01	01		1			H0562	111	1	2018	Parts of Southern, Northern and Central CA	L.A., Orange and San Diego, CA	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	111	2	1	01	01	H0562_111_2	4			1		08/03/2017	2018.03	08/03/2017 10:36:46 AM Pacific Daylight Time	08/04/2017 04:34:07 PM Pacific Daylight Time	08/04/2017 04:34:07 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Sapphire (HMO)	01	01		1			H0562	111	2	2018	Parts of Southern, Northern and Central CA	Kern County, CA	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	111	3	1	01	01	H0562_111_3	4			1		08/03/2017	2018.03	08/03/2017 10:37:20 AM Pacific Daylight Time	08/04/2017 04:34:07 PM Pacific Daylight Time	08/04/2017 04:34:07 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Sapphire (HMO)	01	01		1			H0562	111	3	2018	Parts of Southern, Northern and Central CA	Riverside and San Bernardino Counties	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	112	0	1	01	01	H0562_112_0	4			1		08/03/2017	2018.03	08/03/2017 10:16:17 AM Pacific Daylight Time	08/04/2017 04:34:07 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Ruby Select (HMO)	01	01		1			H0562	112	0	2018	Fresno, CA		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	113	0	1	01	01	H0562_113_0	5			1		08/03/2017	2018.03	08/03/2017 10:29:11 AM Pacific Daylight Time	08/06/2017 01:11:54 AM Pacific Daylight Time	08/04/2017 04:44:52 PM Pacific Daylight Time			08/07/2017 11:03:37 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Ruby Select (HMO)	01	01		1			H0562	113	0	2018	Alameda County		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	114	0	1	01	01	H0562_114_0	5		1	1		08/03/2017	2018.03	08/03/2017 04:03:37 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time			08/04/2017 06:50:54 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Jade (HMO SNP)	01	01		1			H0562	114	0	2018	San Diego		2		2			1	4			00000000000000000010		https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0562	801	0	1	01	01	H0562_801_0	2			1		06/08/2017	2018.03	06/08/2017 03:44:34 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	801	0	2018	California		1	223420	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0562	803	0	1	01	01	H0562_803_0	2			1		06/08/2017	2018.03	06/08/2017 03:45:02 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	803	0	2018	California		1	54257	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0562	804	0	1	01	01	H0562_804_0	2			1		06/08/2017	2018.03	06/08/2017 03:45:23 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA,INC.	Health Net of California	www.healthnet.com/medicare	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	804	0	2018	California		1	33125	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(800)275-4737		(800)275-4737		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0571	001	0	1	01	01	H0571_001_0	8			1		07/27/2017	2018.03	07/27/2017 09:04:14 AM Pacific Daylight Time	08/02/2017 12:45:16 PM Pacific Daylight Time	08/02/2017 08:36:42 AM Pacific Daylight Time			08/17/2017 08:31:57 AM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphealthplan.com/medicare	CCHP Senior Program (HMO)	01	01		1			H0571	001	0	2018	San Francisco and Northern San Mateo counties		2	25920	2			2						www.cchphealthplan.com/medicare-rx-benefit-information-including-part-d	www.cchphealthplan.com/medicare-rx-benefit-information-including-part-d		(888)775-7888		(415)834-2118		(888)681-3888		(415)955-8800	3282	(888)775-7888		(415)834-2118		(888)681-3888		(415)955-8800	3282	(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		2					2					2	1	01	9a;	
H0571	005	0	1	01	01	H0571_005_0	7		1	1	2	07/06/2017	2018.03	07/06/2017 10:44:50 AM Pacific Daylight Time	08/02/2017 08:34:57 AM Pacific Daylight Time	08/02/2017 08:37:07 AM Pacific Daylight Time			08/03/2017 09:03:16 AM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphealthplan.com/medicare	CCHP Senior Select Program (HMO SNP)	01	01		1			H0571	005	0	2018	San Francisco County		2	34010	2			1	3		2		2	www.cchphealthplan.com/medicare-rx-benefit-information-including-part-d	www.cchphealthplan.com/medicare-rx-benefit-information-including-part-d		(888)775-7888		(415)834-2118		(888)681-3888		(415)955-8800	3282	(888)775-7888		(415)834-2118		(888)681-3888		(415)955-8800	3282	(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		(877)681-8898		2					2					2	2			
H0602	001	0	1	18	06	H0602_001_0	4			1		07/06/2017	2018.03	07/06/2017 08:29:40 AM Mountain Daylight Time					07/06/2017 08:59:59 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan (Cost)	06	18		1			H0602	001	0	2018	Colorado		2	66646	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0602	003	0	1	18	06	H0602_003_0	4			1		07/06/2017	2018.03	07/06/2017 08:30:07 AM Mountain Daylight Time					07/06/2017 08:59:59 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Plus Plan (Cost)	06	18		1			H0602	003	0	2018	Colorado		2	4110	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0602	026	0	1	18	06	H0602_026_0	1			1		06/05/2017	2018.03	06/05/2017 11:23:29 AM Mountain Daylight Time					06/05/2017 02:13:31 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Basic Plan (Cost)	06	18		1			H0602	026	0	2018	Colorado		2	16431	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										1	1	5;7d;7e;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;15;16b;	2		2					2				
H0602	027	0	1	18	06	H0602_027_0	4			1		07/06/2017	2018.03	07/06/2017 08:31:23 AM Mountain Daylight Time					07/06/2017 08:59:59 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Thrifty Plan (Cost)	06	18		1			H0602	027	0	2018	Colorado		2	28650	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0602	040	0	2	18	06	H0602_040_0	1			1		06/05/2017	2018.03	06/05/2017 11:31:39 AM Mountain Daylight Time					06/05/2017 02:13:31 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain B Basic Plan (Cost)	06	18		2	2		H0602	040	0	2018	Colorado		2	384	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										1	1	5;7d;7e;7h;8a;8b1;8b2;9b;9c;10a;11a;11b;15;16b;	2		2					2				
H0602	041	0	2	18	06	H0602_041_0	3			1		07/05/2017	2018.03	07/05/2017 11:37:28 AM Mountain Daylight Time					07/05/2017 12:04:12 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain B Standard Plan (Cost)	06	18		2	2		H0602	041	0	2018	Colorado		2	12	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0602	042	0	1	18	06	H0602_042_0	4			1		07/06/2017	2018.03	07/06/2017 08:32:00 AM Mountain Daylight Time					07/06/2017 08:59:59 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Green Plan (Cost)	06	18		1			H0602	042	0	2018	Colorado		2	31722	2			2						www.rmhpmedicare.org	www.rmhpmedicare.org		(888)282-1420		(970)244-7912		(888)282-1420		(970)244-7912										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0609	002	0	1	01	01	H0609_002_0	4			1		06/02/2017	2018.03	06/02/2017 08:14:51 AM Central Daylight Time	08/04/2017 08:31:22 AM Central Daylight Time	08/01/2017 09:07:04 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0609	002	0	2018	El Paso, Fremont, Larimer, Pueblo, Teller, Weld		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	007	0	1	01	01	H0609_007_0	3			1		06/01/2017	2018.03	06/01/2017 08:42:57 AM Central Daylight Time	08/04/2017 08:31:54 AM Central Daylight Time	08/01/2017 09:07:30 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0609	007	0	2018	Denver Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	012	0	1	01	01	H0609_012_0	3			1		08/02/2017	2018.03	08/02/2017 04:30:07 PM Central Daylight Time	08/04/2017 08:32:28 AM Central Daylight Time	08/01/2017 09:07:57 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0609	012	0	2018	Denver Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	015	0	1	01	01	H0609_015_0	2			1		05/23/2017	2018.03	05/23/2017 04:28:15 PM Central Daylight Time	06/01/2017 12:33:18 PM Central Daylight Time				07/06/2017 03:19:00 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0609	015	0	2018	El Paso, Fremont, Larimer, Pueblo, Teller, Weld		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0609	018	0	1	01	01	H0609_018_0	2			1		05/23/2017	2018.03	05/23/2017 04:28:28 PM Central Daylight Time	06/01/2017 12:34:07 PM Central Daylight Time				07/06/2017 03:19:00 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0609	018	0	2018	Denver Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0609	020	0	1	01	01	H0609_020_0	3			1		08/02/2017	2018.03	08/02/2017 01:40:12 PM Central Daylight Time	08/04/2017 08:33:02 AM Central Daylight Time	08/01/2017 09:08:24 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0609	020	0	2018	El Paso, Fremont, Larimer, Pueblo, Teller, Weld		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	025	0	1	01	01	H0609_025_0	3			1		08/02/2017	2018.03	08/02/2017 01:41:05 PM Central Daylight Time	08/03/2017 01:52:51 PM Central Daylight Time	08/01/2017 09:08:52 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H0609	025	0	2018	Pima County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	026	0	1	01	01	H0609_026_0	3			1		08/02/2017	2018.03	08/02/2017 01:42:06 PM Central Daylight Time	08/03/2017 01:53:29 PM Central Daylight Time	08/01/2017 09:09:19 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0609	026	0	2018	Maricopa and Pinal Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(877)370-2843		(877)370-2843		(800)555-5757		(800)555-5757		(877)370-2843		(877)370-2843		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	027	0	1	01	01	H0609_027_0	4			1		08/02/2017	2018.03	08/02/2017 01:43:02 PM Central Daylight Time	08/03/2017 01:54:08 PM Central Daylight Time	08/01/2017 09:09:47 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0609	027	0	2018	Maricopa County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	028	0	1	01	01	H0609_028_0	3			1		08/03/2017	2018.03	08/03/2017 01:01:11 PM Central Daylight Time	08/04/2017 08:33:35 AM Central Daylight Time	08/01/2017 09:10:14 AM Central Daylight Time			08/07/2017 08:19:51 AM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0609	028	0	2018	Clark and Nye County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(888)525-2086		(888)525-2086		(800)555-5757		(800)555-5757		(888)525-2086		(888)525-2086		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0609	801	0	1	01	01	H0609_801_0	1			1		05/23/2017	2018.03	05/23/2017 03:49:28 PM Central Daylight Time					06/02/2017 01:41:12 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	801	0	2018	CO Employer Sponsored Plan Service Area		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	804	0	1	01	01	H0609_804_0	2			1		06/08/2017	2018.03	06/08/2017 11:18:12 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	804	0	2018	CO Employer Sponsored Plan Service Area		1	39456	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	805	0	1	01	01	H0609_805_0	1			1		05/23/2017	2018.03	05/23/2017 03:52:29 PM Central Daylight Time					06/02/2017 01:41:12 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	805	0	2018	CO Employer Sponsored Plan Service Area		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	806	0	2	01	01	H0609_806_0	2			1		06/08/2017	2018.03	06/08/2017 11:18:36 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H0609	806	0	2018	CO Employer Sponsored Plan Service Area		1	1704	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	807	0	1	01	01	H0609_807_0	2			1		06/08/2017	2018.03	06/08/2017 11:19:04 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	807	0	2018	Arizona		1	1212	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	808	0	1	01	01	H0609_808_0	2			1		06/08/2017	2018.03	06/08/2017 11:19:24 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	808	0	2018	Arizona		1	307044	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	809	0	1	01	01	H0609_809_0	2			1		06/08/2017	2018.03	06/08/2017 11:19:59 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	809	0	2018	Arizona		1	132	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	810	0	1	01	01	H0609_810_0	2			1		06/08/2017	2018.03	06/08/2017 11:20:17 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	810	0	2018	Clark and Nye Counties		1	24	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	811	0	1	01	01	H0609_811_0	2			1		06/08/2017	2018.03	06/08/2017 11:20:37 AM Central Daylight Time					06/13/2017 04:34:52 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	811	0	2018	Clark and Nye counties		1	7548	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0609	812	0	1	01	01	H0609_812_0	1			1		05/23/2017	2018.03	05/23/2017 05:12:09 PM Central Daylight Time					06/02/2017 01:41:12 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	812	0	2018	Clark and Nye counties		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H0613	001	0	1	20	08	H0613_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:43:30 PM Mountain Daylight Time		05/24/2017 01:33:21 PM Mountain Daylight Time			05/24/2017 01:47:59 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	InnovAge Greater Colorado PACE	www.myinnovage.org	Total Longterm Care - Dual eligibles (PACE)	08	20		1			H0613	001	0	2018	Metro Denver,Pueblo,Loveland,Fort Collins,Greeley		2		2			2						http://www.pharmerica.com	http://www.totallongtermcare.org										(855)487-6768		(888)678-6915		(877)277-6163		(303)869-4664										(855)487-6768		(855)487-6768		(877)277-6163		(303)869-4664																
H0613	003	0	1	20	08	H0613_003_0	1			1		05/24/2017	2018.03	05/24/2017 01:43:49 PM Mountain Daylight Time		05/24/2017 01:33:08 PM Mountain Daylight Time			05/24/2017 01:47:59 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	InnovAge Greater Colorado PACE	www.myinnovage.org	Total Longterm Care - Medicare only (PACE)	08	20		1			H0613	003	0	2018	Metro Denver,Pueblo,Loveland,Fort Collins,Greeley		2		2			2						http://www.pharmerica.com	http://www.totallongtermcare.org										(855)487-6768	711	(888)678-6915		(877)277-6163		(303)869-4664										(855)487-6768	711	(855)487-6768	711	(877)277-6163		(303)869-4664																
H0624	001	0	1	01	01	H0624_001_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 01:44:50 PM Central Daylight Time	08/03/2017 12:19:47 PM Central Daylight Time	08/01/2017 09:10:41 AM Central Daylight Time			08/04/2017 12:04:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0624	001	0	2018	Denver and Colorado Springs metro areas		2		2			1	3		2		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	013	0	1	01	01	H0630_013_0	8			1		08/03/2017	2018.03	08/03/2017 03:18:44 PM Mountain Daylight Time	08/04/2017 02:29:28 PM Mountain Daylight Time	08/04/2017 02:21:34 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Core (HMO)	01	01		1			H0630	013	0	2018	Denver Metro Area		2	330583	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	014	0	1	01	01	H0630_014_0	8		1	1	2	06/05/2017	2018.03	06/05/2017 03:25:33 PM Mountain Daylight Time	08/04/2017 02:30:22 PM Mountain Daylight Time	08/04/2017 02:22:30 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Medicare Medicaid (HMO SNP)	01	01		1			H0630	014	0	2018	Denver Metro Area		2	37019	2			1	3		2		2	kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	015	0	1	01	01	H0630_015_0	8			1		05/31/2017	2018.03	05/31/2017 10:54:14 AM Mountain Daylight Time	08/04/2017 02:31:18 PM Mountain Daylight Time	08/04/2017 02:23:25 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Silver (HMO)	01	01		1			H0630	015	0	2018	Denver Metro Area		2	380811	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	016	0	1	01	01	H0630_016_0	8			1		08/02/2017	2018.03	08/02/2017 01:05:09 PM Mountain Daylight Time	08/04/2017 02:32:15 PM Mountain Daylight Time	08/04/2017 02:24:23 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Gold (HMO)	01	01		1			H0630	016	0	2018	Denver Metro Area		2	45921	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	017	0	1	01	01	H0630_017_0	10			1		08/02/2017	2018.03	08/02/2017 01:48:17 PM Mountain Daylight Time	08/04/2017 02:33:11 PM Mountain Daylight Time	08/04/2017 02:25:18 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Core (HMO)	01	01		1			H0630	017	0	2018	Southern Colorado		2	84127	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	018	0	1	01	01	H0630_018_0	8			1		08/02/2017	2018.03	08/02/2017 02:12:52 PM Mountain Daylight Time	08/04/2017 02:34:06 PM Mountain Daylight Time	08/04/2017 02:26:13 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Silver (HMO)	01	01		1			H0630	018	0	2018	Southern Colorado		2	31328	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	020	0	1	01	01	H0630_020_0	8			1		08/02/2017	2018.03	08/02/2017 02:33:50 PM Mountain Daylight Time	08/04/2017 02:35:00 PM Mountain Daylight Time	08/04/2017 02:27:08 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Core (HMO)	01	01		1			H0630	020	0	2018	Northern Colorado		2	36819	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	021	0	1	01	01	H0630_021_0	8			1		08/02/2017	2018.03	08/02/2017 02:44:53 PM Mountain Daylight Time	08/04/2017 02:35:55 PM Mountain Daylight Time	08/04/2017 02:28:03 PM Mountain Daylight Time			08/04/2017 04:32:20 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Silver (HMO)	01	01		1			H0630	021	0	2018	Northern Colorado		2	28463	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0630	805	0	2	01	01	H0630_805_0	7			1		05/31/2017	2018.03	05/31/2017 11:05:23 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA-PD_Part B only (HMO)	01	01		2	1		H0630	805	0	2018	Denver Metro Area		1	9938	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	806	0	2	01	01	H0630_806_0	7			1		05/31/2017	2018.03	05/31/2017 11:05:39 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA only_Part B only (HMO)	01	01		2	1		H0630	806	0	2018	Denver Metro Area		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	807	0	1	01	01	H0630_807_0	7			1		05/31/2017	2018.03	05/31/2017 11:07:04 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA-PD (HMO)	01	01		1			H0630	807	0	2018	Denver Metro Area		1	263866	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	808	0	1	01	01	H0630_808_0	7			1		05/31/2017	2018.03	05/31/2017 11:08:16 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Adv_Group_MA only (HMO)	01	01		1			H0630	808	0	2018	Denver Metro Area		1	12	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	809	0	2	01	01	H0630_809_0	7			1		05/31/2017	2018.03	05/31/2017 11:10:10 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H0630	809	0	2018	Denver Metro Area		1	108	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	810	0	1	01	01	H0630_810_0	7			1		05/31/2017	2018.03	05/31/2017 11:11:24 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H0630	810	0	2018	Denver Metro Area		1	33687	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	811	0	2	01	01	H0630_811_0	7			1		05/31/2017	2018.03	05/31/2017 11:13:33 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA-PD_Part B only (HMO)	01	01		2	1		H0630	811	0	2018	Southern Colorado		1	1999	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	812	0	2	01	01	H0630_812_0	7			1		05/31/2017	2018.03	05/31/2017 11:14:40 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA only_Part B only (HMO)	01	01		2	1		H0630	812	0	2018	Southern Colorado		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	813	0	1	01	01	H0630_813_0	7			1		05/31/2017	2018.03	05/31/2017 11:15:47 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA-PD (HMO)	01	01		1			H0630	813	0	2018	Southern Colorado		1	34712	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	814	0	1	01	01	H0630_814_0	7			1		05/31/2017	2018.03	05/31/2017 11:16:58 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Adv Group_MA only (HMO)	01	01		1			H0630	814	0	2018	Southern Colorado		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	815	0	2	01	01	H0630_815_0	7			1		05/31/2017	2018.03	05/31/2017 11:18:16 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H0630	815	0	2018	Southern Colorado		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	816	0	1	01	01	H0630_816_0	7			1		05/31/2017	2018.03	05/31/2017 11:20:41 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H0630	816	0	2018	Southern Colorado		1	3572	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	817	0	2	01	01	H0630_817_0	7			1		05/31/2017	2018.03	05/31/2017 11:23:44 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MAPD Part B Only (HMO)	01	01		2	1		H0630	817	0	2018	Northern Colorado		1	317	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	818	0	2	01	01	H0630_818_0	7			1		05/31/2017	2018.03	05/31/2017 11:25:18 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA Only Part B Only (HMO)	01	01		2	1		H0630	818	0	2018	Northern Colorado		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	819	0	1	01	01	H0630_819_0	7			1		05/31/2017	2018.03	05/31/2017 11:47:09 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MAPD (HMO)	01	01		1			H0630	819	0	2018	Northern Colorado		1	9615	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	820	0	1	01	01	H0630_820_0	7			1		05/31/2017	2018.03	05/31/2017 11:28:09 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	Senior Advantage Group MA Only (HMO)	01	01		1			H0630	820	0	2018	Northern Colorado		1	12	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	821	0	2	01	01	H0630_821_0	7			1		05/31/2017	2018.03	05/31/2017 11:29:25 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB B Only with D (HMO)	01	01		2	1		H0630	821	0	2018	Northern Colorado		1	0	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0630	822	0	1	01	01	H0630_822_0	7			1		05/31/2017	2018.03	05/31/2017 11:49:43 AM Mountain Daylight Time					06/05/2017 01:44:17 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H0630	822	0	2018	Northern Colorado		1	1060	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(800)476-2167		(303)338-3800		(877)408-3492		(877)408-3492		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;16b;	1					2				
H0657	005	0	1	18	06	H0657_005_0	2			2		06/05/2017	2018.03	06/05/2017 05:17:11 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Silver SV Plan (Cost)	06	18		1			H0657	005	0	2018	The 6 County San Luis Valley Area		2	125	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0657	006	0	1	18	06	H0657_006_0	1			2		06/05/2017	2018.03	06/05/2017 04:28:25 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Gold SV Plan (Cost)	06	18		1			H0657	006	0	2018	The 6 County San Luis Valley Area		2	50	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0657	007	0	1	18	06	H0657_007_0	1			2		06/05/2017	2018.03	06/05/2017 04:31:16 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Platinum SV Plan (Cost)	06	18		1			H0657	007	0	2018	The 6 County San Luis Valley Area		2	520	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0657	008	0	1	18	06	H0657_008_0	1			2		06/05/2017	2018.03	06/05/2017 04:53:42 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Silver Plan (Cost)	06	18		1			H0657	008	0	2018	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	110	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0657	009	0	1	18	06	H0657_009_0	1			2		06/05/2017	2018.03	06/05/2017 05:02:31 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Gold Plan (Cost)	06	18		1			H0657	009	0	2018	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	10	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0657	010	0	1	18	06	H0657_010_0	1			2		06/05/2017	2018.03	06/05/2017 05:09:51 PM Mountain Daylight Time					06/05/2017 05:17:20 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.cochoice.com	Colorado Choice Platinum Plan (Cost)	06	18		1			H0657	010	0	2018	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	15	2			2									(800)475-8466		(719)589-3696		(800)475-8466		(719)589-3696										(800)659-2656		(800)659-2656		(800)659-2656		(800)659-2656										2					2					2	2			
H0710	001	0	1	04	01	H0710_001_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:15:08 PM Central Daylight Time	08/03/2017 12:53:36 PM Central Daylight Time	08/01/2017 09:11:09 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	001	0	2018	State of Connecticut		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	004	0	1	04	01	H0710_004_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:32:30 PM Central Daylight Time	08/03/2017 12:54:10 PM Central Daylight Time	08/01/2017 09:11:35 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	004	0	2018	Select Counties in Alabama and Florida		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	005	0	1	04	01	H0710_005_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:33:14 PM Central Daylight Time	08/03/2017 12:54:44 PM Central Daylight Time	08/01/2017 09:12:03 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	005	0	2018	Maricopa, Pima, and Yavapai counties		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	006	0	1	04	01	H0710_006_0	4		1	1		06/28/2017	2018.03	06/28/2017 03:31:58 PM Central Daylight Time	08/03/2017 12:55:17 PM Central Daylight Time	08/01/2017 09:12:29 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	006	0	2018	Maricopa, Pima, and Yavapai counties		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	007	0	1	04	01	H0710_007_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:33:54 PM Central Daylight Time	08/03/2017 12:55:50 PM Central Daylight Time	08/01/2017 09:12:56 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	007	0	2018	Denver and Colorado Springs metro areas		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	008	0	1	04	01	H0710_008_0	4		1	1		06/28/2017	2018.03	06/28/2017 09:51:08 AM Central Daylight Time	08/03/2017 12:56:24 PM Central Daylight Time	08/01/2017 09:13:23 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	008	0	2018	Denver and Colorado Springs metro areas		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	009	0	1	04	01	H0710_009_0	4		1	1		06/28/2017	2018.03	06/28/2017 09:51:47 AM Central Daylight Time	08/03/2017 12:56:57 PM Central Daylight Time	08/01/2017 09:13:51 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	009	0	2018	State of Connecticut		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	010	0	1	04	01	H0710_010_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:34:40 PM Central Daylight Time	08/03/2017 12:57:32 PM Central Daylight Time	08/01/2017 09:14:19 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	010	0	2018	Select Counties in Florida		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	012	0	1	04	01	H0710_012_0	4		1	1		06/28/2017	2018.03	06/28/2017 09:53:07 AM Central Daylight Time	08/03/2017 12:58:07 PM Central Daylight Time	08/01/2017 09:14:46 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	012	0	2018	Select Counties in Florida		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	013	0	1	04	01	H0710_013_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:35:39 PM Central Daylight Time	08/03/2017 12:58:40 PM Central Daylight Time	08/01/2017 09:15:12 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	013	0	2018	Select Counties in Indiana		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	015	0	1	04	01	H0710_015_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:39:23 PM Central Daylight Time	08/03/2017 12:59:14 PM Central Daylight Time	08/01/2017 09:15:39 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	015	0	2018	Select Counties in Maine and New Hampshire		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	016	0	1	04	01	H0710_016_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:45:54 PM Central Daylight Time	08/03/2017 12:59:49 PM Central Daylight Time	08/01/2017 09:16:06 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	016	0	2018	St. Louis Metro area		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	017	0	1	04	01	H0710_017_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:46:40 PM Central Daylight Time	08/03/2017 01:00:24 PM Central Daylight Time	08/01/2017 09:16:32 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	017	0	2018	Select Counties in Pennsylvania and Delaware		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	018	0	1	04	01	H0710_018_0	4		1	1		07/05/2017	2018.03	07/05/2017 02:01:15 PM Central Daylight Time	08/03/2017 01:00:58 PM Central Daylight Time	08/01/2017 09:16:58 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	018	0	2018	Select Counties in Pennsylvania		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	020	0	1	04	01	H0710_020_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:47:17 PM Central Daylight Time	08/03/2017 01:01:33 PM Central Daylight Time	08/01/2017 09:17:25 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	020	0	2018	Select counties in Texas		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	026	0	1	04	01	H0710_026_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:49:59 PM Central Daylight Time	08/03/2017 01:02:07 PM Central Daylight Time	08/01/2017 09:17:53 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	026	0	2018	Select counties in New Jersey		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	027	0	1	04	01	H0710_027_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:50:49 PM Central Daylight Time	08/03/2017 01:02:42 PM Central Daylight Time	08/01/2017 09:18:20 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	027	0	2018	Select Counties in Ohio		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	030	0	1	04	01	H0710_030_0	4		1	1		06/28/2017	2018.03	06/28/2017 09:57:52 AM Central Daylight Time	08/03/2017 01:03:16 PM Central Daylight Time	08/01/2017 09:18:48 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H0710	030	0	2018	Select counties in Washington		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	031	0	1	04	01	H0710_031_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:51:46 PM Central Daylight Time	08/03/2017 01:03:51 PM Central Daylight Time	08/01/2017 09:19:14 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	031	0	2018	Select counties in Washington		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	032	0	1	04	01	H0710_032_0	5		1	1		07/07/2017	2018.03	07/07/2017 11:34:18 AM Central Daylight Time	08/03/2017 01:04:25 PM Central Daylight Time	08/01/2017 09:19:41 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	032	0	2018	Select Counties in Maryland, Virginia and DC		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	033	0	1	04	01	H0710_033_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:52:31 PM Central Daylight Time	08/03/2017 01:04:59 PM Central Daylight Time	08/01/2017 09:20:07 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	033	0	2018	Select Counties in Georgia		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	034	0	1	04	01	H0710_034_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:54:15 PM Central Daylight Time	08/03/2017 01:05:34 PM Central Daylight Time	08/01/2017 09:20:34 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	034	0	2018	Select Counties in North Carolina		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	035	0	1	04	01	H0710_035_0	5		1	1		07/07/2017	2018.03	07/07/2017 11:34:57 AM Central Daylight Time	08/03/2017 01:06:07 PM Central Daylight Time	08/01/2017 09:21:01 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	035	0	2018	State of Rhode Island		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	036	0	1	04	01	H0710_036_0	5		1	1		07/07/2017	2018.03	07/07/2017 11:35:16 AM Central Daylight Time	08/03/2017 01:06:43 PM Central Daylight Time	08/01/2017 09:21:27 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 2 (PPO SNP)	01	04		1			H0710	036	0	2018	Select Counties in Oregon		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	037	0	1	04	01	H0710_037_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:55:06 PM Central Daylight Time	08/03/2017 01:07:16 PM Central Daylight Time	08/01/2017 09:21:54 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan 2 (PPO SNP)	01	04		1			H0710	037	0	2018	Select Counties in Oregon		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	038	0	1	04	01	H0710_038_0	5		1	1		08/02/2017	2018.03	08/02/2017 03:56:50 PM Central Daylight Time	08/03/2017 01:07:52 PM Central Daylight Time	08/01/2017 09:22:21 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	038	0	2018	Hillsborough County		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H0710	801	0	1	04	01	H0710_801_0	1			1		05/25/2017	2018.03	05/25/2017 11:12:43 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	801	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	802	0	1	04	01	H0710_802_0	1			1		05/25/2017	2018.03	05/25/2017 11:12:52 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	802	0	2018	Nationwide		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0710	803	0	1	04	01	H0710_803_0	1			1		05/25/2017	2018.03	05/25/2017 11:13:04 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	803	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	804	0	2	04	01	H0710_804_0	1			1		05/25/2017	2018.03	05/25/2017 11:13:21 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	804	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	805	0	2	04	01	H0710_805_0	1			1		05/25/2017	2018.03	05/25/2017 11:13:34 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	805	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0710	806	0	2	04	01	H0710_806_0	1			1		05/25/2017	2018.03	05/25/2017 11:13:47 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	806	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	807	0	1	04	01	H0710_807_0	1			1		05/25/2017	2018.03	05/25/2017 11:13:59 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	807	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	808	0	1	04	01	H0710_808_0	1			1		05/25/2017	2018.03	05/25/2017 11:14:10 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	808	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	809	0	1	04	01	H0710_809_0	1			1		05/25/2017	2018.03	05/25/2017 11:14:24 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	809	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	810	0	1	04	01	H0710_810_0	1			1		05/25/2017	2018.03	05/25/2017 11:14:35 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	810	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0710	811	0	1	04	01	H0710_811_0	1			1		05/25/2017	2018.03	05/25/2017 11:14:47 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	811	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	812	0	2	04	01	H0710_812_0	1			1		05/25/2017	2018.03	05/25/2017 11:14:58 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	812	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	813	0	2	04	01	H0710_813_0	1			1		05/25/2017	2018.03	05/25/2017 11:15:17 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	813	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0710	814	0	2	04	01	H0710_814_0	1			1		05/25/2017	2018.03	05/25/2017 11:15:30 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H0710	814	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	815	0	1	04	01	H0710_815_0	1			1		05/25/2017	2018.03	05/25/2017 10:00:30 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	815	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	816	0	1	04	01	H0710_816_0	1			1		05/25/2017	2018.03	05/25/2017 10:00:36 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	816	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	817	0	1	04	01	H0710_817_0	2			1		05/25/2017	2018.03	05/25/2017 10:00:48 AM Pacific Daylight Time					06/02/2017 01:42:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	817	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H0710	818	0	1	04	01	H0710_818_0	2			1		05/25/2017	2018.03	05/25/2017 10:01:00 AM Pacific Daylight Time					06/02/2017 01:42:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	818	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	819	0	1	04	01	H0710_819_0	1			1		05/25/2017	2018.03	05/25/2017 10:01:06 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	819	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	820	0	1	04	01	H0710_820_0	1			1		05/25/2017	2018.03	05/25/2017 10:01:16 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	820	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	821	0	1	04	01	H0710_821_0	1			1		05/25/2017	2018.03	05/25/2017 10:01:22 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	821	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	822	0	1	04	01	H0710_822_0	1			1		05/25/2017	2018.03	05/25/2017 10:01:30 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	822	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0710	823	0	1	04	01	H0710_823_0	1			1		05/25/2017	2018.03	05/25/2017 10:01:37 AM Pacific Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H0710	823	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H0712	005	0	1	01	01	H0712_005_0	2		1	1	2	06/02/2017	2018.03	06/02/2017 07:39:29 AM Eastern Daylight Time	08/04/2017 02:42:19 PM Eastern Daylight Time	07/31/2017 06:45:27 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H0712	005	0	2018	Fairfield, Hartford Counties		2	43239	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)635-7047		(866)635-7047		(866)527-0056		(866)527-0056		(866)635-7047		(866)635-7047		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	019	0	1	01	01	H0712_019_0	3			1		08/03/2017	2018.03	08/03/2017 09:37:31 AM Eastern Daylight Time	08/04/2017 03:40:09 PM Eastern Daylight Time	07/31/2017 06:45:50 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	Wellcare Value (HMO)	01	01		1			H0712	019	0	2018	Select counties in CT		2	32244	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	020	0	1	02	01	H0712_020_0	3			1		06/01/2017	2018.03	06/01/2017 01:50:23 PM Eastern Daylight Time	08/04/2017 02:44:28 PM Eastern Daylight Time	07/31/2017 06:46:13 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Rx (HMO-POS)	01	02		1			H0712	020	0	2018	Fairfield, Hartford,Tolland Counties		2	26845	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	021	0	1	01	01	H0712_021_0	3			1		08/03/2017	2018.03	08/03/2017 09:38:24 AM Eastern Daylight Time	08/04/2017 02:46:25 PM Eastern Daylight Time	07/31/2017 06:46:35 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Preferred (HMO)	01	01		1			H0712	021	0	2018	Select Counties in CT		2	2664	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fap_search	(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(866)579-8006		(866)579-8006		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	022	0	1	01	01	H0712_022_0	3			1		08/03/2017	2018.03	08/03/2017 09:39:26 AM Eastern Daylight Time	08/04/2017 02:48:20 PM Eastern Daylight Time	07/31/2017 06:46:58 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H0712	022	0	2018	Select Counties in NC		2	1569	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	023	0	1	01	01	H0712_023_0	3			1		08/03/2017	2018.03	08/03/2017 09:40:28 AM Eastern Daylight Time	08/04/2017 02:50:19 PM Eastern Daylight Time	07/31/2017 06:47:21 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H0712	023	0	2018	Select Counties in NC		2	1584	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	024	0	1	01	01	H0712_024_0	3			1		08/03/2017	2018.03	08/03/2017 09:41:15 AM Eastern Daylight Time	08/04/2017 02:52:09 PM Eastern Daylight Time	07/31/2017 06:47:43 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H0712	024	0	2018	Select Counties in NC		2	1393	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)655-2425		(877)655-2425		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0712	025	0	1	01	01	H0712_025_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:52:57 AM Eastern Daylight Time	08/03/2017 03:15:39 PM Eastern Daylight Time	07/31/2017 06:48:07 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H0712	025	0	2018	Select Counties in NC		2	2061	2			1	3		2		2	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)655-2422		(877)655-2422		(866)527-0056		(866)527-0056		(877)655-2422		(877)655-2422		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0724	001	0	1	01	01	H0724_001_0	2			1		08/03/2017	2018.03	08/03/2017 08:48:35 AM Eastern Daylight Time	08/04/2017 04:49:49 PM Pacific Daylight Time	08/04/2017 04:49:26 PM Pacific Daylight Time			08/04/2017 07:59:42 PM Pacific Daylight Time	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS	Allwell	allwell.buckeyehealthplan.com	Allwell Medicare (HMO)	01	01		1			H0724	001	0	2018	Northeast Ohio		2		2			2						www.centene.com	www.centene.com	https://advantage.buckeyehealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0724	002	0	1	01	01	H0724_002_0	2			1		08/03/2017	2018.03	08/03/2017 08:49:00 AM Eastern Daylight Time	08/04/2017 04:49:49 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/04/2017 07:59:42 PM Pacific Daylight Time	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS	Allwell	allwell.buckeyehealthplan.com	Allwell Medicare (HMO)	01	01		1			H0724	002	0	2018	Southwest Ohio		2		2			2						www.centene.com	www.centene.com	https://advantage.buckeyehealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H0735	001	0	1	04	01	H0735_001_0	10			1		06/30/2017	2018.03	06/30/2017 11:43:37 AM Central Daylight Time	08/01/2017 08:49:56 AM Central Daylight Time	08/01/2017 08:52:34 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	EssentiaCare	www.essentiacare.org	EssentiaCare Secure (PPO)	01	04		1			H0735	001	0	2018	Northern Minnesota: Ten Counties		2		2			2						EssentiaCare.org	EssentiaCare.org	EssentiaCare.org	(855)432-7025		(218)722-4915		(855)432-7027		(218)722-4783		(855)432-7025		(218)722-4915		(855)432-7027		(218)722-4783		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2						2			
H0735	002	0	1	04	01	H0735_002_0	9			1		06/30/2017	2018.03	06/30/2017 11:44:16 AM Central Daylight Time	08/01/2017 08:54:40 AM Central Daylight Time	08/01/2017 08:55:59 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	EssentiaCare	www.essentiacare.org	EssentiaCare Grand (PPO)	01	04		1			H0735	002	0	2018	Northern Minnesota: Ten Counties		2		2			2						EssentiaCare.org	EssentiaCare.org	EssentiaCare.org	(855)432-7025		(218)722-4915		(855)432-7027		(218)722-4783		(855)432-7025		(218)722-4915		(855)432-7027		(218)722-4783		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2						2			
H0755	030	0	1	01	01	H0755_030_0	3			1		08/01/2017	2018.03	08/01/2017 02:10:21 PM Central Daylight Time	08/04/2017 08:27:42 AM Central Daylight Time	08/01/2017 09:22:48 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Plan 1 (HMO)	01	01		1			H0755	030	0	2018	State of Connecticut		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	031	0	1	01	01	H0755_031_0	3			1		06/01/2017	2018.03	06/01/2017 08:53:16 AM Central Daylight Time	08/04/2017 08:28:14 AM Central Daylight Time	08/01/2017 09:23:16 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Plan 2 (HMO)	01	01		1			H0755	031	0	2018	State of Connecticut		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	032	0	1	01	01	H0755_032_0	2			1		05/09/2017	2018.03	05/09/2017 11:28:39 AM Central Daylight Time	06/01/2017 12:10:02 PM Central Daylight Time				07/06/2017 03:18:57 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Essential (HMO)	01	01		1			H0755	032	0	2018	State of Connecticut		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0755	033	0	1	01	01	H0755_033_0	3			1		08/02/2017	2018.03	08/02/2017 01:39:49 PM Central Daylight Time	08/04/2017 08:28:45 AM Central Daylight Time	08/01/2017 09:23:43 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Plan 3 (HMO)	01	01		1			H0755	033	0	2018	State of Connecticut		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(800)711-0646		(800)711-0646		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	034	0	1	01	01	H0755_034_0	3			1		08/02/2017	2018.03	08/02/2017 02:33:59 PM Central Daylight Time	08/04/2017 08:29:15 AM Central Daylight Time	08/01/2017 09:24:11 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0755	034	0	2018	Select Counties in New Jersey		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	035	0	1	01	01	H0755_035_0	3			1		06/01/2017	2018.03	06/01/2017 08:44:04 AM Central Daylight Time	08/04/2017 08:29:45 AM Central Daylight Time	08/01/2017 09:24:37 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H0755	035	0	2018	Select Counties in New Jersey		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	036	0	1	01	01	H0755_036_0	3			1		06/01/2017	2018.03	06/01/2017 08:44:52 AM Central Daylight Time	08/04/2017 08:30:16 AM Central Daylight Time	08/01/2017 09:25:03 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 4 (HMO)	01	01		1			H0755	036	0	2018	Select Counties in New Jersey		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	037	0	1	01	01	H0755_037_0	2			1		05/25/2017	2018.03	05/25/2017 11:28:23 AM Central Daylight Time	06/01/2017 12:12:45 PM Central Daylight Time				07/06/2017 03:39:35 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H0755	037	0	2018	Select Counties in New Jersey		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H0755	038	0	1	01	01	H0755_038_0	3			1		08/02/2017	2018.03	08/02/2017 02:34:17 PM Central Daylight Time	08/03/2017 01:47:22 PM Central Daylight Time	08/01/2017 09:25:28 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0755	038	0	2018	Essex and Ocean Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0755	810	0	1	01	01	H0755_810_0	2			1		06/08/2017	2018.03	06/08/2017 11:21:03 AM Central Daylight Time					06/13/2017 04:38:11 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	810	0	2018	Connecticut		1	4200	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H0755	811	0	1	01	01	H0755_811_0	1			1		05/24/2017	2018.03	05/24/2017 09:00:22 AM Central Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	811	0	2018	Connecticut		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H0755	812	0	1	01	01	H0755_812_0	1			1		05/24/2017	2018.03	05/24/2017 09:01:31 AM Central Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	812	0	2018	Connecticut		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H0755	813	0	1	01	01	H0755_813_0	2			1		06/08/2017	2018.03	06/08/2017 11:21:25 AM Central Daylight Time					06/13/2017 04:38:11 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	813	0	2018	NJ		1	3492	2			2						www.UHCRetiree.com	www.UHCRetiree.com	www.UHCRetiree.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H0755	814	0	1	01	01	H0755_814_0	1			1		05/24/2017	2018.03	05/24/2017 09:03:26 AM Central Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	814	0	2018	NJ		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H0755	815	0	1	01	01	H0755_815_0	1			1		05/24/2017	2018.03	05/24/2017 09:10:10 AM Central Daylight Time					06/01/2017 04:15:25 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	815	0	2018	NJ		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H0809	001	0	1	20	08	H0809_001_0	1			1		05/24/2017	2018.03	05/24/2017 12:53:14 PM Eastern Daylight Time		05/24/2017 12:16:35 PM Eastern Daylight Time			05/26/2017 09:34:44 AM Eastern Daylight Time	MERCY LIFE, INC.	Mercy LIFE	www.mymercylife.com	Mercy LIFE, Inc. (PACE)	08	20		1			H0809	001	0	2018	Mercy LIFE		2		2			2						www.mercycares.com	www.mercycares.com										(413)748-7223		(413)748-7223		(413)748-7223		(413)748-7223										(800)439-2370		(800)439-2370		(800)439-2370		(800)439-2370																
H0809	002	0	1	20	08	H0809_002_0	1			1		05/24/2017	2018.03	05/24/2017 12:53:59 PM Eastern Daylight Time		05/24/2017 12:16:23 PM Eastern Daylight Time			05/26/2017 09:34:44 AM Eastern Daylight Time	MERCY LIFE, INC.	Mercy LIFE	www.mymercylife.com	Mercy LIFE, Inc. (PACE)	08	20		1			H0809	002	0	2018	Mercy LIFE		2		2			2						www.mercycares.com	www.mercycares.com										(413)748-7223		(413)748-7223		(413)748-7223		(413)748-7223										(800)439-2370		(800)439-2370		(800)439-2370		(800)439-2370																
H0811	001	0	1	49	05	H0811_001_0	3			1		07/07/2017	2018.03	07/07/2017 01:29:20 PM Eastern Daylight Time					07/07/2017 01:31:18 PM Eastern Daylight Time	GUILDNET, INC.	GuildNet Gold Plus FIDA	http://www.guildnetny.org	GuildNet Gold Plus FIDA Plan (Medicare-Medicaid Plan)	05	49		1			H0811	001	0	2018	Bronx, Kings, Queens, NY, Richmond		2		2			2						http://www.guildnetny.org	http://www.guildnetny.org	http://www.guildnetny.org	(800)815-0000		(800)815-0000		(800)815-0000		(800)815-0000		(877)444-3973		(877)444-3973		(800)815-0000		(800)815-0000		(711)-		(711)-		(711)-		(711)-		(866)248-0640		(866)248-0640		(711)-		(711)-																
H0819	001	0	1	20	08	H0819_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:54:37 AM Eastern Daylight Time		05/24/2017 08:18:43 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE YORK, INC.	York County PACE	www.seniorlifepa.com	Senior LIFE York Dual Eligibile (PACE)	08	20		1			H0819	001	0	2018	Senior LIFE York County		2	2370	2			2						http://granerx.com/	www.seniorlifeyork.com										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H0819	002	0	1	20	08	H0819_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:54:45 AM Eastern Daylight Time		05/24/2017 08:18:38 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE YORK, INC.	York County PACE	http://www.seniorlifeyork.com	Senior LIFE York Medicare Only (PACE)	08	20		1			H0819	002	0	2018	York County PACE Medicare Only		2	12	2			2						http://granerx.com/	www.seniorlifeyork.com										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H0838	020	0	1	01	01	H0838_020_0	12		1	1		08/01/2017	2018.03	08/01/2017 04:56:16 PM Pacific Daylight Time	08/14/2017 04:03:59 PM Pacific Daylight Time	08/14/2017 04:42:44 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Harmony Choice for Medi-Medi (HMO SNP)	01	01		1			H0838	020	0	2018	KER KIN LA ORA RIV SBD		2	34536	2			1	4			00000000000010000000		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	024	0	1	01	01	H0838_024_0	13		1	1	2	08/01/2017	2018.03	08/01/2017 04:56:28 PM Pacific Daylight Time	08/14/2017 04:04:40 PM Pacific Daylight Time	08/14/2017 04:56:26 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Dual Coverage (HMO SNP)	01	01		1			H0838	024	0	2018	KER KIN LA ORA RIV SBD		2	12012	2			1	3		2		2	https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	025	0	1	01	01	H0838_025_0	13			1		08/01/2017	2018.03	08/01/2017 04:56:43 PM Pacific Daylight Time	08/14/2017 04:05:16 PM Pacific Daylight Time	08/14/2017 04:51:20 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Classic Care Drug Savings (HMO)	01	01		1			H0838	025	0	2018	Counties:  KER LA ORA RIV SBD SD		2	53412	2			2						https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	026	0	1	01	01	H0838_026_0	9		1	1		08/01/2017	2018.03	08/01/2017 04:56:53 PM Pacific Daylight Time	08/14/2017 04:05:54 PM Pacific Daylight Time	08/14/2017 04:50:43 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://www.bndhmo.com	Brand New Day In Control Drug Savings (HMO SNP)	01	01		1			H0838	026	0	2018	Counties:  KER KIN LA ORA RIV SBD		2	5039	2			1	4			00000010000000000000		https://www.bndhmo.com	https://www.bndhmo.com	https://www.bndhmo.com	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	027	0	1	01	01	H0838_027_0	8		1	1		08/01/2017	2018.03	08/01/2017 04:57:07 PM Pacific Daylight Time	08/14/2017 04:06:38 PM Pacific Daylight Time	08/14/2017 04:55:56 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com	Brand New Day In Control Choice for Medi-Medi (HMO SNP)	01	01		1			H0838	027	0	2018	Counties:  KER KIN LA ORA RIV SBD		2	6951	2			1	4			00000010000000000000		https://bndhmo.com	https://bndhmo.com	https://bndhmo.com	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	028	0	1	01	01	H0838_028_0	13		1	1		08/01/2017	2018.03	08/01/2017 04:57:18 PM Pacific Daylight Time	08/14/2017 04:07:25 PM Pacific Daylight Time	08/14/2017 04:55:20 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Bridges Drug Savings (HMO SNP)	01	01		1			H0838	028	0	2018	KER LA ORA RIV SBD		2	3084	2			1	4			00000100000000000000		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	029	0	1	01	01	H0838_029_0	13		1	1		08/01/2017	2018.03	08/01/2017 04:57:27 PM Pacific Daylight Time	08/14/2017 04:08:08 PM Pacific Daylight Time	08/14/2017 04:54:46 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Bridges Choice for Medi-Medi (HMO SNP)	01	01		1			H0838	029	0	2018	KER LA ORA RIV SBD		2	2856	2			1	4			00000100000000000000		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	032	0	1	01	01	H0838_032_0	14		1	1		08/01/2017	2018.03	08/01/2017 04:57:37 PM Pacific Daylight Time	08/14/2017 04:09:45 PM Pacific Daylight Time	08/14/2017 04:54:02 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Harmony Drug Savings (HMO SNP)	01	01		1			H0838	032	0	2018	KIN KER  LA ORA RIV SBD		2	4524	2			1	4			00000000000010000000		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	033	0	1	01	01	H0838_033_0	13			1		08/01/2017	2018.03	08/01/2017 04:57:50 PM Pacific Daylight Time	08/14/2017 04:10:31 PM Pacific Daylight Time	08/14/2017 04:53:28 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Classic Choice for Medi-Medi (HMO)	01	01		1			H0838	033	0	2018	FRE IMP KER KIN LA ORA RIV SBD  SD SM SCL TUL		2	51510	2			2						https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	035	0	1	01	01	H0838_035_0	15		1	1		08/01/2017	2018.03	08/01/2017 04:58:03 PM Pacific Daylight Time	08/14/2017 04:12:04 PM Pacific Daylight Time	08/14/2017 04:52:58 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Embrace Care Drug Savings (HMO SNP)	01	01		1			H0838	035	0	2018	FRE IMP KER KIN LA ORA RIV SBD SD SM SCL TUL		2	44575	2			1	4			00000000000000000010		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	036	0	1	01	01	H0838_036_0	15		1	1		08/01/2017	2018.03	08/01/2017 04:58:12 PM Pacific Daylight Time	08/14/2017 04:13:00 PM Pacific Daylight Time	08/14/2017 04:52:31 PM Pacific Daylight Time			08/15/2017 12:58:38 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Embrace Choice for Medi-Medi (HMO SNP)	01	01		1			H0838	036	0	2018	FRE IMP KIN KER LA ORA RIV SBD SD SM SCL TUL		2	45747	2			1	4			00000000000000000010		https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0838	037	0	1	01	01	H0838_037_0	13			1		08/01/2017	2018.03	08/01/2017 04:58:21 PM Pacific Daylight Time	08/01/2017 01:34:45 PM Pacific Daylight Time	07/31/2017 01:55:12 PM Pacific Daylight Time			08/03/2017 03:54:10 PM Pacific Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	https://bndhmo.com/	Brand New Day Classic Care Drug Savings (HMO)	01	01		1			H0838	037	0	2018	FRE IMP KIN SM SCL SM TUL		2	5700	2			2						https://bndhmo.com/	https://bndhmo.com/	https://bndhmo.com/	(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)255-4795		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		(866)321-5955		2					2					2	2			
H0839	001	0	1	20	08	H0839_001_0	2			1		07/06/2017	2018.03	07/06/2017 12:41:29 PM Mountain Daylight Time		07/06/2017 12:33:18 PM Mountain Daylight Time			07/06/2017 12:43:09 PM Mountain Daylight Time	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	Senior CommUnity Care of North Carolina	www.seniorcommunitycarenc.org	Senior CommUnity Care of North Carolina (PACE)	08	20		1			H0839	001	0	2018	Wake Co, Durham Co, Granville Co.		2		2			2						www.seniorcommunitycarenc.org	www.seniorcommunitycarenc.org										(919)425-3000		(919)425-3000		(919)425-3000		(919)425-3000										(919)425-3000		(919)425-3000		(919)425-3000		(919)425-3000																
H0839	002	0	1	20	08	H0839_002_0	2			1		07/06/2017	2018.03	07/06/2017 12:41:49 PM Mountain Daylight Time		07/06/2017 12:33:20 PM Mountain Daylight Time			07/06/2017 12:43:09 PM Mountain Daylight Time	VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC	Senior CommUnity Care of North Carolina	www.seniorcommunitycarenc.org	Senior CommUnity Care of North Carolina (PACE)	08	20		1			H0839	002	0	2018	Wake Co., Durham Co, Granville Co		2		2			2						www.seniorcommunitycarenc.org	www.seniorcommunitycarenc.org										(919)425-3000		(919)425-3000		(919)425-3000		(919)425-3000										(919)425-3000		(919)425-3000		(919)425-3000		(919)425-3000																
H0904	004	0	1	01	01	H0904_004_0	9			1		08/03/2017	2018.03	08/03/2017 03:52:05 PM SA Western Standard Time	08/03/2017 04:03:36 PM SA Western Standard Time	08/03/2017 01:25:46 PM SA Western Standard Time			08/07/2017 11:40:20 AM SA Western Standard Time	GOLDEN CROSS HEALTH PLAN CORP.	CMC Care Advantege	cmccare.care	CMC Care Advantage Vida (HMO) (HMO)	01	01		1			H0904	004	0	2018	CMC Care Advantage Vida (HMO)		2	12	2			2						cmccare.care	cmccare.care	cmccare.care			(787)725-1116				(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		2					2					2	2			
H0904	005	0	1	01	01	H0904_005_0	8			1		07/06/2017	2018.03	07/06/2017 03:32:26 PM SA Western Standard Time	08/03/2017 04:05:14 PM SA Western Standard Time	08/03/2017 01:26:46 PM SA Western Standard Time			08/07/2017 11:40:20 AM SA Western Standard Time	GOLDEN CROSS HEALTH PLAN CORP.	CMC Care Advantege	cmccare.care	CMC Care Advantage Maximo (HMO) (HMO)	01	01		1			H0904	005	0	2018	CMC Care Advantage Maximo (HMO)		2	12	2			2						cmccare.care	cmccare.care	cmccare.care			(787)725-1116				(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		2					2					2	2			
H0904	006	0	1	01	01	H0904_006_0	8			1		08/03/2017	2018.03	08/03/2017 03:55:20 PM SA Western Standard Time	08/03/2017 05:23:58 PM SA Western Standard Time	08/03/2017 01:27:38 PM SA Western Standard Time			08/07/2017 11:40:20 AM SA Western Standard Time	GOLDEN CROSS HEALTH PLAN CORP.	CMC Care Advantege	cmccare.care	CMC Care Advantage Ahorro (HMO) (HMO)	01	01		1			H0904	006	0	2018	CMC Care Advantage Ahorro (HMO)		2	12	2			2						cmccare.care	cmccare.care	cmccare.care			(787)725-1116				(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0070		(787)725-1116		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		(888)907-0020		2					2					2	2			
H0908	001	0	1	01	01	H0908_001_0	6		1	1	2	08/03/2017	2018.03	08/03/2017 08:49:39 AM Eastern Daylight Time	08/04/2017 04:52:20 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/04/2017 07:59:42 PM Pacific Daylight Time	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Allwell	allwell.buckeyehealthplan.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H0908	001	0	2018	Northwest, Northeast, Southwest, and Eastern Ohio		2	581	2			1	3		2		2	https://advantage.buckeyehealthplan.com/findadoctor	https://advantage.buckeyehealthplan.com/partdformulary	https://advantage.buckeyehealthplan.com/findadoctor	(866)389-7690		(866)389-7690		(877)826-5518		(877)826-5518		(866)389-7690		(866)389-7690		(877)826-5518		(877)826-5518		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H0913	002	0	1	01	01	H0913_002_0	3			1		08/03/2017	2018.03	08/03/2017 09:44:40 AM Eastern Daylight Time	08/03/2017 03:16:47 PM Eastern Daylight Time	07/31/2017 06:48:30 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H0913	002	0	2018	Select counties in NJ		2	12977	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8570		(866)687-8570		(866)527-0056		(866)527-0056		(866)687-8570		(866)687-8570		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0913	012	0	1	01	01	H0913_012_0	3			1		08/03/2017	2018.03	08/03/2017 09:46:02 AM Eastern Daylight Time	08/03/2017 03:17:54 PM Eastern Daylight Time	07/31/2017 06:48:54 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H0913	012	0	2018	Select counties in NJ		2	7629	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8570		(866)687-8570		(866)527-0056		(866)527-0056		(866)687-8570		(866)687-8570		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0913	013	0	1	01	01	H0913_013_0	2		1	1	2	08/03/2017	2018.03	08/03/2017 09:47:30 AM Eastern Daylight Time	08/03/2017 03:19:03 PM Eastern Daylight Time	07/31/2017 06:49:17 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H0913	013	0	2018	Select Counties in NJ		2	33017	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)706-9509		(877)706-9509		(866)527-0056		(866)527-0056		(877)706-9509		(877)706-9509		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H0927	001	0	1	48	05	H0927_001_0	7			1		09/18/2017	2018.03	09/18/2017 01:51:02 PM Central Daylight Time					09/18/2017 01:53:13 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Community MMAI	www.hcsc.com	Blue Medicare Advantage (Medicare-Medicaid Plan)	05	48		1			H0927	001	0	2018	Cook, DuPage, Kane, Kankakee, Lake, and Will ctys		2	180000	2			2						www.yourpartd.com	https://myprime.com		(877)723-7702		(877)723-7702		(877)723-7702		(877)723-7702		(877)723-7702		(877)723-7702		(877)723-7702		(877)723-7702		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H1016	001	0	1	01	01	H1016_001_0	15			1		08/07/2017	2018.03	08/07/2017 09:49:36 AM Eastern Daylight Time	08/04/2017 12:10:14 PM Eastern Daylight Time	08/02/2017 08:10:00 AM Eastern Daylight Time			08/07/2017 07:30:03 PM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Medicare Choice (HMO)	01	01		1			H1016	001	0	2018	Miami-Dade County		2	13500	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7d;	
H1016	021	0	1	01	01	H1016_021_0	14			1		08/07/2017	2018.03	08/07/2017 09:48:58 AM Eastern Daylight Time	08/04/2017 12:11:04 PM Eastern Daylight Time	08/02/2017 08:12:02 AM Eastern Daylight Time			08/07/2017 07:30:03 PM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Medicare Choice (HMO)	01	01		1			H1016	021	0	2018	Broward County		2	16000	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7d;	
H1016	801	0	1	01	01	H1016_801_0	9			1		05/16/2017	2018.03	05/16/2017 11:53:54 AM Eastern Daylight Time					06/05/2017 08:28:28 AM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Employer Group MAPD Plan (HMO)	01	01		1			H1016	801	0	2018	AvMed Florida Employer Group Plan		1	10	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1016	802	0	1	01	01	H1016_802_0	9			1		05/02/2017	2018.03	05/02/2017 09:20:26 AM Eastern Daylight Time					06/05/2017 08:28:28 AM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Employer Group MA Only Plan (HMO)	01	01		1			H1016	802	0	2018	AvMed Florida Employer Group Plan		1	10	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003									(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1016	803	0	1	01	01	H1016_803_0	9			1		05/02/2017	2018.03	05/02/2017 09:24:42 AM Eastern Daylight Time					06/05/2017 08:28:28 AM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Employer Group MAPD Non-CY Plan (HMO)	01	01		1			H1016	803	0	2018	AvMed Florida  Employer Group Plan		1	10	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1016	804	0	1	01	01	H1016_804_0	9			1		05/02/2017	2018.03	05/02/2017 09:26:19 AM Eastern Daylight Time					06/05/2017 08:28:28 AM Eastern Daylight Time	AVMED, INC.	AvMed Medicare	www.avmed.org	AvMed Employer Group MA Only Non-CY Plan (HMO)	01	01		1			H1016	804	0	2018	AvMed Florida Employer Group Plan		1	10	2			2						www.avmed.org	www.avmed.org	www.avmed.org	(800)782-8633		(305)671-5437	22147	(800)535-9355		(305)671-5437	21003									(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1019	001	0	1	01	01	H1019_001_0	2			1		08/02/2017	2018.03	08/02/2017 03:26:25 PM Eastern Daylight Time	08/04/2017 11:20:23 AM Eastern Daylight Time	08/04/2017 09:51:08 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	001	0	2018	Broward County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	006	0	1	01	01	H1019_006_0	2			1		08/02/2017	2018.03	08/02/2017 03:29:13 PM Eastern Daylight Time	08/04/2017 11:17:57 AM Eastern Daylight Time	08/04/2017 09:51:08 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	006	0	2018	Miami-Dade County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	023	0	1	01	01	H1019_023_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 09:43:32 AM Eastern Daylight Time	08/04/2017 11:13:12 AM Eastern Daylight Time	08/04/2017 09:51:09 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	023	0	2018	Broward and Palm Beach counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	024	0	1	01	01	H1019_024_0	4		1	1	2	06/03/2017	2018.03	06/03/2017 10:02:31 AM Eastern Daylight Time	08/04/2017 11:14:03 AM Eastern Daylight Time	08/04/2017 09:51:09 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	024	0	2018	Miami-Dade County		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	026	0	1	01	01	H1019_026_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 09:24:31 AM Eastern Daylight Time	08/04/2017 11:15:04 AM Eastern Daylight Time	08/04/2017 09:51:10 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	026	0	2018	Hillsborough, Pasco, Pinellas and Polk counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	028	0	1	01	01	H1019_028_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 09:28:51 AM Eastern Daylight Time	08/04/2017 11:15:54 AM Eastern Daylight Time	08/04/2017 09:51:11 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	028	0	2018	Select local counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	043	0	1	01	01	H1019_043_0	2			1		08/02/2017	2018.03	08/02/2017 03:33:08 PM Eastern Daylight Time	08/04/2017 11:10:24 AM Eastern Daylight Time	08/04/2017 09:51:11 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	043	0	2018	Brevard and Indian River counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	054	0	1	01	01	H1019_054_0	2			1		08/02/2017	2018.03	08/02/2017 03:42:08 PM Eastern Daylight Time	08/04/2017 11:10:47 AM Eastern Daylight Time	08/04/2017 09:51:15 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	054	0	2018	Hillsborough, Pasco, Pinellas and Polk counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	057	0	1	01	01	H1019_057_0	2			1		08/02/2017	2018.03	08/02/2017 03:43:10 PM Eastern Daylight Time	08/04/2017 11:11:11 AM Eastern Daylight Time	08/04/2017 09:51:16 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	057	0	2018	Select local counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	060	0	1	01	01	H1019_060_0	2			1		05/27/2017	2018.03	05/27/2017 11:32:24 AM Eastern Daylight Time	08/04/2017 11:11:36 AM Eastern Daylight Time	08/04/2017 09:51:16 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	060	0	2018	Hillsborough, Pasco, Pinellas and Polk counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	065	0	1	01	01	H1019_065_0	2			1		08/02/2017	2018.03	08/02/2017 03:34:08 PM Eastern Daylight Time	08/04/2017 11:12:00 AM Eastern Daylight Time	08/04/2017 09:51:17 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	065	0	2018	Broward and Palm Beach counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	069	0	1	01	01	H1019_069_0	3			1		08/02/2017	2018.03	08/02/2017 03:43:55 PM Eastern Daylight Time	08/04/2017 11:12:25 AM Eastern Daylight Time	08/04/2017 09:51:17 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	069	0	2018	Duval County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	073	0	1	01	01	H1019_073_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 03:44:28 PM Eastern Daylight Time	08/04/2017 11:17:00 AM Eastern Daylight Time	08/04/2017 09:51:18 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	073	0	2018	Duval County		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	076	0	1	01	01	H1019_076_0	2			1		08/02/2017	2018.03	08/02/2017 03:35:00 PM Eastern Daylight Time	08/04/2017 11:12:48 AM Eastern Daylight Time	08/04/2017 09:51:19 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree PLUS (HMO)	01	01		1			H1019	076	0	2018	Miami-Dade County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	077	0	1	01	01	H1019_077_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 09:32:12 AM Eastern Daylight Time	08/04/2017 11:16:26 AM Eastern Daylight Time	08/04/2017 09:51:19 AM Eastern Daylight Time			08/06/2017 08:56:03 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	077	0	2018	Select local counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	079	0	1	01	01	H1019_079_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 09:33:58 AM Eastern Daylight Time	08/04/2017 11:15:29 AM Eastern Daylight Time	08/04/2017 09:51:20 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	079	0	2018	Hillsborough, Pasco, Pinellas and Polk counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	081	0	1	01	01	H1019_081_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 09:45:13 AM Eastern Daylight Time	08/04/2017 11:13:37 AM Eastern Daylight Time	08/04/2017 09:51:20 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	081	0	2018	Broward and Palm Beach counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	083	0	1	01	01	H1019_083_0	4		1	1	2	06/03/2017	2018.03	06/03/2017 10:03:06 AM Eastern Daylight Time	08/04/2017 11:14:37 AM Eastern Daylight Time	08/04/2017 09:51:21 AM Eastern Daylight Time			08/06/2017 09:23:46 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	083	0	2018	Miami-Dade County		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	085	0	1	01	01	H1019_085_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 09:35:33 AM Eastern Daylight Time	08/04/2017 11:17:31 AM Eastern Daylight Time	08/04/2017 09:51:21 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	085	0	2018	Duval County		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	089	0	1	01	01	H1019_089_0	3			1		06/03/2017	2018.03	06/03/2017 10:05:04 AM Eastern Daylight Time	08/04/2017 11:18:23 AM Eastern Daylight Time	08/04/2017 09:51:22 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareExtra (HMO)	01	01		1			H1019	089	0	2018	Miami-Dade County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	090	0	1	01	01	H1019_090_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 09:37:34 AM Eastern Daylight Time	08/04/2017 11:18:47 AM Eastern Daylight Time	08/04/2017 09:51:22 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	090	0	2018	Brevard and Indian River counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	091	0	1	01	01	H1019_091_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 09:39:27 AM Eastern Daylight Time	08/04/2017 11:19:10 AM Eastern Daylight Time	08/04/2017 09:51:23 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	091	0	2018	Brevard and Indian River counties		2		2			1	3		2		2	www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	092	0	1	01	01	H1019_092_0	2			1		08/02/2017	2018.03	08/02/2017 03:45:19 PM Eastern Daylight Time	08/04/2017 11:19:35 AM Eastern Daylight Time	08/04/2017 09:51:24 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	092	0	2018	Select Local Counties		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1019	094	0	1	01	01	H1019_094_0	2			1		08/02/2017	2018.03	08/02/2017 03:46:11 PM Eastern Daylight Time	08/04/2017 11:19:58 AM Eastern Daylight Time	08/04/2017 09:51:24 AM Eastern Daylight Time			08/06/2017 09:06:27 AM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	094	0	2018	Duval County		2		2			2						www.careplushealthplans.com/pharmacy-finder	www.careplushealthplans.com/medicare-plans/2018-prescription-drug-guides	www.careplushealthplans.com/physician-finder	(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(800)794-5907		(800)794-5907		(800)794-4105		(800)794-4105		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1026	001	0	1	01	01	H1026_001_0	10			1		08/03/2017	2018.03	08/03/2017 03:07:15 PM Eastern Daylight Time	08/04/2017 12:17:45 PM Eastern Daylight Time	08/02/2017 12:45:44 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic (HMO)	01	01		1			H1026	001	0	2018	Miami-Dade County		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	038	0	1	01	01	H1026_038_0	11			1		08/07/2017	2018.03	08/07/2017 02:09:59 PM Eastern Daylight Time	08/04/2017 12:14:33 PM Eastern Daylight Time	08/02/2017 12:51:48 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic (HMO)	01	01		1			H1026	038	0	2018	Palm Beach County		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	040	0	1	01	01	H1026_040_0	13			1		08/03/2017	2018.03	08/03/2017 03:19:33 PM Eastern Daylight Time	08/04/2017 12:11:31 PM Eastern Daylight Time	08/02/2017 12:52:59 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic (HMO)	01	01		1			H1026	040	0	2018	South, Central and NE counties		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	056	0	1	01	01	H1026_056_0	11			1		08/03/2017	2018.03	08/03/2017 03:25:09 PM Eastern Daylight Time	08/04/2017 11:56:20 AM Eastern Daylight Time	08/04/2017 01:08:27 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic (HMO)	01	01		1			H1026	056	0	2018	Orange, Osceola and Seminole counties		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	057	0	1	01	01	H1026_057_0	11			1		08/03/2017	2018.03	08/03/2017 01:34:13 PM Eastern Daylight Time	08/04/2017 11:53:03 AM Eastern Daylight Time	08/04/2017 01:14:54 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic (HMO)	01	01		1			H1026	057	0	2018	Hillsborough, Hernando, Pasco and Polk counties		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	058	0	1	01	01	H1026_058_0	10			1		08/03/2017	2018.03	08/03/2017 03:45:16 PM Eastern Daylight Time	08/04/2017 11:49:29 AM Eastern Daylight Time	08/02/2017 12:57:25 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic Plus (HMO)	01	01		1			H1026	058	0	2018	Palm Beach County		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	059	0	1	01	01	H1026_059_0	10			1		08/04/2017	2018.03	08/04/2017 09:17:23 AM Eastern Daylight Time	08/04/2017 11:46:10 AM Eastern Daylight Time	08/02/2017 12:59:19 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Classic Plus (HMO)	01	01		1			H1026	059	0	2018	Polk		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	060	0	1	01	01	H1026_060_0	12			1		08/03/2017	2018.03	08/03/2017 01:37:28 PM Eastern Daylight Time	08/04/2017 11:43:57 AM Eastern Daylight Time	08/02/2017 01:01:03 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Premier (HMO)	01	01		1			H1026	060	0	2018	Dade		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	061	0	1	01	01	H1026_061_0	10			1		08/04/2017	2018.03	08/04/2017 03:07:57 PM Eastern Daylight Time	08/04/2017 11:41:04 AM Eastern Daylight Time	08/02/2017 01:02:08 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Premier (HMO)	01	01		1			H1026	061	0	2018	Broward		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	062	0	1	01	01	H1026_062_0	10			1		08/03/2017	2018.03	08/03/2017 01:41:44 PM Eastern Daylight Time	08/04/2017 11:37:23 AM Eastern Daylight Time	08/02/2017 01:03:21 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Premier (HMO)	01	01		1			H1026	062	0	2018	Orange		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	063	0	1	01	01	H1026_063_0	11		1	1	2	08/07/2017	2018.03	08/07/2017 01:12:04 PM Eastern Daylight Time	08/04/2017 11:34:46 AM Eastern Daylight Time	08/02/2017 01:06:00 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Complete (HMO SNP)	01	01		1			H1026	063	0	2018	Miami-Dade County		2		2			1	3		1		1	www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	064	0	1	01	01	H1026_064_0	12		1	1	2	08/07/2017	2018.03	08/07/2017 01:12:36 PM Eastern Daylight Time	08/04/2017 11:32:09 AM Eastern Daylight Time	08/02/2017 01:07:17 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Complete (HMO SNP)	01	01		1			H1026	064	0	2018	Broward County		2		2			1	3		1		1	www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	065	0	1	01	01	H1026_065_0	11		1	1	2	08/07/2017	2018.03	08/07/2017 01:13:11 PM Eastern Daylight Time	08/04/2017 11:27:59 AM Eastern Daylight Time	08/02/2017 01:08:20 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Complete (HMO SNP)	01	01		1			H1026	065	0	2018	Orange County		2		2			1	3		1		1	www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1026	066	0	1	01	01	H1026_066_0	11		1	1	2	08/07/2017	2018.03	08/07/2017 01:13:44 PM Eastern Daylight Time	08/04/2017 11:24:56 AM Eastern Daylight Time	08/02/2017 01:10:07 PM Eastern Daylight Time			08/07/2017 06:37:21 PM Eastern Daylight Time	HEALTH OPTIONS, INC.	Florida Blue HMO	BlueMedicareFL.com	BlueMedicare Complete (HMO SNP)	01	01		1			H1026	066	0	2018	Polk County		2		2			1	3		1		1	www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H1032	032	0	1	01	01	H1032_032_0	4			1		08/03/2017	2018.03	08/03/2017 11:04:41 AM Eastern Daylight Time	08/04/2017 02:54:04 PM Eastern Daylight Time	07/31/2017 06:49:41 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	032	0	2018	Select Counties in FL		2	52193	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	040	0	1	01	01	H1032_040_0	3			1		08/03/2017	2018.03	08/03/2017 11:06:20 AM Eastern Daylight Time	08/04/2017 02:55:56 PM Eastern Daylight Time	07/31/2017 06:50:08 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	040	0	2018	Miami-Dade County		2	26355	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	061	0	1	01	01	H1032_061_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:46:55 AM Eastern Daylight Time	08/04/2017 02:58:00 PM Eastern Daylight Time	07/31/2017 06:50:31 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Select (HMO SNP)	01	01		1			H1032	061	0	2018	Select Counties in FL		2	47447	2			1	3		2		2	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	073	0	1	01	01	H1032_073_0	3			1		08/03/2017	2018.03	08/03/2017 11:08:08 AM Eastern Daylight Time	08/04/2017 02:59:55 PM Eastern Daylight Time	07/31/2017 06:50:54 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H1032	073	0	2018	Duval County		2	39080	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	079	0	1	02	01	H1032_079_0	3			1		08/03/2017	2018.03	08/03/2017 11:26:34 AM Eastern Daylight Time	08/04/2017 03:01:57 PM Eastern Daylight Time	07/31/2017 06:51:17 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1032	079	0	2018	Select Counties in FL		2	17557	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	091	0	1	02	01	H1032_091_0	3			1		08/03/2017	2018.03	08/03/2017 11:10:07 AM Eastern Daylight Time	08/04/2017 03:03:54 PM Eastern Daylight Time	07/31/2017 06:51:39 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO-POS)	01	02		1			H1032	091	0	2018	Select Counties in FL		2	217602	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	124	0	1	01	01	H1032_124_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:34:59 AM Eastern Daylight Time	08/04/2017 03:06:12 PM Eastern Daylight Time	07/31/2017 06:52:03 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1032	124	0	2018	Select Counties in FL		2	195427	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	133	0	1	02	01	H1032_133_0	4			1		08/03/2017	2018.03	08/03/2017 11:10:58 AM Eastern Daylight Time	08/04/2017 03:08:15 PM Eastern Daylight Time	07/31/2017 06:52:25 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1032	133	0	2018	Select Counties in FL		2	16864	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	170	0	1	01	01	H1032_170_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:35:32 AM Eastern Daylight Time	08/04/2017 03:10:07 PM Eastern Daylight Time	07/31/2017 06:52:48 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1032	170	0	2018	Miami-Dade County		2	3460	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	174	0	1	02	01	H1032_174_0	3			1		08/03/2017	2018.03	08/03/2017 11:11:51 AM Eastern Daylight Time	08/04/2017 03:12:05 PM Eastern Daylight Time	07/31/2017 06:53:11 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO-POS)	01	02		1			H1032	174	0	2018	Select Counties in FL		2	115753	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	175	0	1	01	01	H1032_175_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:35:57 AM Eastern Daylight Time	08/04/2017 03:14:24 PM Eastern Daylight Time	07/31/2017 06:53:33 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1032	175	0	2018	Select Counties in FL		2	208585	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	176	0	1	01	01	H1032_176_0	3		1	1	2	08/03/2017	2018.03	08/03/2017 11:13:03 AM Eastern Daylight Time	08/04/2017 03:16:16 PM Eastern Daylight Time	07/31/2017 06:53:55 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1032	176	0	2018	Miami-Dade County		2	6054	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	182	0	1	01	01	H1032_182_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:36:26 AM Eastern Daylight Time	08/04/2017 03:18:24 PM Eastern Daylight Time	07/31/2017 06:54:18 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Select (HMO SNP)	01	01		1			H1032	182	0	2018	Select Counties in FL		2	19427	2			1	3		2		2	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(866)637-8041		(866)637-8041		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	184	0	1	01	01	H1032_184_0	3		1	1		08/03/2017	2018.03	08/03/2017 11:14:49 AM Eastern Daylight Time	08/04/2017 03:20:17 PM Eastern Daylight Time	07/31/2017 06:54:40 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Guardian (HMO SNP)	01	01		1			H1032	184	0	2018	Select Counties in FL		2	3804	2			1	4			00000000000000000010		www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	1	01	7a;7g;	
H1032	186	0	1	01	01	H1032_186_0	3		1	1		08/03/2017	2018.03	08/03/2017 11:15:57 AM Eastern Daylight Time	08/03/2017 03:36:55 PM Eastern Daylight Time	07/31/2017 06:55:02 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Guardian (HMO SNP)	01	01		1			H1032	186	0	2018	Select Counties in FL		2	2604	2			1	4			00000000000000000010		www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	1	01	7a;7g;	
H1032	187	1	1	01	01	H1032_187_1	3			1		08/03/2017	2018.03	08/03/2017 11:16:54 AM Eastern Daylight Time	08/03/2017 03:38:05 PM Eastern Daylight Time	07/31/2017 06:55:24 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	187	1	2018	Select Counties in FL	Select Counties in FL	2	28389	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	187	2	1	01	01	H1032_187_2	3			1		08/03/2017	2018.03	08/03/2017 11:17:52 AM Eastern Daylight Time	08/03/2017 03:39:17 PM Eastern Daylight Time	07/31/2017 06:55:47 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	187	2	2018	Select Counties in FL	Select Counties in FL	2	179185	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	188	1	1	01	01	H1032_188_1	3			1		08/03/2017	2018.03	08/03/2017 11:18:49 AM Eastern Daylight Time	08/03/2017 03:40:30 PM Eastern Daylight Time	07/31/2017 06:56:10 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	188	1	2018	Select Counties in FL	Select Counties in FL	2	27400	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1032	188	2	1	01	01	H1032_188_2	3			1		08/03/2017	2018.03	08/03/2017 11:19:38 AM Eastern Daylight Time	08/03/2017 03:41:42 PM Eastern Daylight Time	07/31/2017 06:56:32 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF FLORIDA, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1032	188	2	2018	Select Counties in FL	Select Counties in FL	2	8134	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1035	002	0	1	02	01	H1035_002_0	5			1		08/06/2017	2018.03	08/06/2017 07:23:43 PM Eastern Daylight Time	08/04/2017 04:55:13 PM Eastern Daylight Time	08/04/2017 05:12:38 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Medvantage Rx Plus Plan (HMO-POS)	01	02		1			H1035	002	0	2018	Flagler and Volusia Counties, FL		2	106221	2			2						www.fhcp.com/medicare-2018-directory	www.fhcp.com/medicare-2018-formulary	www.fhcp.com/medicare-2018-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	006	0	1	01	01	H1035_006_0	4			1		08/06/2017	2018.03	08/06/2017 07:18:31 PM Eastern Daylight Time	08/04/2017 04:57:57 PM Eastern Daylight Time	08/04/2017 05:09:44 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's  Medvantage Rx Plan (HMO)	01	01		1			H1035	006	0	2018	Flagler and Volusia Counties, FL		2	46827	2			2						www.fhcp.com/medicare-2018-directory	www.fhcp.com/medicare-2018-formulary	www.fhcp.com/medicare-2018-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	007	0	1	01	01	H1035_007_0	2			1		06/20/2017	2018.03	06/20/2017 01:41:07 PM Eastern Daylight Time	06/05/2017 10:41:12 AM Eastern Daylight Time				06/22/2017 01:15:32 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Medvantage Plan (HMO)	01	01		1			H1035	007	0	2018	Flagler and Volusia Counties, FL		2	2011	2			2						www.fhcp.com/medicare-2018-MAdirectory	http://www.fhcp.com/medicare/2017/Rx-Determination-Criteria-and-Forms	www.fhcp.com/medicare-2018-MAdirectory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110										(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771										2					2					2	2			
H1035	010	0	1	01	01	H1035_010_0	4			1		08/06/2017	2018.03	08/06/2017 07:18:04 PM Eastern Daylight Time	08/04/2017 04:50:28 PM Eastern Daylight Time	08/04/2017 05:42:56 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Premier Plan (HMO)	01	01		1			H1035	010	0	2018	Brevard, Seminole and St. Johns Counties, FL		2	6000	2			2						www.fhcp.com/medicare-2018-directory-brevard	www.fhcp.com/medicare-2018-formulary-brevard	www.fhcp.com/medicare-2018-directory-brevard	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	011	0	1	01	01	H1035_011_0	4			1		06/20/2017	2018.03	06/20/2017 01:41:44 PM Eastern Daylight Time	08/04/2017 04:48:05 PM Eastern Daylight Time	08/04/2017 05:08:25 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Premier Plus Plan (HMO)	01	01		1			H1035	011	0	2018	Brevard, Seminole and St. Johns Counties, FL		2	12000	2			2						www.fhcp.com/medicare-2018-directory-brevard	www.fhcp.com/medicare-2018-formulary-brevard	www.fhcp.com/medicare-2018-directory-brevard	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	014	0	1	01	01	H1035_014_0	5			1		08/04/2017	2018.03	08/04/2017 10:31:26 AM Eastern Daylight Time	08/04/2017 05:01:42 PM Eastern Daylight Time	08/04/2017 05:06:08 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Medvantage Savings Plan (HMO)	01	01		1			H1035	014	0	2018	Volusia and Flagler Counties, FL		2	6000	2			2						www.fhcp.com/medicare-2018-directory	www.fhcp.com/medicare-2018-formulary	www.fhcp.com/medicare-2018-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	015	0	1	01	01	H1035_015_0	5			1		06/23/2017	2018.03	06/23/2017 02:20:03 PM Eastern Daylight Time	08/04/2017 04:52:09 PM Eastern Daylight Time	08/04/2017 05:53:29 PM Eastern Daylight Time			08/06/2017 07:24:17 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	FHCP's Premier Savings Plan (HMO)	01	01		1			H1035	015	0	2018	St. Johns county		2	6000	2			2						www.fhcp.com/medicare-2018-directory	www.fhcp.com/medicare-2018-formulary	www.fhcp.com/medicare-2018-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1035	801	0	1	01	01	H1035_801_0	1			1		06/02/2017	2018.03	06/02/2017 04:50:06 PM Eastern Daylight Time					06/03/2017 07:14:22 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	GRPMED (HMO)	01	01		1			H1035	801	0	2018	Florida		1	500	2			2						www.fhcp.com/medicare-directory	www.fhcp.com/medicare-formulary	www.fhcp.com/medicare-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;12;16b;	1	1a;1b;2;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;12;16b;	1					2				
H1035	802	0	1	01	01	H1035_802_0	1			1		06/02/2017	2018.03	06/02/2017 04:58:05 PM Eastern Daylight Time					06/03/2017 07:31:48 PM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plans	www.fhcp.com/fhcp-medicare	GRPMED+ (HMO)	01	01		1			H1035	802	0	2018	Florida		1	500	2			2						www.fhcp.com/medicare-directory	www.fhcp.com/medicare-formulary	www.fhcp.com/medicare-directory	(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(877)615-4022		(386)615-4022		(855)462-3427		(386)676-7110		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;12;16b;	1	1a;1b;2;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;12;16b;	1					2				
H1036	025	0	1	01	01	H1036_025_0	2			1		08/02/2017	2018.03	08/02/2017 01:26:24 PM Eastern Daylight Time	08/03/2017 02:54:23 PM Eastern Daylight Time	08/04/2017 09:51:25 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-025 (HMO)	01	01		1			H1036	025	0	2018	Hillsborough, Pasco and Pinellas counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	044	0	1	01	01	H1036_044_0	3			1		08/02/2017	2018.03	08/02/2017 12:46:47 PM Eastern Daylight Time	08/03/2017 03:00:49 PM Eastern Daylight Time	08/04/2017 09:51:25 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-044 (HMO)	01	01		1			H1036	044	0	2018	Flagler and Volusia counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	054	0	1	01	01	H1036_054_0	4			1		08/03/2017	2018.03	08/03/2017 02:50:02 PM Eastern Daylight Time	08/04/2017 12:49:52 PM Eastern Daylight Time	08/04/2017 09:51:26 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-054C (HMO)	01	01		1			H1036	054	0	2018	Miami-Dade County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	056	0	1	01	01	H1036_056_0	3			1		05/27/2017	2018.03	05/27/2017 11:35:38 AM Eastern Daylight Time	06/01/2017 10:25:18 AM Eastern Daylight Time				06/02/2017 09:02:13 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-056 (HMO)	01	01		1			H1036	056	0	2018	Flagler and Volusia counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1036	062	0	1	01	01	H1036_062_0	3			1		08/03/2017	2018.03	08/03/2017 09:40:05 AM Eastern Daylight Time	08/04/2017 12:50:50 PM Eastern Daylight Time	08/04/2017 09:51:26 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-062C (HMO)	01	01		1			H1036	062	0	2018	Palm Beach County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	065	0	1	01	01	H1036_065_0	3			1		08/03/2017	2018.03	08/03/2017 09:40:21 AM Eastern Daylight Time	08/04/2017 12:50:23 PM Eastern Daylight Time	08/04/2017 09:51:27 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-065C (HMO)	01	01		1			H1036	065	0	2018	Broward County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	067	0	1	01	01	H1036_067_0	3			1		08/02/2017	2018.03	08/02/2017 01:27:45 PM Eastern Daylight Time	08/03/2017 02:14:05 PM Eastern Daylight Time	08/04/2017 09:51:27 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-067 (HMO)	01	01		1			H1036	067	0	2018	Hernando County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	068	0	1	01	01	H1036_068_0	3			1		08/02/2017	2018.03	08/02/2017 12:50:32 PM Eastern Daylight Time	08/03/2017 02:58:15 PM Eastern Daylight Time	08/04/2017 09:51:28 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-068 (HMO)	01	01		1			H1036	068	0	2018	Jacksonville Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	074	0	1	01	01	H1036_074_0	3			1		08/02/2017	2018.03	08/02/2017 01:29:06 PM Eastern Daylight Time	08/03/2017 02:16:12 PM Eastern Daylight Time	08/04/2017 09:51:29 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-074 (HMO)	01	01		1			H1036	074	0	2018	Manatee County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	077	0	1	01	01	H1036_077_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 11:42:03 AM Eastern Daylight Time	08/04/2017 12:56:25 PM Eastern Daylight Time	08/04/2017 09:51:30 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-077A (HMO SNP)	01	01		1			H1036	077	0	2018	Miami-Dade County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	081	0	1	01	01	H1036_081_0	3			1		08/02/2017	2018.03	08/02/2017 12:53:04 PM Eastern Daylight Time	08/03/2017 02:59:29 PM Eastern Daylight Time	08/04/2017 09:51:30 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-081D (HMO)	01	01		1			H1036	081	0	2018	Baker, Duval and Nassau counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	102	0	1	01	01	H1036_102_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 10:31:46 AM Eastern Daylight Time	08/03/2017 02:23:22 PM Eastern Daylight Time	08/04/2017 09:51:31 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-102 (HMO SNP)	01	01		1			H1036	102	0	2018	Tampa Metro Area		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	103	0	1	01	01	H1036_103_0	4		1	1	2	06/03/2017	2018.03	06/03/2017 10:00:07 AM Eastern Daylight Time	08/04/2017 12:55:27 PM Eastern Daylight Time	08/04/2017 09:51:31 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-103A (HMO SNP)	01	01		1			H1036	103	0	2018	Broward County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	104	0	1	01	01	H1036_104_0	4		1	1	2	06/03/2017	2018.03	06/03/2017 10:00:26 AM Eastern Daylight Time	08/04/2017 12:57:43 PM Eastern Daylight Time	08/04/2017 09:51:32 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-104A (HMO SNP)	01	01		1			H1036	104	0	2018	Palm Beach County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	119	0	1	01	01	H1036_119_0	3			1		05/27/2017	2018.03	05/27/2017 12:52:18 PM Eastern Daylight Time	06/01/2017 09:59:57 AM Eastern Daylight Time				06/02/2017 08:50:34 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-119 (HMO)	01	01		1			H1036	119	0	2018	Tampa Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1036	121	0	1	01	01	H1036_121_0	3		1	1		08/03/2017	2018.03	08/03/2017 09:40:39 AM Eastern Daylight Time	08/04/2017 12:51:21 PM Eastern Daylight Time	08/04/2017 09:51:32 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes (HMO SNP)	01	01		1			H1036	121	0	2018	Broward County		2		2			1	4			00000010000000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	130	0	1	01	01	H1036_130_0	2		1	1		08/03/2017	2018.03	08/03/2017 09:41:02 AM Eastern Daylight Time	08/04/2017 12:52:17 PM Eastern Daylight Time	08/04/2017 09:51:33 AM Eastern Daylight Time			08/06/2017 09:12:08 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes (HMO SNP)	01	01		1			H1036	130	0	2018	Palm Beach County		2		2			1	4			00000010000000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	137	0	1	01	01	H1036_137_0	4			1		08/03/2017	2018.03	08/03/2017 12:34:47 PM Eastern Daylight Time	08/04/2017 03:13:38 PM Eastern Daylight Time	08/04/2017 09:51:33 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-137 (HMO)	01	01		1			H1036	137	0	2018	Charlotte Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	138	0	1	01	01	H1036_138_0	2			1		08/03/2017	2018.03	08/03/2017 11:04:57 AM Eastern Daylight Time	08/04/2017 03:12:12 PM Eastern Daylight Time	08/04/2017 09:51:34 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-138 (HMO)	01	01		1			H1036	138	0	2018	Greensboro / Winston-Salem Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	140	0	1	01	01	H1036_140_0	3			1		08/02/2017	2018.03	08/02/2017 01:31:24 PM Eastern Daylight Time	08/03/2017 02:17:07 PM Eastern Daylight Time	08/04/2017 09:51:35 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-140 (HMO)	01	01		1			H1036	140	0	2018	Citrus County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	143	0	1	01	01	H1036_143_0	3			1		08/02/2017	2018.03	08/02/2017 12:55:03 PM Eastern Daylight Time	08/03/2017 03:02:09 PM Eastern Daylight Time	08/04/2017 09:51:35 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-143 (HMO)	01	01		1			H1036	143	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	146	0	1	01	01	H1036_146_0	2			1		08/02/2017	2018.03	08/02/2017 01:32:37 PM Eastern Daylight Time	08/03/2017 02:18:09 PM Eastern Daylight Time	08/04/2017 09:51:36 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-146 (HMO)	01	01		1			H1036	146	0	2018	Orange, Osceola and Seminole counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	151	0	1	01	01	H1036_151_0	5			1		06/28/2017	2018.03	06/28/2017 11:16:47 AM Eastern Daylight Time	08/04/2017 02:02:30 PM Eastern Daylight Time	08/04/2017 09:51:36 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-151 (HMO)	01	01		1			H1036	151	0	2018	Jackson Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	153	0	1	01	01	H1036_153_0	6			1		08/02/2017	2018.03	08/02/2017 03:37:59 PM Eastern Daylight Time	08/04/2017 05:18:50 PM Eastern Daylight Time	08/04/2017 09:51:37 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-153 (HMO)	01	01		1			H1036	153	0	2018	Clackamas, Multnomah and Washington counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	156	0	1	01	01	H1036_156_0	4		1	1		08/02/2017	2018.03	08/02/2017 12:56:38 PM Eastern Daylight Time	08/03/2017 03:03:33 PM Eastern Daylight Time	08/04/2017 09:51:37 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes (HMO SNP)	01	01		1			H1036	156	0	2018	Flagler and Volusia counties		2		2			1	4			00000010000000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	157	0	1	01	01	H1036_157_0	3			1		05/27/2017	2018.03	05/27/2017 12:11:36 PM Eastern Daylight Time	08/03/2017 03:04:47 PM Eastern Daylight Time	08/04/2017 09:51:38 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-157 (HMO)	01	01		1			H1036	157	0	2018	Flagler and Volusia counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	160	0	1	01	01	H1036_160_0	3		1	1		08/02/2017	2018.03	08/02/2017 01:33:51 PM Eastern Daylight Time	08/03/2017 02:19:14 PM Eastern Daylight Time	08/04/2017 09:51:38 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus - Diabetes (HMO SNP)	01	01		1			H1036	160	0	2018	Tampa Metro Area		2		2			1	4			00000010000000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	167	0	1	01	01	H1036_167_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 12:13:43 PM Eastern Daylight Time	08/04/2017 03:12:41 PM Eastern Daylight Time	08/04/2017 09:51:39 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-167 (HMO SNP)	01	01		1			H1036	167	0	2018	Charlotte Metro Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	168	0	1	01	01	H1036_168_0	2		1	1	2	05/30/2017	2018.03	05/30/2017 10:44:02 AM Eastern Daylight Time	08/04/2017 03:13:10 PM Eastern Daylight Time	08/04/2017 09:51:40 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-168 (HMO SNP)	01	01		1			H1036	168	0	2018	Greensboro / Winston-Salem Metro Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	171	0	1	01	01	H1036_171_0	3			1		05/27/2017	2018.03	05/27/2017 12:25:09 PM Eastern Daylight Time	08/04/2017 02:06:19 PM Eastern Daylight Time	08/04/2017 09:51:40 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-171 (HMO)	01	01		1			H1036	171	0	2018	Gulf Coast Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	175	0	1	01	01	H1036_175_0	4		1	1		08/02/2017	2018.03	08/02/2017 01:00:03 PM Eastern Daylight Time	08/03/2017 03:06:04 PM Eastern Daylight Time	08/04/2017 09:51:41 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes (HMO SNP)	01	01		1			H1036	175	0	2018	Jacksonville Area		2		2			1	4			00000010000000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	199	0	1	01	01	H1036_199_0	3			1		08/03/2017	2018.03	08/03/2017 09:41:16 AM Eastern Daylight Time	08/04/2017 12:53:13 PM Eastern Daylight Time	08/04/2017 09:51:41 AM Eastern Daylight Time			08/06/2017 09:54:31 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-199 (HMO)	01	01		1			H1036	199	0	2018	Palm Beach County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	209	0	1	01	01	H1036_209_0	5		1	1	2	07/20/2017	2018.03	07/20/2017 03:40:06 PM Eastern Daylight Time	08/03/2017 03:08:45 PM Eastern Daylight Time	08/04/2017 09:51:42 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-209 (HMO SNP)	01	01		1			H1036	209	0	2018	Flagler and Volusia counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	210	0	1	01	01	H1036_210_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 10:22:55 AM Eastern Daylight Time	08/03/2017 03:10:53 PM Eastern Daylight Time	08/04/2017 09:51:42 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-210 (HMO SNP)	01	01		1			H1036	210	0	2018	Jacksonville Area		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	213	0	1	01	01	H1036_213_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 10:33:05 AM Eastern Daylight Time	08/03/2017 02:41:08 PM Eastern Daylight Time	08/04/2017 09:51:43 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-213 (HMO SNP)	01	01		1			H1036	213	0	2018	Orange, Osceola and Seminole counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	214	0	1	01	01	H1036_214_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 10:23:56 AM Eastern Daylight Time	08/03/2017 03:13:06 PM Eastern Daylight Time	08/04/2017 09:51:43 AM Eastern Daylight Time			08/06/2017 08:29:44 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-214 (HMO SNP)	01	01		1			H1036	214	0	2018	Select Counties in Florida		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	215	0	1	01	01	H1036_215_0	2			1		08/02/2017	2018.03	08/02/2017 01:36:07 PM Eastern Daylight Time	08/03/2017 02:20:14 PM Eastern Daylight Time	08/04/2017 09:51:44 AM Eastern Daylight Time			08/06/2017 09:11:51 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-215 (HMO)	01	01		1			H1036	215	0	2018	Sarasota County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	217	0	1	01	01	H1036_217_0	2			1		08/02/2017	2018.03	08/02/2017 01:37:24 PM Eastern Daylight Time	08/03/2017 02:55:42 PM Eastern Daylight Time	08/04/2017 09:51:44 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-217 (HMO)	01	01		1			H1036	217	0	2018	Charlotte, Collier and Lee counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	219	0	1	01	01	H1036_219_0	6			1		06/28/2017	2018.03	06/28/2017 10:27:22 AM Eastern Daylight Time	08/04/2017 05:22:30 PM Eastern Daylight Time	08/04/2017 09:51:45 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-219 (HMO)	01	01		1			H1036	219	0	2018	Deschutes and Jefferson counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	222	0	1	01	01	H1036_222_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 10:48:33 AM Eastern Daylight Time	08/04/2017 02:08:41 PM Eastern Daylight Time	08/04/2017 09:51:46 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-222 (HMO SNP)	01	01		1			H1036	222	0	2018	Select Counties in Mississippi		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	223	0	1	01	01	H1036_223_0	4			1		05/27/2017	2018.03	05/27/2017 12:26:46 PM Eastern Daylight Time	08/04/2017 02:06:48 PM Eastern Daylight Time	08/04/2017 09:51:46 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-223 (HMO)	01	01		1			H1036	223	0	2018	DeSoto County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	226	0	1	01	01	H1036_226_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 12:01:35 PM Eastern Daylight Time	08/04/2017 12:58:59 PM Eastern Daylight Time	08/04/2017 09:51:47 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-226 (HMO SNP)	01	01		1			H1036	226	0	2018	Glades, Martin, Okeechobee and St. Lucie counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	229	0	1	01	01	H1036_229_0	2			1		08/03/2017	2018.03	08/03/2017 09:54:29 AM Eastern Daylight Time	08/04/2017 12:53:47 PM Eastern Daylight Time	08/04/2017 09:51:47 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-229 (HMO)	01	01		1			H1036	229	0	2018	Glades, Martin, Okeechobee and St. Lucie counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	230	0	1	01	01	H1036_230_0	3			1		08/02/2017	2018.03	08/02/2017 01:38:38 PM Eastern Daylight Time	08/03/2017 02:21:23 PM Eastern Daylight Time	08/04/2017 09:51:48 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-230 (HMO)	01	01		1			H1036	230	0	2018	Hardee, Highlands and Polk counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	231	0	1	01	01	H1036_231_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 10:33:52 AM Eastern Daylight Time	08/03/2017 02:25:30 PM Eastern Daylight Time	08/04/2017 09:51:48 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-231 (HMO SNP)	01	01		1			H1036	231	0	2018	Hardee, Highlands and Polk counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	233	0	1	01	01	H1036_233_0	3			1		08/03/2017	2018.03	08/03/2017 11:12:56 AM Eastern Daylight Time	08/04/2017 03:14:07 PM Eastern Daylight Time	08/04/2017 09:51:49 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-233 (HMO)	01	01		1			H1036	233	0	2018	Raleigh Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	234	0	1	01	01	H1036_234_0	6		1	1		08/03/2017	2018.03	08/03/2017 09:49:37 AM Eastern Daylight Time	08/04/2017 05:33:46 PM Eastern Daylight Time	08/04/2017 09:51:49 AM Eastern Daylight Time			08/06/2017 09:50:06 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Community HMO Diabetes and Heart (HMO SNP)	01	01		1			H1036	234	0	2018	Jefferson County		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	235	0	1	01	01	H1036_235_0	5		1	1	2	07/18/2017	2018.03	07/18/2017 02:41:29 PM Eastern Daylight Time	08/04/2017 05:34:13 PM Eastern Daylight Time	08/04/2017 09:51:50 AM Eastern Daylight Time			08/06/2017 09:50:06 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Community HMO SNP-DE (HMO SNP)	01	01		1			H1036	235	0	2018	Jefferson County		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	236	0	1	01	01	H1036_236_0	3			1		08/03/2017	2018.03	08/03/2017 10:21:02 AM Eastern Daylight Time	08/04/2017 05:33:19 PM Eastern Daylight Time	08/04/2017 09:51:51 AM Eastern Daylight Time			08/06/2017 09:50:06 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Community HMO (HMO)	01	01		1			H1036	236	0	2018	Jefferson County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	237	1	1	01	01	H1036_237_1	2			1		08/03/2017	2018.03	08/03/2017 09:41:31 AM Eastern Daylight Time	08/04/2017 12:54:23 PM Eastern Daylight Time	08/04/2017 09:51:51 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-237 (HMO)	01	01		1			H1036	237	1	2018	South Florida: Broward or Miami-Dade	South Florida- Broward	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	237	2	1	01	01	H1036_237_2	3			1		08/03/2017	2018.03	08/03/2017 09:41:44 AM Eastern Daylight Time	08/04/2017 12:52:44 PM Eastern Daylight Time	08/04/2017 09:51:52 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-237 (HMO)	01	01		1			H1036	237	2	2018	South Florida: Broward or Miami-Dade	South Florida- Miami-Dade	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	241	0	1	01	01	H1036_241_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:25:01 AM Eastern Daylight Time	08/03/2017 03:07:20 PM Eastern Daylight Time	08/04/2017 09:51:52 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-241 (HMO SNP)	01	01		1			H1036	241	0	2018	Flagler and Volusia counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	243	0	1	01	01	H1036_243_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:26:02 AM Eastern Daylight Time	08/03/2017 03:09:48 PM Eastern Daylight Time	08/04/2017 09:51:53 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-243 (HMO SNP)	01	01		1			H1036	243	0	2018	Jacksonville Area		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	245	0	1	01	01	H1036_245_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:27:09 AM Eastern Daylight Time	08/03/2017 03:12:00 PM Eastern Daylight Time	08/04/2017 09:51:53 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-245 (HMO SNP)	01	01		1			H1036	245	0	2018	Select Counties in Florida		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	247	0	1	01	01	H1036_247_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 01:40:26 PM Eastern Daylight Time	08/03/2017 02:26:40 PM Eastern Daylight Time	08/04/2017 09:51:54 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-247 (HMO SNP)	01	01		1			H1036	247	0	2018	Orange, Osceola and Seminole counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	249	0	1	01	01	H1036_249_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 12:02:05 PM Eastern Daylight Time	08/04/2017 12:58:15 PM Eastern Daylight Time	08/04/2017 09:51:54 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-249 (HMO SNP)	01	01		1			H1036	249	0	2018	Glades, Martin, Okeechobee and St. Lucie counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	251	0	1	01	01	H1036_251_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:35:35 AM Eastern Daylight Time	08/03/2017 02:22:22 PM Eastern Daylight Time	08/04/2017 09:51:55 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-251 (HMO SNP)	01	01		1			H1036	251	0	2018	Tampa Metro Area		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	253	0	1	01	01	H1036_253_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:36:22 AM Eastern Daylight Time	08/03/2017 02:24:30 PM Eastern Daylight Time	08/04/2017 09:51:55 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-253 (HMO SNP)	01	01		1			H1036	253	0	2018	Hardee, Highlands and Polk counties		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	255	0	1	01	01	H1036_255_0	3		1	1	2	06/03/2017	2018.03	06/03/2017 10:00:43 AM Eastern Daylight Time	08/04/2017 12:54:56 PM Eastern Daylight Time	08/04/2017 09:51:56 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-255 (HMO SNP)	01	01		1			H1036	255	0	2018	Broward County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	257	0	1	01	01	H1036_257_0	3		1	1	2	06/03/2017	2018.03	06/03/2017 10:01:00 AM Eastern Daylight Time	08/04/2017 12:55:59 PM Eastern Daylight Time	08/04/2017 09:51:56 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-257 (HMO SNP)	01	01		1			H1036	257	0	2018	Miami-Dade County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	259	0	1	01	01	H1036_259_0	3		1	1	2	06/03/2017	2018.03	06/03/2017 10:01:53 AM Eastern Daylight Time	08/04/2017 12:57:07 PM Eastern Daylight Time	08/04/2017 09:51:57 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-259 (HMO SNP)	01	01		1			H1036	259	0	2018	Palm Beach County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	261	0	1	01	01	H1036_261_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 10:37:08 AM Eastern Daylight Time	08/03/2017 02:42:29 PM Eastern Daylight Time	08/04/2017 09:51:58 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-261 (HMO SNP)	01	01		1			H1036	261	0	2018	Sarasota County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	262	0	1	01	01	H1036_262_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:38:34 AM Eastern Daylight Time	08/03/2017 02:43:44 PM Eastern Daylight Time	08/04/2017 09:51:58 AM Eastern Daylight Time			08/06/2017 09:18:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1036-262 (HMO SNP)	01	01		1			H1036	262	0	2018	Sarasota County		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	263	0	1	01	01	H1036_263_0	2			1		08/03/2017	2018.03	08/03/2017 11:13:35 AM Eastern Daylight Time	08/04/2017 03:17:32 PM Eastern Daylight Time	08/04/2017 09:51:59 AM Eastern Daylight Time			08/06/2017 09:15:17 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-263 (HMO)	01	01		1			H1036	263	0	2018	Charlotte Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	264	0	1	01	01	H1036_264_0	5			1		06/28/2017	2018.03	06/28/2017 11:31:40 AM Eastern Daylight Time	08/04/2017 12:59:46 PM Eastern Daylight Time	08/04/2017 09:51:59 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Value Plus H1036-264 (HMO)	01	01		1			H1036	264	0	2018	Miami-Dade County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	265	1	1	01	01	H1036_265_1	2			1		05/27/2017	2018.03	05/27/2017 01:24:23 PM Eastern Daylight Time	08/03/2017 02:53:04 PM Eastern Daylight Time	08/04/2017 09:52:00 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-265 (HMO)	01	01		1			H1036	265	1	2018	Tampa Metro Area	Tampa Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	265	2	1	01	01	H1036_265_2	2			1		05/27/2017	2018.03	05/27/2017 01:29:58 PM Eastern Daylight Time	08/03/2017 02:49:10 PM Eastern Daylight Time	08/04/2017 09:52:00 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-265 (HMO)	01	01		1			H1036	265	2	2018	Tampa Metro Area	Manatee County	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	266	0	1	01	01	H1036_266_0	2			1		05/29/2017	2018.03	05/29/2017 09:41:24 AM Eastern Daylight Time	08/03/2017 02:47:42 PM Eastern Daylight Time	08/04/2017 09:52:01 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-266 (HMO)	01	01		1			H1036	266	0	2018	Citrus County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	267	0	1	01	01	H1036_267_0	2			1		05/29/2017	2018.03	05/29/2017 09:44:00 AM Eastern Daylight Time	08/03/2017 02:57:01 PM Eastern Daylight Time	08/04/2017 09:52:02 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-267 (HMO)	01	01		1			H1036	267	0	2018	Sarasota County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	268	0	1	01	01	H1036_268_0	2			1		05/27/2017	2018.03	05/27/2017 01:41:41 PM Eastern Daylight Time	08/03/2017 02:50:31 PM Eastern Daylight Time	08/04/2017 09:52:02 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-268 (HMO)	01	01		1			H1036	268	0	2018	Hardee, Highlands and Polk counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	269	0	1	01	01	H1036_269_0	2			1		05/30/2017	2018.03	05/30/2017 11:18:20 AM Eastern Daylight Time	08/03/2017 02:51:46 PM Eastern Daylight Time	08/04/2017 09:52:03 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-269 (HMO)	01	01		1			H1036	269	0	2018	Orange, Osceola and Seminole counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	270	0	1	01	01	H1036_270_0	2			1		05/27/2017	2018.03	05/27/2017 01:49:17 PM Eastern Daylight Time	08/03/2017 03:15:25 PM Eastern Daylight Time	08/04/2017 09:52:03 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-270 (HMO)	01	01		1			H1036	270	0	2018	Jacksonville Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	271	0	1	01	01	H1036_271_0	2			1		05/27/2017	2018.03	05/27/2017 01:52:27 PM Eastern Daylight Time	08/03/2017 03:14:23 PM Eastern Daylight Time	08/04/2017 09:52:04 AM Eastern Daylight Time			08/06/2017 08:36:43 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-271 (HMO)	01	01		1			H1036	271	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	274	0	1	01	01	H1036_274_0	3			1		08/02/2017	2018.03	08/02/2017 02:46:01 PM Eastern Daylight Time	08/04/2017 02:15:56 PM Eastern Daylight Time	08/04/2017 09:52:04 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H1036-274 (HMO)	01	01		1			H1036	274	0	2018	Jackson Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1036	801	0	1	01	01	H1036_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:10:00 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1036	801	0	2018	Select counties in Florida		1	71832	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1036	806	0	1	01	01	H1036_806_0	3			1		06/13/2017	2018.03	06/13/2017 10:10:18 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1036	806	0	2018	Select counties in Florida		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1036	810	0	1	01	01	H1036_810_0	3			1		06/13/2017	2018.03	06/13/2017 10:10:38 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1036	810	0	2018	Select Counties in MS, OR and NC		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1036	811	0	1	01	01	H1036_811_0	3			1		06/13/2017	2018.03	06/13/2017 10:10:51 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1036	811	0	2018	Select Counties in MS, OR and NC		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1043	001	0	1	20	08	H1043_001_0	3			1		05/24/2017	2018.03	05/24/2017 12:12:24 PM Eastern Daylight Time		05/24/2017 03:22:26 PM Eastern Daylight Time			05/24/2017 03:29:09 PM Eastern Daylight Time	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	miamijewishhealthsystems.org	Florida PACE Centers, Inc. (PACE)	08	20		1			H1043	001	0	2018	Florida PACE Centers, Inc.		2		2			2						www.floridapace.org	www.noformulary.com										(855)737-7223		(305)751-8626	66725	(855)737-7223		(305)751-8626	66725									(855)737-7223		(305)751-8626	66725	(855)737-7223		(305)751-8626	66725															
H1043	002	0	1	20	08	H1043_002_0	1			1		05/24/2017	2018.03	05/24/2017 12:13:21 PM Eastern Daylight Time		05/24/2017 12:17:00 PM Eastern Daylight Time			05/24/2017 01:30:29 PM Eastern Daylight Time	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	miamijewishhealthsystems.org	Florida PACE Centers, Inc (PACE)	08	20		1			H1043	002	0	2018	Florida PACE Centers, Inc.		2		2			2						www.floridapace.org	www.noformulary.com										(855)737-7223		(305)751-8626	8465	(855)737-7223		(305)751-8626	8465									(855)737-7223		(305)751-8626	8465	(855)737-7223		(305)751-8626	8465															
H1045	001	0	1	01	01	H1045_001_0	3			1		08/04/2017	2018.03	08/04/2017 09:07:27 AM Central Daylight Time	08/04/2017 09:28:11 AM Central Daylight Time	08/01/2017 09:25:55 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Choice Dade (HMO)	01	01		1			H1045	001	0	2018	Miami-Dade County		2		2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.myPreferredCare.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	005	0	1	01	01	H1045_005_0	3			1		08/04/2017	2018.03	08/04/2017 09:40:56 AM Central Daylight Time	08/04/2017 10:10:32 AM Central Daylight Time	08/01/2017 09:26:22 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Choice Broward (HMO)	01	01		1			H1045	005	0	2018	Broward County		2		2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.myPreferredCare.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	012	0	1	01	01	H1045_012_0	3		1	1	2	08/03/2017	2018.03	08/03/2017 03:55:05 PM Central Daylight Time	08/03/2017 12:51:11 PM Central Daylight Time	08/01/2017 09:26:48 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Medicare Assist (HMO SNP)	01	01		1			H1045	012	0	2018	Miami-Dade and Broward Counties		2		2			1	3		2		2	www.myPreferredCare.com	www.myPreferredCare.com	www.myPreferredCare.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	018	0	1	01	01	H1045_018_0	3		1	1		08/03/2017	2018.03	08/03/2017 05:29:55 PM Central Daylight Time	08/03/2017 03:45:44 PM Central Daylight Time	08/01/2017 09:27:14 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Special Care Miami-Dade (HMO SNP)	01	01		1			H1045	018	0	2018	Miami-Dade County		2		2			1	4			00000000000000000010		www.myPreferredCare.com	www.myPreferredCare.com	www.myPreferredCare.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	025	0	1	01	01	H1045_025_0	6			1		08/02/2017	2018.03	08/02/2017 04:07:11 PM Central Daylight Time	08/03/2017 12:52:29 PM Central Daylight Time	08/01/2017 09:27:40 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare The Villages MedicareComplete 1 (HMO)	01	01		1			H1045	025	0	2018	Lake, Marion and Sumter counties		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	026	0	1	01	01	H1045_026_0	3			1		08/02/2017	2018.03	08/02/2017 04:08:18 PM Central Daylight Time	08/03/2017 12:53:08 PM Central Daylight Time	08/01/2017 09:28:06 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	026	0	2018	Clay, Duval, and Nassau counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	027	0	1	02	01	H1045_027_0	4			1		06/02/2017	2018.03	06/02/2017 09:50:34 AM Central Daylight Time	08/03/2017 12:53:48 PM Central Daylight Time	08/01/2017 09:28:32 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare The Villages MedicareComplete 2 (HMO-POS)	01	02		1			H1045	027	0	2018	Lake, Marion and Sumter counties		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	028	0	1	01	01	H1045_028_0	3			1		08/02/2017	2018.03	08/02/2017 04:13:32 PM Central Daylight Time	08/03/2017 12:54:25 PM Central Daylight Time	08/01/2017 09:28:58 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	028	0	2018	Select Counties in Central Florida		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H1045	030	0	1	01	01	H1045_030_0	3			1		08/02/2017	2018.03	08/02/2017 04:14:57 PM Central Daylight Time	08/03/2017 12:55:01 PM Central Daylight Time	08/01/2017 09:29:25 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	030	0	2018	Brevard, Orange, Osceola and Seminole counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H1045	031	0	1	01	01	H1045_031_0	3			1		08/02/2017	2018.03	08/02/2017 04:16:42 PM Central Daylight Time	08/03/2017 12:55:41 PM Central Daylight Time	08/01/2017 09:29:52 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	031	0	2018	Escambia, Okaloosa and Santa Rosa counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	032	0	1	01	01	H1045_032_0	3			1		08/02/2017	2018.03	08/02/2017 04:17:26 PM Central Daylight Time	08/03/2017 12:56:18 PM Central Daylight Time	08/01/2017 09:30:18 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	032	0	2018	Bay and Walton counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	033	0	1	01	01	H1045_033_0	3			1		08/02/2017	2018.03	08/02/2017 04:18:01 PM Central Daylight Time	08/03/2017 12:57:00 PM Central Daylight Time	08/01/2017 09:30:44 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	033	0	2018	Alachua, Columbia, Gilchrist, and Suwanne counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	034	0	1	01	01	H1045_034_0	3			1		08/02/2017	2018.03	08/02/2017 04:18:45 PM Central Daylight Time	08/03/2017 12:57:37 PM Central Daylight Time	08/01/2017 09:31:10 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1045	034	0	2018	Select counties in Fort Myers/Naples Florida		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	035	0	1	01	01	H1045_035_0	3			1		08/02/2017	2018.03	08/02/2017 04:19:30 PM Central Daylight Time	08/03/2017 01:33:48 PM Central Daylight Time	08/01/2017 09:31:37 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	035	0	2018	Flagler, Putnam, and St. Johns counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	036	0	1	01	01	H1045_036_0	3			1		08/02/2017	2018.03	08/02/2017 04:20:24 PM Central Daylight Time	08/03/2017 01:34:25 PM Central Daylight Time	08/01/2017 09:32:03 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (HMO)	01	01		1			H1045	036	0	2018	Indian River, Martin and St. Lucie counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	037	0	1	01	01	H1045_037_0	3			1		08/02/2017	2018.03	08/02/2017 04:20:46 PM Central Daylight Time	08/03/2017 01:35:02 PM Central Daylight Time	08/01/2017 09:32:30 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Choice Palm Beach (HMO)	01	01		1			H1045	037	0	2018	Palm Beach county		2		2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.myPreferredCare.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	038	0	1	01	01	H1045_038_0	3		1	1	2	05/26/2017	2018.03	05/26/2017 10:20:51 AM Central Daylight Time	08/03/2017 01:35:37 PM Central Daylight Time	08/01/2017 09:32:57 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.myPreferredCare.com	Preferred Medicare Assist Palm Beach (HMO SNP)	01	01		1			H1045	038	0	2018	Palm Beach county		2		2			1	3		2		2	www.myPreferredCare.com	www.myPreferredCare.com	www.UHCMedicareSolutions.com	(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(866)231-7201		(866)231-7201		(877)485-5595		(877)485-5595		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	039	0	1	01	01	H1045_039_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:19:44 AM Central Daylight Time	08/03/2017 01:36:14 PM Central Daylight Time	08/01/2017 09:33:23 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H1045	039	0	2018	Select counties in Central Florida		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	040	0	1	01	01	H1045_040_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:20:35 AM Central Daylight Time	08/03/2017 01:36:50 PM Central Daylight Time	08/01/2017 09:33:50 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H1045	040	0	2018	Select counties in Florida		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)627-7806		(866)627-7806		(888)834-3721		(888)834-3721		(866)627-7806		(866)627-7806		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	041	0	1	02	01	H1045_041_0	4			1		08/02/2017	2018.03	08/02/2017 04:21:28 PM Central Daylight Time	08/03/2017 01:37:25 PM Central Daylight Time	08/01/2017 09:34:17 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1045	041	0	2018	Gadsden, Holmes, Jackson, and Washington counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1045	042	0	1	01	01	H1045_042_0	4			1		08/02/2017	2018.03	08/02/2017 04:22:00 PM Central Daylight Time	08/03/2017 01:38:03 PM Central Daylight Time	08/01/2017 09:34:43 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	042	0	2018	DeSoto, Highlands, and Hardee counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H1045	043	0	1	01	01	H1045_043_0	4			1		08/02/2017	2018.03	08/02/2017 04:23:22 PM Central Daylight Time	08/03/2017 01:38:39 PM Central Daylight Time	08/01/2017 09:35:08 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1045	043	0	2018	Citrus and Levy counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(866)627-7806		(866)627-7806		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H1045	801	0	1	01	01	H1045_801_0	3			1		06/08/2017	2018.03	06/08/2017 11:21:49 AM Central Daylight Time					06/13/2017 04:39:26 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1045	801	0	2018	Select counties in Florida		1	540	2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1045	802	0	1	01	01	H1045_802_0	1			1		05/25/2017	2018.03	05/25/2017 11:16:55 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1045	802	0	2018	Select counties in Florida		1	0	2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1045	803	0	1	01	01	H1045_803_0	1			1		05/24/2017	2018.03	05/24/2017 09:45:48 AM Central Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1045	803	0	2018	Select counties in Florida		1	0	2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1045	804	0	2	01	01	H1045_804_0	1			1		05/25/2017	2018.03	05/25/2017 10:50:46 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	PREFERRED CARE PARTNERS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H1045	804	0	2018	Select counties in Florida		1	0	2			2						www.myPreferredCare.com	www.myPreferredCare.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1099	001	0	1	02	01	H1099_001_0	14			1		07/06/2017	2018.03	07/06/2017 03:55:39 PM Eastern Daylight Time	08/01/2017 04:03:09 PM Eastern Daylight Time	08/04/2017 09:20:19 PM Eastern Daylight Time			08/06/2017 07:43:19 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	Health First Classic Plan (HMO-POS)	01	02		1			H1099	001	0	2018	Counties: BR, IR		2	131615	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1099	006	0	1	01	01	H1099_006_0	12			1		08/02/2017	2018.03	08/02/2017 10:24:44 AM Eastern Daylight Time	08/02/2017 10:44:49 AM Eastern Daylight Time	08/04/2017 09:28:59 PM Eastern Daylight Time			08/06/2017 07:43:19 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	Health First Value Plan (HMO)	01	01		1			H1099	006	0	2018	Counties: BR, IR		2	121137	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1099	009	0	1	01	01	H1099_009_0	6			1		07/06/2017	2018.03	07/06/2017 04:02:09 PM Eastern Daylight Time	07/12/2017 12:01:36 PM Eastern Daylight Time				07/14/2017 10:55:42 AM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	Health First Secure Plan (HMO)	01	01		1			H1099	009	0	2018	Counties: BR, IR		2	5867	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737										(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771										2					2					2	2			
H1099	014	0	1	01	01	H1099_014_0	11			1		08/02/2017	2018.03	08/02/2017 10:26:45 AM Eastern Daylight Time	08/02/2017 11:28:34 AM Eastern Daylight Time	08/04/2017 09:50:22 PM Eastern Daylight Time			08/06/2017 07:43:19 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	Health First Rewards Plan (HMO)	01	01		1			H1099	014	0	2018	Counties: BR, IR		2	90662	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1099	016	0	1	02	01	H1099_016_0	12			1		07/06/2017	2018.03	07/06/2017 04:03:54 PM Eastern Daylight Time	08/02/2017 11:17:56 AM Eastern Daylight Time	08/04/2017 10:00:16 PM Eastern Daylight Time			08/06/2017 07:43:19 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myFHCA.org	Florida Hospital SunSaver Plan (HMO-POS)	01	02		1			H1099	016	0	2018	Counties: VO, FL, HA, HI, SE		2	94929	2			2						myFHCA.org	myFHCA.org	myFHCA.org	(855)882-6467		(855)882-6467		(855)882-6467		(855)882-6467		(855)882-6467		(855)882-6467		(855)882-6467		(855)882-6467		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		2					2					2	2			
H1099	802	0	1	01	01	H1099_802_0	1			1		06/07/2017	2018.03	06/07/2017 02:06:59 PM Eastern Daylight Time					06/07/2017 02:08:00 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	EMPLOYER GROUP PLUS (HMO)	01	01		1			H1099	802	0	2018	Central Florida Area		1	12303	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		1	1	1a;1b;2;3-1;3-3;6;7i;8a;8b2;9a;9b;9c;10a;11a;11b;14e3;15;16b;	2		1					1				
H1099	804	0	1	02	01	H1099_804_0	1			1		05/19/2017	2018.03	05/19/2017 09:02:47 AM Eastern Daylight Time					06/07/2017 02:08:00 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS	Health First Health Plans, Inc.	myHFHP.org	EMPLOYER GROUP POS (HMO-POS)	01	02		1			H1099	804	0	2018	Central Florida Area		1	910	2			2						myHFHP.org	myHFHP.org	myHFHP.org	(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)716-7737		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		(800)955-8771		1	1	1a;1b;2;3-1;3-2;3-3;6;7c;7i;8a;8b1;8b2;9a;9b;9c;9d;10a;11a;11b;11c;14e3;15;16b;	2		1	1	1a;1b;2;3-1;3-2;3-3;6;7c;7i;8a;8b1;8b2;9a;9b;9c;9d;10a;11a;11b;11c;14e3;15;16b;	2		1				
H1100	001	0	1	04	01	H1100_001_0	5			1		06/28/2017	2018.03	06/28/2017 10:00:07 AM Eastern Daylight Time	08/04/2017 08:19:03 PM Eastern Daylight Time	07/31/2017 06:26:07 PM Eastern Daylight Time			08/04/2017 08:50:13 PM Eastern Daylight Time	INNOVATION HEALTH INSURANCE COMPANY	Innovation Health	www.aetnamedicare.com	Innovation Health Medicare Voyager Plan (PPO)	01	04		1			H1100	001	0	2018	Fairfax County and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	4b;7a;7d;7g;	
H1109	005	0	1	01	01	H1109_005_0	5			1		08/02/2017	2018.03	08/02/2017 02:47:51 PM Eastern Daylight Time	08/02/2017 01:34:48 PM Central Daylight Time	07/31/2017 04:34:28 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC.(GA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H1109	005	0	2018	Atlanta and Surrounding Counties		2	100	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1109	801	0	1	01	01	H1109_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:27:37 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC.(GA)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H1109	801	0	2018	Georgia		1	1420	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1109	802	0	1	01	01	H1109_802_0	2			1		05/30/2017	2018.03	05/30/2017 05:05:02 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC.(GA)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H1109	802	0	2018	Georgia		1	6040	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1111	006	0	1	01	01	H1111_006_0	3			1		08/02/2017	2018.03	08/02/2017 02:19:28 PM Central Daylight Time	08/03/2017 01:39:14 PM Central Daylight Time	08/01/2017 09:35:35 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1111	006	0	2018	Select counties in Georgia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1111	007	0	1	01	01	H1111_007_0	3			1		06/28/2017	2018.03	06/28/2017 09:41:06 AM Central Daylight Time	08/03/2017 01:39:50 PM Central Daylight Time	08/01/2017 09:36:02 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1111	007	0	2018	Select counties in Georgia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1111	801	0	1	01	01	H1111_801_0	1			1		05/25/2017	2018.03	05/25/2017 11:11:09 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	801	0	2018	GA Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1111	804	0	1	01	01	H1111_804_0	1			1		05/25/2017	2018.03	05/25/2017 11:11:24 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	804	0	2018	GA Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1111	805	0	1	01	01	H1111_805_0	1			1		05/25/2017	2018.03	05/25/2017 11:17:33 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	805	0	2018	GA Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1111	807	0	2	01	01	H1111_807_0	1			1		05/25/2017	2018.03	05/25/2017 11:11:51 AM Pacific Daylight Time					06/01/2017 04:22:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H1111	807	0	2018	GA Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1112	006	0	1	01	01	H1112_006_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 09:26:57 AM Eastern Daylight Time	08/04/2017 03:26:48 PM Eastern Daylight Time	07/31/2017 06:56:55 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1112	006	0	2018	Select Counties in GA		2	189335	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)482-3361		(866)482-3361		(866)527-0056		(866)527-0056		(866)482-3361		(866)482-3361		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1112	027	0	1	01	01	H1112_027_0	4			1		08/03/2017	2018.03	08/03/2017 11:23:21 AM Eastern Daylight Time	08/04/2017 03:28:03 PM Eastern Daylight Time	07/31/2017 06:57:18 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H1112	027	0	2018	Select Counties in GA		2	311100	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-7730		(866)334-7730		(866)527-0056		(866)527-0056		(866)334-7730		(866)334-7730		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1112	033	0	1	01	01	H1112_033_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 09:28:36 AM Eastern Daylight Time	08/04/2017 03:29:17 PM Eastern Daylight Time	07/31/2017 06:57:39 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1112	033	0	2018	Select Counties in GA		2	35464	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)482-3361		(866)482-3361		(866)527-0056		(866)527-0056		(866)482-3361		(866)482-3361		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1112	034	0	1	02	01	H1112_034_0	2			1		05/26/2017	2018.03	05/26/2017 04:42:30 PM Eastern Daylight Time	06/01/2017 12:15:01 PM Eastern Daylight Time				06/02/2017 11:39:57 AM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Advance (HMO-POS)	01	02		1			H1112	034	0	2018	Select Counties in GA		2	5934	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-7730		(866)334-7730		(866)527-0056		(866)527-0056										(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272										2					2					2	2			
H1112	035	0	1	01	01	H1112_035_0	3			1		08/03/2017	2018.03	08/03/2017 11:24:38 AM Eastern Daylight Time	08/03/2017 03:46:43 PM Eastern Daylight Time	07/31/2017 06:58:01 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO)	01	01		1			H1112	035	0	2018	Cobb County		2	3279	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-7730		(866)334-7730		(866)527-0056		(866)527-0056		(866)334-7730		(866)334-7730		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1170	002	0	1	01	01	H1170_002_0	8			1		08/02/2017	2018.03	08/02/2017 01:56:39 PM Eastern Daylight Time	08/04/2017 11:56:54 AM Eastern Daylight Time	08/04/2017 12:06:20 PM Eastern Daylight Time			08/04/2017 02:47:06 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced (HMO)	01	01		1			H1170	002	0	2018	Atlanta Metro Area		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1170	008	0	1	01	01	H1170_008_0	7		1	1	2	08/02/2017	2018.03	08/02/2017 01:55:07 PM Eastern Daylight Time	08/04/2017 11:59:47 AM Eastern Daylight Time	08/04/2017 12:41:25 PM Eastern Daylight Time			08/04/2017 02:47:06 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	Senior Advantage Medicare Medicaid Plan (HMO SNP)	01	01		1			H1170	008	0	2018	Atlanta Metro Area		2		2			1	3		2		2	kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1170	009	0	1	01	01	H1170_009_0	8			1		08/02/2017	2018.03	08/02/2017 01:57:21 PM Eastern Daylight Time	08/04/2017 11:58:20 AM Eastern Daylight Time	08/04/2017 12:17:03 PM Eastern Daylight Time			08/04/2017 02:47:06 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H1170	009	0	2018	Atlanta Metro Area		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1170	801	0	1	01	01	H1170_801_0	3			1		05/26/2017	2018.03	05/26/2017 11:40:31 AM Eastern Daylight Time					06/05/2017 07:27:13 AM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Employer Group Plan (HMO)	01	01		1			H1170	801	0	2018	Atlanta Metro Area		1	1	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;16b;	1					2				
H1170	802	0	1	01	01	H1170_802_0	3			1		05/26/2017	2018.03	05/26/2017 11:33:05 AM Eastern Daylight Time					06/05/2017 07:27:13 AM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Employer Group With Part D (HMO)	01	01		1			H1170	802	0	2018	Atlanta Metro Area		1	51363	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;16b;	1					2				
H1170	805	0	1	01	01	H1170_805_0	3			1		05/26/2017	2018.03	05/26/2017 11:31:54 AM Eastern Daylight Time					06/05/2017 07:27:13 AM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente	kp.org/medicare	FEHB Part AB  with D (HMO)	01	01		1			H1170	805	0	2018	Atlanta Metro Area		1	19499	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(800)232-4404		(800)232-4404		(877)408-3493		(877)408-3493		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;16b;	1					2				
H1181	001	0	1	07	02	H1181_001_0	5			2		06/02/2017	2018.03	06/02/2017 08:25:19 AM Central Daylight Time			06/04/2017 01:33:13 PM Central Daylight Time		06/04/2017 01:39:24 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	NetworkPrime (MSA)	02	07	2	1			H1181	001	0	2018	Wisconsin		2		2			2									(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280										(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529																								
H1189	001	0	1	01	01	H1189_001_0	6			1		08/04/2017	2018.03	08/04/2017 03:18:29 PM Pacific Daylight Time	08/07/2017 01:29:34 PM Pacific Daylight Time	07/31/2017 03:52:24 PM Pacific Daylight Time			08/07/2017 04:00:26 PM Pacific Daylight Time	CHRISTUS HEALTH PLAN	CHRISTUS Health Plan Generations	http://www.christushealthplan.org	CHRISTUS Health Plan Generations (HMO)	01	01		1			H1189	001	0	2018	North Central New Mexico		2	4283	2			2						www.christushealthplan.org	www.christushealthplan.org		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		2					2					2	2			
H1189	002	0	1	01	01	H1189_002_0	6			1		08/04/2017	2018.03	08/04/2017 11:54:42 AM Pacific Daylight Time	08/07/2017 01:31:10 PM Pacific Daylight Time	07/31/2017 03:53:02 PM Pacific Daylight Time			08/07/2017 04:00:26 PM Pacific Daylight Time	CHRISTUS HEALTH PLAN	CHRISTUS Health Plan Generations	http://www.christushealthplan.org	CHRISTUS Health Plan Generations Plus (HMO)	01	01		1			H1189	002	0	2018	North Central New Mexico		2	1071	2			2						www.christushealthplan.org	www.christushealthplan.org		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		2					2					2	2			
H1189	003	0	1	01	01	H1189_003_0	4			1		08/04/2017	2018.03	08/04/2017 02:31:48 PM Pacific Daylight Time	08/07/2017 01:32:48 PM Pacific Daylight Time	07/31/2017 03:54:46 PM Pacific Daylight Time			08/07/2017 04:00:26 PM Pacific Daylight Time	CHRISTUS HEALTH PLAN	CHRISTUS Health Plan Generations	http://www.christushealthplan.org/	CHRISTUS Health Plan Generations (HMO)	01	01		1			H1189	003	0	2018	Cherokee, Smith and Wood counties		2	7200	2			2						www.christushealthplan.org	www.christushealthplan.org		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		2					2					2	2			
H1189	004	0	1	01	01	H1189_004_0	4			1		08/04/2017	2018.03	08/04/2017 11:55:14 AM Pacific Daylight Time	08/07/2017 01:37:05 PM Pacific Daylight Time	07/31/2017 03:56:50 PM Pacific Daylight Time			08/07/2017 04:00:26 PM Pacific Daylight Time	CHRISTUS HEALTH PLAN	CHRISTUS Health Plan Generations	http://www.christushealthplan.org/	CHRISTUS Health Plan Generations Plus (HMO)	01	01		1			H1189	004	0	2018	Cherokee, Smith and Wood counties		2	7200	2			2						www.christushealthplan.org	www.christushealthplan.org		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(844)282-3026		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		(800)659-8331		2					2					2	2			
H1225	001	0	1	01	01	H1225_001_0	5			1		08/04/2017	2018.03	08/04/2017 02:07:36 PM Eastern Daylight Time	08/03/2017 03:00:00 PM Eastern Daylight Time	08/03/2017 07:31:46 PM Eastern Daylight Time			08/04/2017 02:09:18 PM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	http://www.hopkinsmedicare.com/	Johns Hopkins Advantage MD (HMO)	01	01		1			H1225	001	0	2018	Counties: AA BL CV CR FR HW MG SS WH WC WR		2	15960	2			2						http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1225	002	0	1	01	01	H1225_002_0	5			1		08/04/2017	2018.03	08/04/2017 02:08:07 PM Eastern Daylight Time	08/03/2017 03:03:12 PM Eastern Daylight Time	08/03/2017 07:32:22 PM Eastern Daylight Time			08/04/2017 02:09:18 PM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	http://www.hopkinsmedicare.com	Johns Hopkins Advantage MD (HMO)	01	01		1			H1225	002	0	2018	Baltimore City		2	6012	2			2						http://www.hopkinsmedicare.com	http://www.hopkinsmedicare.com	http://www.hopkinsmedicare.com	(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	001	0	1	01	01	H1230_001_0	7			1		07/18/2017	2018.03	07/18/2017 09:49:41 AM Hawaiian Standard Time	08/04/2017 08:29:51 AM Hawaiian Standard Time	08/04/2017 08:22:51 AM Hawaiian Standard Time			08/04/2017 01:45:12 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced (HMO)	01	01		1			H1230	001	0	2018	Island of Oahu		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	003	0	1	01	01	H1230_003_0	7			1		08/01/2017	2018.03	08/01/2017 03:50:33 PM Hawaiian Standard Time	08/04/2017 08:30:45 AM Hawaiian Standard Time	08/04/2017 08:24:07 AM Hawaiian Standard Time			08/04/2017 01:45:12 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H1230	003	0	2018	Island of Oahu		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	008	0	1	01	01	H1230_008_0	5		1	1	2	06/02/2017	2018.03	06/02/2017 11:52:27 AM Hawaiian Standard Time	08/04/2017 08:31:37 AM Hawaiian Standard Time	08/04/2017 08:25:25 AM Hawaiian Standard Time			08/04/2017 01:45:12 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Senior Advantage Medicare Medicaid (HMO SNP)	01	01		1			H1230	008	0	2018	Islands of Oahu and Maui		2		2			1	3		1		2	kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	013	0	1	01	01	H1230_013_0	8			1		07/13/2017	2018.03	07/13/2017 02:54:10 PM Hawaiian Standard Time	08/04/2017 08:32:25 AM Hawaiian Standard Time	08/04/2017 08:26:37 AM Hawaiian Standard Time			08/04/2017 01:45:12 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Maui (HMO)	01	01		1			H1230	013	0	2018	Island of Maui		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	014	0	1	01	01	H1230_014_0	8			1		07/13/2017	2018.03	07/13/2017 02:54:33 PM Hawaiian Standard Time	08/04/2017 08:33:14 AM Hawaiian Standard Time	08/04/2017 08:27:50 AM Hawaiian Standard Time			08/04/2017 01:45:12 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Hawaii Island (HMO)	01	01		1			H1230	014	0	2018	Island of Hawaii except for 3 ZIPs		2		2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(800)805-2739		(800)805-2739		(877)408-3494		(877)408-3494		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1230	801	0	1	01	01	H1230_801_0	4			1		06/02/2017	2018.03	06/02/2017 11:39:04 AM Hawaiian Standard Time					06/05/2017 09:03:13 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Employer Group MA only (HMO)	01	01		1			H1230	801	0	2018	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1	1162	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;6;7b;7g;9b;9d;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;14e1;14e3;16b;18a;	1					2				
H1230	803	0	1	01	01	H1230_803_0	4			1		05/23/2017	2018.03	05/23/2017 03:23:20 PM Hawaiian Standard Time					06/05/2017 09:03:13 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Employer Group MA-PD (HMO)	01	01		1			H1230	803	0	2018	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1	153604	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;6;7b;7g;9b;9d;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;14e1;14e3;16b;18a;	1					2				
H1230	804	0	2	01	01	H1230_804_0	4			1		05/23/2017	2018.03	05/23/2017 03:24:07 PM Hawaiian Standard Time					06/05/2017 09:03:13 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Employer Group MA-PD Part B (HMO)	01	01		2	1		H1230	804	0	2018	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1	1552	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;6;7b;7g;9b;9d;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;14e1;14e3;16b;18a;	1					2				
H1230	805	0	1	01	01	H1230_805_0	4			1		05/23/2017	2018.03	05/23/2017 03:24:40 PM Hawaiian Standard Time					06/05/2017 09:03:13 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H1230	805	0	2018	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1	26271	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;6;7b;7g;9b;9d;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;14e1;14e3;16b;18a;	1					2				
H1230	806	0	2	01	01	H1230_806_0	4			1		05/23/2017	2018.03	05/23/2017 03:25:55 PM Hawaiian Standard Time					06/05/2017 09:03:13 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H1230	806	0	2018	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1	265	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(800)805-2739		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;6;7b;7g;9b;9d;10a;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;14a;14e1;14e3;16b;18a;	1					2				
H1234	001	0	1	20	08	H1234_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:11:48 PM Eastern Daylight Time		05/25/2017 12:55:35 PM Eastern Daylight Time			05/25/2017 01:12:56 PM Eastern Daylight Time	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org/LIFE	SFMC-Dual (PACE)	08	20		1			H1234	001	0	2018	Mercer County and portions of Burlington County		2		2			2						www.pharmastarpbm.com	www.stfrancismedical.org										(609)599-5474		(609)599-5474		(609)599-5474		(609)599-5474										(609)599-5474		(609)599-5474		(609)599-5474		(609)599-5474																
H1234	002	0	1	20	08	H1234_002_0	1			1		05/25/2017	2018.03	05/25/2017 12:44:29 PM Eastern Daylight Time		05/25/2017 12:56:03 PM Eastern Daylight Time			05/25/2017 01:12:56 PM Eastern Daylight Time	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org/LIFE	SFMC-Medicare only (PACE)	08	20		1			H1234	002	0	2018	Mercer County and portions of Burlington County		2		2			2						www.pharmastarpbm.com	www.stfrancismedical.org										(609)599-5474		(609)599-5474		(609)599-5474		(609)599-5474										(609)599-5474		(609)599-5474		(609)599-5474		(609)599-5474																
H1239	001	0	1	20	08	H1239_001_0	2			1		05/31/2017	2018.03	05/31/2017 04:05:03 PM Eastern Daylight Time		07/18/2017 01:30:56 PM Eastern Daylight Time			07/18/2017 01:34:00 PM Eastern Daylight Time	KISSITO PACE OF ROANOKE, INC.	Kissito PACE Marketing	http://kissitopace.org	Kissito PACE Part D (PACE)	08	20		1			H1239	001	0	2018	Kissito PACE of Roanoke, INC.		2		2			2						www.seniorscript.com	www.kissitopace.org										(540)904-2817	113	(540)904-2817	113	(540)904-2817	113	(540)904-2817	113									(540)904-2817	113	(540)904-2817	113	(540)904-2817	113	(540)904-2817	113															
H1239	002	0	1	20	08	H1239_002_0	1			1		05/31/2017	2018.03	05/31/2017 04:05:36 PM Eastern Daylight Time		06/01/2017 12:30:44 PM Eastern Daylight Time			06/01/2017 12:32:15 PM Eastern Daylight Time	KISSITO PACE OF ROANOKE, INC.	Kissito PACE Marketing	www.KissitoPACE.org	Kissito PACE of Roanoke (PACE)	08	20		1			H1239	002	0	2018	Kissito PACE of Roanoke INC.		2		2			2						www.seniorscript.com	www.kissitopace.org										(540)904-2817	113	(540)904-2817	113	(540)904-2817	113	(540)904-2817	113									(540)904-2817	113	(540)904-2817	113	(540)904-2817	113	(540)904-2817	113															
H1264	007	0	1	01	01	H1264_007_0	3		1	1	2	06/02/2017	2018.03	06/02/2017 07:51:05 AM Eastern Daylight Time	08/04/2017 03:30:27 PM Eastern Daylight Time	07/31/2017 06:58:23 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1264	007	0	2018	Select Counties in TX		2	146476	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	008	0	1	01	01	H1264_008_0	3			1		08/03/2017	2018.03	08/03/2017 09:48:23 AM Eastern Daylight Time	08/04/2017 03:31:37 PM Eastern Daylight Time	07/31/2017 06:58:46 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1264	008	0	2018	Select Counties in TX		2	110716	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	020	0	1	01	01	H1264_020_0	2		1	1	2	06/02/2017	2018.03	06/02/2017 07:56:24 AM Eastern Daylight Time	08/04/2017 03:32:47 PM Eastern Daylight Time	07/31/2017 06:59:09 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1264	020	0	2018	Select counties in TX		2	37610	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	021	0	1	01	01	H1264_021_0	2		1	1	2	06/02/2017	2018.03	06/02/2017 09:45:57 AM Eastern Daylight Time	08/04/2017 03:33:55 PM Eastern Daylight Time	07/31/2017 06:59:32 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1264	021	0	2018	Select Counties in TX		2	20313	2			1	3		1		1	www.wellcare.com/our_pharmacies	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(866)530-9495		(866)530-9495		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	022	0	1	01	01	H1264_022_0	3			1		08/03/2017	2018.03	08/03/2017 09:51:14 AM Eastern Daylight Time	08/04/2017 03:35:05 PM Eastern Daylight Time	07/31/2017 06:59:55 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend Prime (HMO)	01	01		1			H1264	022	0	2018	Denton, El Paso, Fort Bend, Harris Counties		2	29510	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	024	1	1	02	01	H1264_024_1	5			1		08/03/2017	2018.03	08/03/2017 09:51:50 AM Eastern Daylight Time	08/04/2017 03:36:13 PM Eastern Daylight Time	07/31/2017 07:00:17 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1264	024	1	2018	Select Counties in Texas	Select Counties in Texas	2	96789	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1264	024	2	1	02	01	H1264_024_2	5			1		08/03/2017	2018.03	08/03/2017 09:52:32 AM Eastern Daylight Time	08/04/2017 03:37:21 PM Eastern Daylight Time	07/31/2017 07:00:40 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1264	024	2	2018	Select Counties in Texas	Select Counties in Texas	2	11382	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(866)687-8878		(866)687-8878		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1286	002	0	1	01	01	H1286_002_0	3			1		05/25/2017	2018.03	05/25/2017 11:29:57 AM Central Daylight Time	08/03/2017 01:40:25 PM Central Daylight Time	08/01/2017 09:36:28 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1286	002	0	2018	Spokane County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1286	003	0	1	01	01	H1286_003_0	2			1		05/11/2017	2018.03	05/11/2017 02:48:39 PM Central Daylight Time	06/01/2017 12:42:10 PM Central Daylight Time				07/06/2017 03:39:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H1286	003	0	2018	Spokane County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1286	009	0	1	01	01	H1286_009_0	3			1		05/25/2017	2018.03	05/25/2017 11:30:09 AM Central Daylight Time	08/03/2017 01:41:01 PM Central Daylight Time	08/01/2017 09:36:54 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1286	009	0	2018	Spokane County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1302	004	0	1	04	01	H1302_004_0	2			2		06/02/2017	2018.03	06/02/2017 03:12:59 PM Mountain Daylight Time	06/03/2017 12:51:48 PM Mountain Daylight Time				06/05/2017 12:23:21 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	Secure Blue No Rx (PPO)	01	04		1			H1302	004	0	2018	Select Counties in Idaho		2	9184	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673										(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363										2					2						2			
H1304	001	0	1	04	01	H1304_001_0	8			1		07/07/2017	2018.03	07/07/2017 01:17:09 PM Mountain Daylight Time	06/04/2017 08:01:19 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H1304	001	0	2018	Select Counties in Idaho/Asotin Co, WA		2	4146	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H1304	002	0	1	04	01	H1304_002_0	9			1		07/07/2017	2018.03	07/07/2017 01:17:28 PM Mountain Daylight Time	08/04/2017 04:40:34 PM Mountain Daylight Time	08/01/2017 06:39:55 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H1304	002	0	2018	Select Counties in Idaho/Asotin Co, WA		2	40417	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1304	004	0	1	04	01	H1304_004_0	10			1		05/16/2017	2018.03	05/16/2017 04:13:41 PM Mountain Daylight Time	08/04/2017 04:42:23 PM Mountain Daylight Time	08/01/2017 06:40:53 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H1304	004	0	2018	Select Counties in Idaho/Asotin Co, WA		2	11097	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1304	008	0	1	04	01	H1304_008_0	8			1		07/07/2017	2018.03	07/07/2017 01:17:50 PM Mountain Daylight Time	06/04/2017 08:05:03 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H1304	008	0	2018	Ada, Boise, Canyon, Gem, and Owyhee counties		2	665	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H1304	009	0	1	04	01	H1304_009_0	9			1		07/07/2017	2018.03	07/07/2017 01:18:10 PM Mountain Daylight Time	08/04/2017 04:44:10 PM Mountain Daylight Time	08/01/2017 06:41:52 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H1304	009	0	2018	Ada, Boise, Canyon, Gem, and Owyhee counties		2	11386	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1304	010	0	1	04	01	H1304_010_0	8			1		05/16/2017	2018.03	05/16/2017 04:14:09 PM Mountain Daylight Time	08/04/2017 04:45:57 PM Mountain Daylight Time	08/01/2017 06:42:59 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H1304	010	0	2018	Ada, Boise, Canyon, Gem, and Owyhee counties		2	2148	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1304	803	0	1	04	01	H1304_803_0	3			1		05/23/2017	2018.03	05/23/2017 02:57:25 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H1304	803	0	2018	Nationwide except territories		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H1304	804	0	1	04	01	H1304_804_0	3			1		06/02/2017	2018.03	06/02/2017 10:34:16 AM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H1304	804	0	2018	Nationwide except territories		1	5192	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H1310	001	0	1	20	08	H1310_001_0	1			1		05/26/2017	2018.03	05/26/2017 02:06:02 PM Eastern Daylight Time		05/25/2017 12:09:54 PM Eastern Daylight Time			05/26/2017 02:07:03 PM Eastern Daylight Time	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	www.mycentracare.com	CentraCare Dual (PACE)	08	20		1			H1310	001	0	2018	Calhoun, Kalamazoo, and VanBuren Counties		2		2			2						mycentracare.com	mycentracare.com										(877)284-4071		(269)441-9300		(877)284-4071		(269)441-9300										(800)649-3777		(269)441-9329		(800)649-3777		(269)441-9329																
H1310	003	0	1	20	08	H1310_003_0	1			1		05/26/2017	2018.03	05/26/2017 02:06:10 PM Eastern Daylight Time		05/25/2017 12:09:38 PM Eastern Daylight Time			05/26/2017 02:07:03 PM Eastern Daylight Time	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	www.mycentracare.com	CentraCare Medicare-only (PACE)	08	20		1			H1310	003	0	2018	Calhoun, Kalamazoo, and VanBuren Counties		2		2			2						mycentracare.com	mycentracare.com										(877)284-4071		(269)441-9300		(877)284-4071		(269)441-9300										(800)649-3777		(269)441-9329		(800)649-3777		(269)441-9329																
H1343	001	0	1	01	01	H1343_001_0	5		1	1		08/01/2017	2018.03	08/01/2017 03:48:28 PM Central Daylight Time		08/03/2017 04:28:13 PM Central Daylight Time		08/03/2017 04:28:39 PM Central Daylight Time	08/03/2017 04:34:28 PM Central Daylight Time	FRESENIUS HEALTH PLANS OF TEXAS, INC.	Fresenius Health Plans	www.esrdplans.com	Fresenius Total Health (HMO SNP)	01	01		1			H1343	001	0	2018	Cook County		2	2032	2			1	4			00000000100000000000		www.esrdplans.com	www.esrdplans.com	www.esrdplans.com	(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		2					2					2	2			
H1350	006	0	1	01	01	H1350_006_0	3			1		06/01/2017	2018.03	06/01/2017 08:51:06 AM Mountain Daylight Time	06/03/2017 12:56:46 PM Mountain Daylight Time				06/05/2017 12:23:21 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue No Rx (HMO)	01	01		1			H1350	006	0	2018	Select Counties in Idaho		2	42104	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673										(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363										2					2					2	2			
H1350	009	0	1	01	01	H1350_009_0	4		1	1	2	06/01/2017	2018.03	06/01/2017 02:59:17 PM Mountain Daylight Time	08/02/2017 12:43:40 PM Mountain Daylight Time	08/02/2017 08:45:42 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.truebluesnp.com	True Blue Special Needs Plan (HMO SNP)	01	01		1			H1350	009	0	2018	Select Counties in Idaho		2	84341	2			1	3		1		2	www.bcidaho.com/SNPpharmacy	www.bcidaho.com/SNPdrugs	www.bcidaho.com/FindAProvider	(888)495-2583		(208)286-3675		(888)495-2583		(208)286-3675		(888)495-2583		(208)286-3675		(888)495-2583		(208)286-3675		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	015	1	1	01	01	H1350_015_1	4			1		06/08/2017	2018.03	06/08/2017 12:14:55 PM Mountain Daylight Time	08/02/2017 12:45:20 PM Mountain Daylight Time	08/02/2017 08:43:56 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option I (HMO)	01	01		1			H1350	015	1	2018	Select Counties Idaho	Select Counties 1 Idaho	2	104552	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	015	2	1	01	01	H1350_015_2	4			1		06/08/2017	2018.03	06/08/2017 12:15:21 PM Mountain Daylight Time	08/02/2017 12:46:12 PM Mountain Daylight Time	08/02/2017 08:42:44 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option I (HMO)	01	01		1			H1350	015	2	2018	Select Counties Idaho	Select Counties 2 Idaho	2	24890	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	016	1	1	01	01	H1350_016_1	4			1		08/02/2017	2018.03	08/02/2017 01:17:14 PM Mountain Daylight Time	08/02/2017 12:47:14 PM Mountain Daylight Time	08/02/2017 08:47:44 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option II (HMO)	01	01		1			H1350	016	1	2018	Select Counties Idaho	Select Counties 1 Idaho	2	47451	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	016	2	1	01	01	H1350_016_2	4			1		08/02/2017	2018.03	08/02/2017 01:17:41 PM Mountain Daylight Time	08/02/2017 12:48:28 PM Mountain Daylight Time	08/02/2017 08:49:10 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option II (HMO)	01	01		1			H1350	016	2	2018	Select Counties Idaho	Select Counties 2 Idaho	2	20491	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	019	1	1	01	01	H1350_019_1	4			1		08/02/2017	2018.03	08/02/2017 01:18:04 PM Mountain Daylight Time	08/02/2017 12:50:18 PM Mountain Daylight Time	08/02/2017 08:50:10 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx (HMO)	01	01		1			H1350	019	1	2018	Select Counties Idaho	Select Counties 1 Idaho	2	47175	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1350	019	2	1	01	01	H1350_019_2	4			1		08/02/2017	2018.03	08/02/2017 01:18:26 PM Mountain Daylight Time	08/02/2017 12:51:46 PM Mountain Daylight Time	08/02/2017 08:51:12 AM Mountain Daylight Time			08/03/2017 02:49:13 PM Mountain Daylight Time	BLUE CROSS OF IDAHO CARE PLUS, INC.	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx (HMO)	01	01		1			H1350	019	2	2018	Select Counties Idaho	Select Counties 2 Idaho	2	27730	2			2						www.bcidaho.com/FindAPharmacy	www.bcidaho.com/DrugList	www.bcidaho.com/FindAProvider	(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(888)494-2583		(208)395-8200		(888)492-2583		(208)286-3673		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		(800)377-1363		2					2					2	2			
H1352	001	0	1	01	01	H1352_001_0	7			1		08/07/2017	2018.03	08/07/2017 07:27:49 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time			08/07/2017 07:29:13 AM Central Daylight Time	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Complete (HMO)	01	01		1			H1352	001	0	2018	Kansas City Area		2	28800	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1352	002	0	1	01	01	H1352_002_0	6			1		08/07/2017	2018.03	08/07/2017 07:27:59 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time			08/07/2017 07:29:13 AM Central Daylight Time	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Plus (HMO)	01	01		1			H1352	002	0	2018	Kansas City Area		2	84000	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1352	801	0	1	01	01	H1352_801_0	3			1		06/01/2017	2018.03	06/01/2017 12:06:28 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group Plan MA-CY (HMO)	01	01		1			H1352	801	0	2018	Kansas City Area		1	15600	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7h;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;	1	3-1;3-2;3-3;6;7b;7d;7f;7g;7i;8a;8b1;8b2;	1					1				
H1352	803	0	1	01	01	H1352_803_0	3			1		06/01/2017	2018.03	06/01/2017 12:07:13 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group Plan MAPDCY (HMO)	01	01		1			H1352	803	0	2018	Kansas City Area		1	6000	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7h;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;	1	3-1;3-2;3-3;6;7b;7d;7f;7g;7i;8a;8b1;8b2;	1					1				
H1352	804	0	1	01	01	H1352_804_0	3			1		06/01/2017	2018.03	06/01/2017 12:07:40 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group Plan MAPDBY (HMO)	01	01		1			H1352	804	0	2018	Kansas City Area		1	6000	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7h;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;	1	3-1;3-2;3-3;6;7b;7d;7f;7g;7i;8a;8b1;8b2;	1					1				
H1357	001	0	1	20	08	H1357_001_0	1			1		05/24/2017	2018.03	05/24/2017 09:16:54 AM Eastern Daylight Time		05/24/2017 08:42:29 AM Eastern Daylight Time			05/24/2017 09:21:12 AM Eastern Daylight Time	CAROLINA SENIORCARE	Carolina SeniorCare	http://www.carolinaseniorcare.org/	Carolina SeniorCare (PACE)	08	20		1			H1357	001	0	2018	Carolina SeniorCare		2		2			2						https://www.carolinaseniorcare.org/	https://www.carolinaseniorcare.org/										(888)351-7227		(336)746-3500		(888)351-7227		(336)746-3500										(888)351-7227		(336)746-3500		(888)351-7227		(336)746-3500																
H1357	002	0	1	20	08	H1357_002_0	1			1		05/24/2017	2018.03	05/24/2017 09:18:08 AM Eastern Daylight Time		05/24/2017 08:42:54 AM Eastern Daylight Time			05/24/2017 09:21:12 AM Eastern Daylight Time	CAROLINA SENIORCARE	Carolina SeniorCare	http://www.carolinaseniorcare.org/	Carolina SeniorCare (PACE)	08	20		1			H1357	002	0	2018	Carolina SeniorCare		2		2			2						https://www.carolinaseniorcare.org/	https://www.carolinaseniorcare.org/										(888)351-7227		(336)746-3500		(888)351-7227		(336)746-3500										(888)351-7227		(336)746-3500		(888)351-7227		(336)746-3500																
H1365	001	0	1	04	01	H1365_001_0	4			1		08/03/2017	2018.03	08/03/2017 04:31:13 PM Eastern Daylight Time	08/06/2017 09:40:36 AM Eastern Daylight Time	08/06/2017 09:40:43 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select (PPO)	01	04		1			H1365	001	0	2018	Counties: Andr,Cumb,Frk,Knx,Linc,Oxf, Sag,Wald,Yrk		2	15392	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(888)640-4423		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1365	002	0	1	04	01	H1365_002_0	4			1		08/03/2017	2018.03	08/03/2017 04:31:43 PM Eastern Daylight Time	08/06/2017 09:40:56 AM Eastern Daylight Time	08/06/2017 09:41:04 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select (PPO)	01	04		1			H1365	002	0	2018	Counties: Aroos, Hanc,Kenn,Penob,Pisc, Som,Wash		2	7122	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1365	003	0	1	04	01	H1365_003_0	4			1		08/03/2017	2018.03	08/03/2017 04:32:10 PM Eastern Daylight Time	08/06/2017 09:41:16 AM Eastern Daylight Time	08/06/2017 09:41:25 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select (PPO)	01	04		1			H1365	003	0	2018	Hillsborough, Strafford, NH		2	1608	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1365	802	0	1	04	01	H1365_802_0	2			1		05/19/2017	2018.03	05/19/2017 06:15:20 AM Eastern Daylight Time					06/02/2017 03:31:58 PM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Premier Group (PPO)	01	04		1			H1365	802	0	2018	National		1	0	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(888)423-9320		(888)423-9320		(877)542-2654		(877)542-2654		(888)423-9320		(888)423-9320		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1365	803	0	1	04	01	H1365_803_0	2			1		05/19/2017	2018.03	05/19/2017 06:15:31 AM Eastern Daylight Time					06/02/2017 03:31:58 PM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Premier Group (PPO)	01	04		1			H1365	803	0	2018	National		1	0	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(888)423-9320		(888)423-9320		(877)542-2654		(877)542-2654		(888)423-9320		(888)423-9320		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1372	001	0	1	01	01	H1372_001_0	4		1	1		08/07/2017	2018.03	08/07/2017 11:03:19 AM Central Daylight Time	08/07/2017 10:57:42 AM Central Daylight Time	08/07/2017 10:57:58 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	MARQUIS ADVANTAGE, INC.	AgeRight Advantage Health Plan (HMO SNP)	www.agerightadvantage.com	AgeRight Advantage Health Plan (HMO SNP)	01	01		1			H1372	001	0	2018	OR Counties: CLK, KLA, MUL, WSH & YAM		2	7200	2			1	1	3				www.agerightadvantage.com	www.agerightadvantage.com	www.agerightadvantage.com	(844)854-6885		(844)854-6885		(844)854-6885		(844)854-6885		(844)854-6885		(844)854-6885		(844)854-6885		(844)854-6885		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1415	013	0	1	01	01	H1415_013_0	4			1		05/16/2017	2018.03	05/16/2017 02:33:43 PM Central Daylight Time	05/30/2017 05:30:06 PM Central Daylight Time				06/02/2017 02:40:31 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H1415	013	0	2018	Cook, DuPage, Kane, and Will		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)886-1993		(888)886-1993										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1415	021	0	1	02	01	H1415_021_0	5			1		08/03/2017	2018.03	08/03/2017 08:02:45 AM Central Daylight Time	08/03/2017 09:10:15 AM Central Daylight Time	08/01/2017 02:01:53 PM Central Daylight Time			08/04/2017 03:12:34 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier (HMO-POS)	01	02		1			H1415	021	0	2018	Cook, DuPage, Kane, and Will		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)886-1993		(888)886-1993		(800)668-3813		(800)668-3813		(888)886-1993		(888)886-1993		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1415	024	0	1	01	01	H1415_024_0	5			1		05/15/2017	2018.03	05/15/2017 05:14:44 PM Central Daylight Time	08/03/2017 09:10:36 AM Central Daylight Time	08/01/2017 02:02:16 PM Central Daylight Time			08/04/2017 03:12:34 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Primary (HMO)	01	01		1			H1415	024	0	2018	Cook, DuPage, Kane, and Will		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)886-1993		(888)886-1993		(800)668-3813		(800)668-3813		(888)886-1993		(888)886-1993		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1416	009	0	1	02	01	H1416_009_0	3			1		08/03/2017	2018.03	08/03/2017 09:53:36 AM Eastern Daylight Time	08/03/2017 03:56:12 PM Eastern Daylight Time	07/31/2017 07:01:03 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1416	009	0	2018	Select Counties in IL		2	85423	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	023	0	1	01	01	H1416_023_0	2			1		06/02/2017	2018.03	06/02/2017 11:09:08 AM Eastern Daylight Time	08/04/2017 02:56:42 PM Eastern Daylight Time	07/31/2017 07:01:25 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Rx (HMO)	01	01		1			H1416	023	0	2018	Select Counties in IL		2	31346	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	024	0	1	02	01	H1416_024_0	4			1		08/03/2017	2018.03	08/03/2017 09:54:40 AM Eastern Daylight Time	08/03/2017 03:58:33 PM Eastern Daylight Time	07/31/2017 07:01:47 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO-POS)	01	02		1			H1416	024	0	2018	Select Counties in IL		2	4554	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	026	0	1	02	01	H1416_026_0	4			1		08/03/2017	2018.03	08/03/2017 09:55:31 AM Eastern Daylight Time	08/03/2017 03:59:54 PM Eastern Daylight Time	07/31/2017 07:02:10 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO-POS)	01	02		1			H1416	026	0	2018	Select Counties in MS		2	68923	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	027	0	1	02	01	H1416_027_0	2			1		05/24/2017	2018.03	05/24/2017 01:09:51 PM Eastern Daylight Time	06/02/2017 01:49:51 PM Eastern Daylight Time				06/02/2017 04:17:19 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Advance (HMO-POS)	01	02		1			H1416	027	0	2018	Select Counties in AR, TN, MS, SC		2	16381	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056										(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272										2					2					2	2			
H1416	031	0	1	02	01	H1416_031_0	3			1		08/03/2017	2018.03	08/03/2017 09:56:19 AM Eastern Daylight Time	08/03/2017 04:01:15 PM Eastern Daylight Time	07/31/2017 07:02:32 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1416	031	0	2018	Select Counties in TN		2	14783	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	032	0	1	02	01	H1416_032_0	4			1		08/03/2017	2018.03	08/03/2017 09:57:11 AM Eastern Daylight Time	08/03/2017 04:02:38 PM Eastern Daylight Time	07/31/2017 07:02:53 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO-POS)	01	02		1			H1416	032	0	2018	Select Counties in AR		2	48900	2			2						www.wellcare.com/our_pharmacies	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	033	0	1	01	01	H1416_033_0	3		1	1	2	06/01/2017	2018.03	06/01/2017 10:38:46 AM Eastern Daylight Time	08/03/2017 04:04:01 PM Eastern Daylight Time	07/31/2017 07:03:15 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1416	033	0	2018	Select Counties in AR		2	58975	2			1	3		1		1	www.wellcare.com/our_pharmacies	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	034	0	1	01	01	H1416_034_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 09:58:32 AM Eastern Daylight Time	08/04/2017 02:58:01 PM Eastern Daylight Time	07/31/2017 07:03:39 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1416	034	0	2018	Select Counties in MS		2	139723	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	035	0	1	01	01	H1416_035_0	4		1	1	2	07/28/2017	2018.03	07/28/2017 11:51:00 AM Eastern Daylight Time	08/03/2017 04:06:57 PM Eastern Daylight Time	07/31/2017 07:04:01 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1416	035	0	2018	Select Counties in TN		2	72017	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	036	0	1	01	01	H1416_036_0	4		1	1	2	07/12/2017	2018.03	07/12/2017 09:43:07 AM Eastern Daylight Time	08/03/2017 04:08:07 PM Eastern Daylight Time	07/31/2017 07:04:23 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H1416	036	0	2018	Select Counties in SC		2	28860	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	038	0	1	01	01	H1416_038_0	4			1		08/03/2017	2018.03	08/03/2017 09:59:38 AM Eastern Daylight Time	08/03/2017 04:09:28 PM Eastern Daylight Time	07/31/2017 07:04:48 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H1416	038	0	2018	Select Counties in MS		2	105547	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	039	0	1	01	01	H1416_039_0	3			1		08/03/2017	2018.03	08/03/2017 10:00:34 AM Eastern Daylight Time	08/03/2017 04:10:47 PM Eastern Daylight Time	07/31/2017 07:05:11 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Dividend (HMO)	01	01		1			H1416	039	0	2018	Select Counties in TN		2	44395	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	041	0	1	01	01	H1416_041_0	4			1		06/28/2017	2018.03	06/28/2017 09:55:10 AM Eastern Daylight Time	08/04/2017 02:59:23 PM Eastern Daylight Time	07/31/2017 07:05:34 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Rx (HMO)	01	01		1			H1416	041	0	2018	Select Counties in AR		2	75395	2			2						www.wellcare.com/our_pharmacies	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	042	0	1	01	01	H1416_042_0	4			1		06/28/2017	2018.03	06/28/2017 09:55:29 AM Eastern Daylight Time	08/03/2017 04:13:33 PM Eastern Daylight Time	08/01/2017 09:55:14 AM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Rx (HMO)	01	01		1			H1416	042	0	2018	Select Counties in TN		2	26943	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	043	0	1	01	01	H1416_043_0	3		1	1	2	06/01/2017	2018.03	06/01/2017 11:01:22 AM Eastern Daylight Time	08/03/2017 04:14:58 PM Eastern Daylight Time	07/31/2017 07:06:19 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1416	043	0	2018	Select Counties in AR		2	20839	2			1	3		1		1	www.wellcare.com/our_pharmacies	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	044	0	1	01	01	H1416_044_0	3		1	1	2	06/01/2017	2018.03	06/01/2017 11:03:38 AM Eastern Daylight Time	08/04/2017 03:00:45 PM Eastern Daylight Time	07/31/2017 07:06:42 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H1416	044	0	2018	Select Counties in MS		2	27787	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	048	0	1	01	01	H1416_048_0	3			1		06/02/2017	2018.03	06/02/2017 08:16:21 AM Eastern Daylight Time	08/03/2017 04:17:30 PM Eastern Daylight Time	07/31/2017 07:07:05 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Plus (HMO)	01	01		1			H1416	048	0	2018	Select Counties in IL		2	43167	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(866)334-6876		(866)334-6876		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	050	0	1	02	01	H1416_050_0	4			1		08/03/2017	2018.03	08/03/2017 10:01:39 AM Eastern Daylight Time	08/03/2017 04:18:39 PM Eastern Daylight Time	07/31/2017 07:07:27 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO-POS)	01	02		1			H1416	050	0	2018	Select Counties in SC		2	272	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fap_search	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	051	0	1	02	01	H1416_051_0	3			1		08/03/2017	2018.03	08/03/2017 10:02:52 AM Eastern Daylight Time	08/03/2017 04:19:48 PM Eastern Daylight Time	07/31/2017 07:07:49 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO-POS)	01	02		1			H1416	051	0	2018	Select Counties in TN		2	5198	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	052	1	1	01	01	H1416_052_1	4			1		08/03/2017	2018.03	08/03/2017 10:04:25 AM Eastern Daylight Time	08/03/2017 04:20:57 PM Eastern Daylight Time	07/31/2017 07:08:12 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H1416	052	1	2018	Select Counties in South Carolina	Select Counties in South Carolina	2	53108	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fap_search	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1416	052	2	1	01	01	H1416_052_2	4			1		08/03/2017	2018.03	08/03/2017 10:05:20 AM Eastern Daylight Time	08/03/2017 04:22:06 PM Eastern Daylight Time	07/31/2017 07:08:35 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	HARMONY HEALTH PLAN,  INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H1416	052	2	2018	Select Counties in South Carolina	Select Counties in South Carolina	2	15347	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fap_search	(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H1436	001	0	1	01	01	H1436_001_0	2			1		08/03/2017	2018.03	08/03/2017 05:00:16 PM Pacific Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:24 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Medicare (HMO)	01	01		1			H1436	001	0	2018	Abbeville, Chesterfield, Georgetown, Beaufort		2		2			2						www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1436	002	0	1	01	01	H1436_002_0	2			1		08/03/2017	2018.03	08/03/2017 07:02:54 AM Central Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Medicare (HMO)	01	01		1			H1436	002	0	2018	Greater Charleston Area		2		2			2						www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1436	003	0	1	01	01	H1436_003_0	2			1		08/03/2017	2018.03	08/03/2017 07:04:13 AM Central Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Medicare (HMO)	01	01		1			H1436	003	0	2018	Greater Richland Area		2		2			2						www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1436	004	0	1	01	01	H1436_004_0	3			1		08/03/2017	2018.03	08/03/2017 07:05:22 AM Central Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Medicare (HMO)	01	01		1			H1436	004	0	2018	Greater Greenville Area		2		2			2						www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1436	005	0	1	01	01	H1436_005_0	2		1	1	2	08/02/2017	2018.03	08/02/2017 08:53:39 PM Central Daylight Time	08/04/2017 04:34:59 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H1436	005	0	2018	Abbeville, Chesterfield, Georgetown, Beaufort		2		2			1	3		1		1	www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1436	006	0	1	01	01	H1436_006_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 08:56:34 PM Central Daylight Time	08/04/2017 04:35:00 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Allwell	www.allwell.absolutetotalcare.com	Allwell Dual Medicare Essentials (HMO SNP)	01	01		1			H1436	006	0	2018	Abbeville, Chesterfield, Georgetown, Beaufort		2		2			1	3		2		2	www.centene.com	www.centene.com	https://advantage.absolutetotalcare.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1463	001	0	1	01	01	H1463_001_0	2			1		06/03/2017	2018.03	06/03/2017 08:37:10 AM Central Daylight Time	06/01/2017 09:53:06 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO 20 (HMO)	01	01		1			H1463	001	0	2018	North Central, Central, Southern, & Quad Cities		2	13416	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	003	0	1	01	01	H1463_003_0	4			1		08/04/2017	2018.03	08/04/2017 02:26:11 PM Central Daylight Time	08/02/2017 03:04:39 PM Central Daylight Time	08/01/2017 02:38:16 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO 20 Rx (HMO)	01	01		1			H1463	003	0	2018	North Central, Central, Southern, & Quad Cities		2	77644	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	008	0	1	01	01	H1463_008_0	2			1		06/03/2017	2018.03	06/03/2017 08:30:06 AM Central Daylight Time	06/01/2017 09:54:58 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO Basic (HMO)	01	01		1			H1463	008	0	2018	North Central, Central, Southern, & Quad Cities		2	4304	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	009	0	1	01	01	H1463_009_0	4			1		06/06/2017	2018.03	06/06/2017 12:46:12 PM Central Daylight Time	08/02/2017 03:06:28 PM Central Daylight Time	08/01/2017 02:38:50 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO Basic Rx (HMO)	01	01		1			H1463	009	0	2018	North Central, Central, Southern, & Quad Cities		2	33884	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	010	0	1	01	01	H1463_010_0	3			1		06/19/2017	2018.03	06/19/2017 09:45:53 AM Central Daylight Time	08/02/2017 03:07:23 PM Central Daylight Time	08/01/2017 02:39:25 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO 40 Rx (HMO)	01	01		1			H1463	010	0	2018	North Central, Central, Southern, & Quad Cities		2	41730	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	011	0	1	01	01	H1463_011_0	1			1		06/03/2017	2018.03	06/03/2017 08:30:44 AM Central Daylight Time	06/01/2017 09:57:52 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare HMO 40 (HMO)	01	01		1			H1463	011	0	2018	North Central, Central, Southern, & Quad Cities		2	1620	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	012	0	1	01	01	H1463_012_0	3			1		06/03/2017	2018.03	06/03/2017 08:30:59 AM Central Daylight Time	08/02/2017 03:09:05 PM Central Daylight Time	08/01/2017 03:43:38 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Reid Health Alliance Medicare HMO Rx Plus (HMO)	01	01		1			H1463	012	0	2018	East Central IN and Western OH		2	7690	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)749-3253		(877)749-3253		(877)749-3002		(877)749-3002		(877)749-3253		(877)749-3253		(877)749-3002		(877)749-3002		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	013	0	1	01	01	H1463_013_0	3			1		06/03/2017	2018.03	06/03/2017 08:31:13 AM Central Daylight Time	08/02/2017 03:09:53 PM Central Daylight Time	08/01/2017 02:40:34 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Reid Health Alliance Medicare HMO Rx (HMO)	01	01		1			H1463	013	0	2018	East Central IN and Western OH		2	5852	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)749-3253		(877)749-3253		(877)749-3002		(877)749-3002		(877)749-3253		(877)749-3253		(877)749-3002		(877)749-3002		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	014	0	1	02	01	H1463_014_0	1			1		06/03/2017	2018.03	06/03/2017 08:31:27 AM Central Daylight Time	06/01/2017 10:00:06 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare POS Basic (HMO-POS)	01	02		1			H1463	014	0	2018	North Central, Central, Southern, & Quad Cities		2	996	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	015	0	1	02	01	H1463_015_0	3			1		06/03/2017	2018.03	06/03/2017 08:31:40 AM Central Daylight Time	08/02/2017 03:14:52 PM Central Daylight Time	08/01/2017 02:41:08 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare POS Basic Rx (HMO-POS)	01	02		1			H1463	015	0	2018	North Central, Central, Southern, & Quad Cities		2	13516	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	016	0	1	02	01	H1463_016_0	1			1		06/03/2017	2018.03	06/03/2017 08:31:50 AM Central Daylight Time	06/01/2017 10:01:59 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare POS 30 (HMO-POS)	01	02		1			H1463	016	0	2018	North Central, Central, Southern, & Quad Cities		2	1764	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	017	0	1	02	01	H1463_017_0	3			1		06/07/2017	2018.03	06/07/2017 11:17:45 AM Central Daylight Time	08/02/2017 03:16:41 PM Central Daylight Time	08/01/2017 02:41:42 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare POS 30 Rx (HMO-POS)	01	02		1			H1463	017	0	2018	North Central, Central, Southern, & Quad Cities		2	22104	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	018	0	1	02	01	H1463_018_0	1			1		06/03/2017	2018.03	06/03/2017 08:32:24 AM Central Daylight Time	06/01/2017 10:03:53 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	healthalliancemedicare.org	Health Alliance Medicare POS 10 (HMO-POS)	01	02		1			H1463	018	0	2018	North Central, Central, Southern, & Quad Cities		2	2010	2			2						healthalliancemedicare.org	healthalliancemedicare.org	healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	019	0	1	02	01	H1463_019_0	4			1		06/03/2017	2018.03	06/03/2017 08:32:37 AM Central Daylight Time	08/03/2017 04:23:37 PM Central Daylight Time	08/01/2017 02:42:17 PM Central Daylight Time			08/04/2017 02:35:10 PM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	healthalliancemedicare.org	Health Alliance Medicare POS 10 Rx (HMO-POS)	01	02		1			H1463	019	0	2018	North Central, Central, Southern, & Quad Cities		2	43186	2			2						healthalliancemedicare.org	healthalliancemedicare.org	healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1463	020	0	1	01	01	H1463_020_0	1			1		06/03/2017	2018.03	06/03/2017 08:32:51 AM Central Daylight Time	06/01/2017 10:05:40 PM Central Daylight Time				06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Reid Health Alliance Medicare HMO (HMO)	01	01		1			H1463	020	0	2018	East Central IN and Western OH		2	132	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)749-3253		(877)749-3253		(877)749-3002		(877)749-3002										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1463	801	0	1	01	01	H1463_801_0	2			1		06/13/2017	2018.03	06/13/2017 09:34:59 AM Central Daylight Time					06/13/2017 09:41:37 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO (HMO)	01	01		1			H1463	801	0	2018	Illinois		1	1800	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1463	802	0	1	01	01	H1463_802_0	2			1		06/13/2017	2018.03	06/13/2017 09:35:17 AM Central Daylight Time					06/13/2017 09:41:37 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO)	01	01		1			H1463	802	0	2018	Illinois		1	19200	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1463	810	0	1	01	01	H1463_810_0	1			1		04/25/2017	2018.03	04/25/2017 02:53:15 PM Central Daylight Time					06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO) - non calendar year (HMO)	01	01		1			H1463	810	0	2018	Illinois		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1463	811	0	1	02	01	H1463_811_0	2			1		06/13/2017	2018.03	06/13/2017 09:35:46 AM Central Daylight Time					06/13/2017 09:41:37 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO-POS (HMO-POS)	01	02		1			H1463	811	0	2018	Illinois		1	1020	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-										1	2		2		1	2		2		1				
H1463	812	0	1	02	01	H1463_812_0	2			1		06/13/2017	2018.03	06/13/2017 09:36:04 AM Central Daylight Time					06/13/2017 09:41:37 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO-POS with Rx (HMO-POS)	01	02		1			H1463	812	0	2018	Illinois		1	7200	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		1				
H1463	813	0	1	02	01	H1463_813_0	1			1		06/02/2017	2018.03	06/02/2017 02:08:15 PM Central Daylight Time					06/03/2017 09:07:13 AM Central Daylight Time	HEALTH ALLIANCE CONNECT, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO-POS with Rx (HMO-POS)	01	02		1			H1463	813	0	2018	Illinois		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(800)965-4022		(800)965-4022		(888)382-9771		(888)382-9771		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		1				
H1468	007	0	1	01	01	H1468_007_0	2			1		05/27/2017	2018.03	05/27/2017 03:35:29 PM Eastern Daylight Time	08/04/2017 02:41:03 PM Eastern Daylight Time	08/04/2017 09:52:05 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Gold Plus H1468-007 (HMO)	01	01		1			H1468	007	0	2018	Peoria Illinois Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	013	0	1	01	01	H1468_013_0	2			1		08/02/2017	2018.03	08/02/2017 02:58:27 PM Eastern Daylight Time	08/04/2017 02:41:59 PM Eastern Daylight Time	08/04/2017 09:52:05 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Gold Plus H1468-013 (HMO)	01	01		1			H1468	013	0	2018	Cook, Lake and Will counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	014	0	1	01	01	H1468_014_0	2			1		05/27/2017	2018.03	05/27/2017 03:35:58 PM Eastern Daylight Time	08/04/2017 02:43:52 PM Eastern Daylight Time	08/04/2017 09:52:06 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Gold Plus H1468-014 (HMO)	01	01		1			H1468	014	0	2018	Kane, Kendall and McHenry counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	015	0	1	01	01	H1468_015_0	2			1		05/27/2017	2018.03	05/27/2017 03:36:15 PM Eastern Daylight Time	08/04/2017 02:42:28 PM Eastern Daylight Time	08/04/2017 09:52:07 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Gold Plus H1468-015 (HMO)	01	01		1			H1468	015	0	2018	Rockford Illinois area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	016	0	1	01	01	H1468_016_0	2			1		08/02/2017	2018.03	08/02/2017 02:58:47 PM Eastern Daylight Time	08/04/2017 02:45:17 PM Eastern Daylight Time	08/04/2017 09:52:07 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Gold Plus H1468-016 (HMO)	01	01		1			H1468	016	0	2018	DuPage County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	017	0	1	01	01	H1468_017_0	3		1	1		08/02/2017	2018.03	08/02/2017 02:59:20 PM Eastern Daylight Time	08/04/2017 02:46:42 PM Eastern Daylight Time	08/04/2017 09:52:08 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Community HMO Diabetes and Heart (HMO SNP)	01	01		1			H1468	017	0	2018	Cook, DuPage and Will counties		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1468	802	0	1	01	01	H1468_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:11:58 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1468	802	0	2018	Select counties in Peoria Metro area		1	75696	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1468	803	0	1	01	01	H1468_803_0	3			1		06/13/2017	2018.03	06/13/2017 10:11:34 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1468	803	0	2018	Select counties in Peoria Metro area		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1500	001	0	1	20	08	H1500_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:04:19 PM Eastern Daylight Time		05/25/2017 03:24:28 PM Eastern Daylight Time			05/25/2017 03:31:20 PM Eastern Daylight Time	LIFE ST. JOSEPH OF THE PINES, INC.	LIFE St. Joseph of the Pines	www.sjp.org	LIFE St. Joseph of the Pines (PACE)	08	20		1			H1500	001	0	2018	LIFE St. Joseph of the Pines		2		2			2						www.sjp.org	www.sjp.org												(910)483-4911		(910)483-4911		(910)483-4911										(877)452-2514		(877)452-2514		(877)452-2514		(877)452-2514																
H1500	002	0	1	20	08	H1500_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:06:23 PM Eastern Daylight Time		05/25/2017 03:24:40 PM Eastern Daylight Time			05/25/2017 03:31:20 PM Eastern Daylight Time	LIFE ST. JOSEPH OF THE PINES, INC.	LIFE St. Joseph of the Pines	www.sjp.org	LIFE St. Joseph of the Pines (PACE)	08	20		1			H1500	002	0	2018	LIFE St. Joseph of the Pines		2		2			2						www.sjp.org	www.sjp.org										(910)483-4911		(910)483-4911		(910)483-4911		(910)483-4911										(877)452-2514		(877)452-2514		(877)452-2514		(877)452-2514																
H1518	001	0	1	20	08	H1518_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:19:04 PM Eastern Daylight Time		05/24/2017 11:57:53 AM Eastern Daylight Time			05/24/2017 01:22:17 PM Eastern Daylight Time	CATHOLIC HEALTH SYSTEM BUFFALO PACE	Catholic Health LIFE	www.chsbuffalo.org/services/seniorservices/LIFE	CHS Buffalo - Dual (PACE)	08	20		1			H1518	001	0	2018	CHS Lackawanna  Erie County		2		2			2						www.chsbuffalo.org	www.chsbuffalo.org										(855)671-3341		(716)819-5433		(855)671-3341		(716)819-5433												(716)819-5048				(716)819-5048																
H1518	002	0	1	20	08	H1518_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:19:23 PM Eastern Daylight Time		05/24/2017 11:55:42 AM Eastern Daylight Time			05/24/2017 01:22:17 PM Eastern Daylight Time	CATHOLIC HEALTH SYSTEM BUFFALO PACE	Catholic Health LIFE	www.chsbuffalo.org/Services/SeniorServices/LIFE	CHS Buffalo - Medicare only (PACE)	08	20		1			H1518	002	0	2018	CHS Lackawanna Erie County		2		2			2						www.chsbuffalo.org	www.chsbuffalo.org										(855)671-3341		(716)819-5433		(855)671-3341		(716)819-5433												(716)819-5048				(716)819-5048																
H1533	001	0	1	20	08	H1533_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:04:59 PM Eastern Daylight Time		06/02/2017 01:45:49 PM Eastern Daylight Time			06/02/2017 01:49:09 PM Eastern Daylight Time	STAYWELL SENIOR CARE, INC.	StayWell Senior Care	www.staywellseniorcare.org	StayWell Senior Care - Dual Eligible (PACE)	08	20		1			H1533	001	0	2018	StayWell Senior Care		2		2			2						www.carekinesis.com	www.staywellseniorcare.org										(336)628-4200		(336)628-4200		(336)628-4200		(336)628-4200										(336)628-4200		(336)628-4200		(336)628-4200		(336)628-4200																
H1533	002	0	1	20	08	H1533_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:06:40 PM Eastern Daylight Time		06/02/2017 01:46:13 PM Eastern Daylight Time			06/02/2017 01:49:09 PM Eastern Daylight Time	STAYWELL SENIOR CARE, INC.	StayWell Senior Care	www.staywellseniorcare.org	StayWell Senior Care - Medicare Only (PACE)	08	20		1			H1533	002	0	2018	StayWell Senior Care		2		2			2						www.carekinesis.com	www.staywellseniorcare.org										(336)628-4200		(336)628-4200		(336)628-4200		(336)628-4200										(336)628-4200		(336)628-4200		(336)628-4200		(336)628-4200																
H1537	004	0	1	04	01	H1537_004_0	6			1		06/01/2017	2018.03	06/01/2017 08:47:47 AM Central Daylight Time	08/03/2017 01:41:37 PM Central Daylight Time	08/01/2017 09:37:20 AM Central Daylight Time			08/04/2017 12:32:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice (PPO)	01	04		1			H1537	004	0	2018	Montgomery county		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1537	801	0	1	04	01	H1537_801_0	2			1		06/08/2017	2018.03	06/08/2017 11:22:18 AM Central Daylight Time					06/13/2017 04:41:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	801	0	2018	Select Counties		1	16488	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	802	0	1	04	01	H1537_802_0	1			1		05/24/2017	2018.03	05/24/2017 12:22:45 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	802	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1537	803	0	1	04	01	H1537_803_0	1			1		05/24/2017	2018.03	05/24/2017 12:22:56 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	803	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	804	0	2	04	01	H1537_804_0	1			1		05/25/2017	2018.03	05/25/2017 10:52:51 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	804	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	805	0	2	04	01	H1537_805_0	1			1		05/25/2017	2018.03	05/25/2017 10:53:07 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	805	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1537	806	0	2	04	01	H1537_806_0	1			1		05/25/2017	2018.03	05/25/2017 10:53:18 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	806	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	807	0	1	04	01	H1537_807_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:22 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	807	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	808	0	1	04	01	H1537_808_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:48 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	808	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1537	809	0	1	04	01	H1537_809_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:06 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	809	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	816	0	1	04	01	H1537_816_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:36 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	816	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	817	0	1	04	01	H1537_817_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:58 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	817	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	823	0	1	04	01	H1537_823_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:23 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	823	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	824	0	1	04	01	H1537_824_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:47 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	824	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	825	0	1	04	01	H1537_825_0	1			1		05/24/2017	2018.03	05/24/2017 12:28:41 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	825	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1537	826	0	1	04	01	H1537_826_0	1			1		05/24/2017	2018.03	05/24/2017 12:30:55 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	826	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	827	0	2	04	01	H1537_827_0	1			1		05/25/2017	2018.03	05/25/2017 10:53:35 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	827	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	828	0	2	04	01	H1537_828_0	1			1		05/25/2017	2018.03	05/25/2017 10:53:54 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	828	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1537	829	0	2	04	01	H1537_829_0	1			1		05/25/2017	2018.03	05/25/2017 10:54:10 AM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	829	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	830	0	1	04	01	H1537_830_0	1			1		05/24/2017	2018.03	05/24/2017 12:37:01 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	830	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	831	0	1	04	01	H1537_831_0	1			1		05/24/2017	2018.03	05/24/2017 12:37:09 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	831	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	832	0	1	04	01	H1537_832_0	1			1		05/24/2017	2018.03	05/24/2017 12:37:17 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	832	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	833	0	1	04	01	H1537_833_0	1			1		05/24/2017	2018.03	05/24/2017 12:37:27 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	833	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1537	834	0	1	04	01	H1537_834_0	1			1		05/24/2017	2018.03	05/24/2017 12:37:36 PM Pacific Daylight Time					06/01/2017 04:25:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	834	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-9178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1587	001	0	1	02	01	H1587_001_0	7		1	1	2	07/13/2017	2018.03	07/13/2017 10:21:07 AM Central Daylight Time	08/03/2017 12:09:06 PM Central Daylight Time	08/02/2017 04:48:08 PM Central Daylight Time			08/04/2017 04:00:24 PM Central Daylight Time	ARKANSAS SUPERIOR SELECT, INC.	Tribute Health Plan of Arkansas	www.tributehealthplans.com	Tribute (HMO-POS SNP)	01	02		1			H1587	001	0	2018	Arkansas		2	13560	2			1	3		1		1	www.tributehealthplans.com	www.tributehealthplans.com	www.tributehealthplans.com	(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1587	002	0	1	02	01	H1587_002_0	8			1		07/13/2017	2018.03	07/13/2017 09:46:56 AM Central Daylight Time	08/03/2017 12:10:14 PM Central Daylight Time	08/02/2017 04:48:40 PM Central Daylight Time			08/04/2017 04:08:25 PM Central Daylight Time	ARKANSAS SUPERIOR SELECT, INC.	Tribute Health Plan of Arkansas	www.tributehealthplans.com	Horizons (HMO-POS)	01	02		1			H1587	002	0	2018	Arkansas		2	6768	2			2						www.tributehealthplans.com	www.tributehealthplans.com	www.tributehealthplans.com	(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1587	003	0	1	02	01	H1587_003_0	11		1	1		07/13/2017	2018.03	07/13/2017 09:48:43 AM Central Daylight Time	08/07/2017 10:53:05 PM Central Daylight Time	08/02/2017 04:49:04 PM Central Daylight Time			08/07/2017 10:54:38 PM Central Daylight Time	ARKANSAS SUPERIOR SELECT, INC.	Tribute Health Plan of Arkansas	www.tributehealthplans.com	Select (HMO-POS SNP)	01	02		1			H1587	003	0	2018	Arkansas		2	912	2			1	1	3				www.tributehealthplans.com	www.tributehealthplans.com	www.tributehealthplans.com	(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1607	012	0	1	04	01	H1607_012_0	5			1		06/29/2017	2018.03	06/29/2017 09:18:37 AM Pacific Daylight Time	08/07/2017 05:51:43 AM Pacific Daylight Time	08/06/2017 12:05:35 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H1607	012	0	2018	Select Counties in Indiana		2	64692	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)558-1438		(855)558-1438		(800)797-6421		(800)797-6421		(855)558-1438		(855)558-1438		(844)364-2110		(844)364-2110		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1607	804	0	1	04	01	H1607_804_0	1			1		06/03/2017	2018.03	06/03/2017 11:25:28 AM Pacific Daylight Time					06/03/2017 03:48:12 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H1607	804	0	2018	Indiana		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H1607	805	0	1	04	01	H1607_805_0	1			1		06/03/2017	2018.03	06/03/2017 11:25:40 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H1607	805	0	2018	Indiana		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H1607	806	0	1	04	01	H1607_806_0	1			1		06/02/2017	2018.03	06/03/2017 11:19:24 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H1607	806	0	2018	Indiana		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H1608	001	0	1	04	01	H1608_001_0	6			1		08/02/2017	2018.03	08/02/2017 02:11:38 PM Eastern Daylight Time	08/03/2017 04:43:00 PM Eastern Daylight Time	07/31/2017 05:31:50 PM Eastern Daylight Time			08/04/2017 05:43:22 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Platinum (PPO)	01	04		1			H1608	001	0	2018	Partial State of Iowa and South Dakota		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	004	0	1	04	01	H1608_004_0	3			1		08/02/2017	2018.03	08/02/2017 11:58:46 AM Eastern Daylight Time	08/03/2017 04:47:46 PM Eastern Daylight Time	07/31/2017 05:32:18 PM Eastern Daylight Time			08/04/2017 05:43:22 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (PPO)	01	04		1			H1608	004	0	2018	Lincoln, McCook, Minnehaha Counties South Dakota		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	007	0	1	04	01	H1608_007_0	3			1		08/02/2017	2018.03	08/02/2017 06:29:47 PM Eastern Daylight Time	08/03/2017 04:50:20 PM Eastern Daylight Time	07/31/2017 05:32:48 PM Eastern Daylight Time			08/04/2017 06:14:21 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (PPO)	01	04		1			H1608	007	0	2018	Marshall and Story Counties Iowa		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	008	0	1	04	01	H1608_008_0	4			1		08/03/2017	2018.03	08/03/2017 06:05:54 PM Eastern Daylight Time	08/03/2017 04:51:59 PM Eastern Daylight Time	07/31/2017 05:33:18 PM Eastern Daylight Time			08/04/2017 06:14:21 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (PPO)	01	04		1			H1608	008	0	2018	Ida, Monona, Plymouth, Woodbury Counties Iowa		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	012	0	1	04	01	H1608_012_0	4			1		08/04/2017	2018.03	08/04/2017 05:31:49 PM Eastern Daylight Time	08/03/2017 04:53:07 PM Eastern Daylight Time	07/31/2017 05:33:47 PM Eastern Daylight Time			08/04/2017 06:14:21 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Platinum (PPO)	01	04		1			H1608	012	0	2018	Partial State of Nebraska		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	013	0	1	04	01	H1608_013_0	5			1		06/30/2017	2018.03	06/30/2017 10:17:28 AM Eastern Daylight Time	08/03/2017 07:56:36 AM Central Daylight Time	07/31/2017 04:25:09 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra (PPO)	01	04		1			H1608	013	0	2018	St. Louis Metro		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	016	0	1	04	01	H1608_016_0	6			1		08/03/2017	2018.03	08/03/2017 09:59:56 AM Central Daylight Time	08/03/2017 01:49:55 PM Central Daylight Time	07/31/2017 04:25:36 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Freedom (PPO)	01	04		1			H1608	016	0	2018	KC Metro (Kansas & Missouri) Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	017	0	1	04	01	H1608_017_0	5			1		08/02/2017	2018.03	08/02/2017 11:00:29 AM Central Daylight Time	08/02/2017 07:18:02 AM Central Daylight Time	07/31/2017 04:26:01 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Advantage (PPO)	01	04		1			H1608	017	0	2018	Wichita (Kansas) Metro Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	018	0	1	04	01	H1608_018_0	4			1		08/02/2017	2018.03	08/02/2017 11:00:40 AM Central Daylight Time	08/02/2017 07:18:51 AM Central Daylight Time	07/31/2017 04:26:28 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Freedom (PPO)	01	04		1			H1608	018	0	2018	South East Kansas & South West Missouri Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	021	0	1	04	01	H1608_021_0	5			1		08/02/2017	2018.03	08/02/2017 11:00:49 AM Central Daylight Time	08/02/2017 07:15:56 AM Central Daylight Time	07/31/2017 04:26:54 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Freedom (PPO)	01	04		1			H1608	021	0	2018	Central Oklahoma & North West Arkansas Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	023	0	1	04	01	H1608_023_0	4			1		08/03/2017	2018.03	08/03/2017 01:06:36 PM Central Daylight Time	08/03/2017 01:53:34 PM Central Daylight Time	07/31/2017 04:27:20 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Freedom Plus (PPO)	01	04		1			H1608	023	0	2018	North East Kansas and KC Metro (KS & MO) Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	024	0	1	04	01	H1608_024_0	4			1		08/03/2017	2018.03	08/03/2017 01:07:02 PM Central Daylight Time	08/03/2017 01:51:56 PM Central Daylight Time	07/31/2017 04:27:46 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (PPO)	01	04		1			H1608	024	0	2018	North East (Topeka Area) Kansas		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	026	0	1	04	01	H1608_026_0	5			1		07/13/2017	2018.03	07/13/2017 07:48:55 PM Eastern Daylight Time	08/03/2017 01:10:28 PM Eastern Daylight Time	07/31/2017 05:35:39 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H1608	026	0	2018	Northern West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	027	0	1	04	01	H1608_027_0	4			1		07/13/2017	2018.03	07/13/2017 07:49:15 PM Eastern Daylight Time	08/03/2017 01:12:31 PM Eastern Daylight Time	07/31/2017 05:36:01 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H1608	027	0	2018	Southern West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	028	0	1	04	01	H1608_028_0	5			1		06/28/2017	2018.03	06/28/2017 06:35:33 AM Central Daylight Time	08/02/2017 02:07:56 PM Central Daylight Time	07/31/2017 04:34:56 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Preferred (PPO)	01	04		1			H1608	028	0	2018	Georgia Counties		2	1000	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)613-4977		(866)613-4977		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	029	0	1	04	01	H1608_029_0	6			1		08/02/2017	2018.03	08/02/2017 06:16:58 PM Eastern Daylight Time	08/03/2017 09:24:20 AM Eastern Daylight Time	07/31/2017 05:36:22 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H1608	029	0	2018	Northeastern OH		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	031	0	1	04	01	H1608_031_0	3			1		06/27/2017	2018.03	06/27/2017 07:35:29 PM Eastern Daylight Time	08/03/2017 01:13:50 PM Eastern Daylight Time	07/31/2017 05:36:44 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	AdvantraOne (PPO)	01	04		1			H1608	031	0	2018	West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)245-5498		(800)245-5498		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	035	0	1	04	01	H1608_035_0	4			1		06/27/2017	2018.03	06/27/2017 08:46:37 PM Eastern Daylight Time	08/03/2017 08:23:34 AM Central Daylight Time	07/31/2017 04:28:12 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra (PPO)	01	04		1			H1608	035	0	2018	Hannibal MO		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	036	0	1	04	01	H1608_036_0	5			1		07/13/2017	2018.03	07/13/2017 08:10:28 PM Eastern Daylight Time	08/02/2017 07:05:16 AM Central Daylight Time	07/31/2017 04:28:37 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Advantra Freedom (PPO)	01	04		1			H1608	036	0	2018	St. Joseph (KS and MO area)		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formular	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	037	0	1	04	01	H1608_037_0	3			1		08/02/2017	2018.03	08/02/2017 02:14:09 PM Eastern Daylight Time	08/03/2017 04:54:03 PM Eastern Daylight Time	07/31/2017 05:34:16 PM Eastern Daylight Time			08/04/2017 06:14:21 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Elite (PPO)	01	04		1			H1608	037	0	2018	Partial State of Iowa		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	038	0	1	04	01	H1608_038_0	4			1		08/03/2017	2018.03	08/03/2017 03:53:02 PM Central Daylight Time	08/03/2017 04:54:53 PM Eastern Daylight Time	07/31/2017 05:34:46 PM Eastern Daylight Time			08/04/2017 06:14:21 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Elite (PPO)	01	04		1			H1608	038	0	2018	Partial State of Nebraska		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1608	801	0	1	04	01	H1608_801_0	1			1		06/01/2017	2018.03	06/01/2017 04:41:07 PM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Platinum EmpGrp/NoRx/Cyear (PPO)	01	04		1			H1608	801	0	2018	Partial State of Iowa and South Dakota		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	802	0	1	04	01	H1608_802_0	1			1		05/31/2017	2018.03	05/31/2017 10:39:44 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Platinum EmpGrp/Rx/Cyear (PPO)	01	04		1			H1608	802	0	2018	Partial State of Iowa and South Dakota		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	814	0	1	04	01	H1608_814_0	1			1		05/31/2017	2018.03	05/31/2017 07:24:13 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.chcmissourimedicare.com	St. Louis Employer Group w/o Rx (PPO)	01	04		1			H1608	814	0	2018	St Louis		1	120	2			2						www.providerdirectory.coventry-medicare.com	www.moformulary.coventry-medicare.com	www.providerdirectory.coventry-medicare.com	(855)275-5888		(855)275-5888		(866)557-8753		(866)557-8753										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	815	0	1	04	01	H1608_815_0	1			1		05/31/2017	2018.03	05/31/2017 07:24:42 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.chcmissourimedicare.com	St. Louis Employer Group w/Rx (PPO)	01	04		1			H1608	815	0	2018	St. Louis		1	120	2			2						www.providerdirectory.coventry-medicare.com	www.moformulary.coventry-medicare.com	www.providerdirectory.coventry-medicare.com	(855)275-5888		(855)275-5888		(866)557-8753		(866)557-8753		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	816	0	1	04	01	H1608_816_0	1			1		05/31/2017	2018.03	05/31/2017 07:25:01 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Ohio Employer Group w/Rx (PPO)	01	04		1			H1608	816	0	2018	Ohio		1	120	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	817	0	1	04	01	H1608_817_0	1			1		05/31/2017	2018.03	05/31/2017 07:25:16 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	coventry-medicare.coventryhealthcare.com	Heartland Employer Group w/o Rx (PPO)	01	04		1			H1608	817	0	2018	Heartland		1	840	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	818	0	1	04	01	H1608_818_0	1			1		05/31/2017	2018.03	05/31/2017 07:25:36 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Ohio Employer Group w/o Rx (PPO)	01	04		1			H1608	818	0	2018	Ohio		1	120	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	819	0	1	04	01	H1608_819_0	1			1		05/31/2017	2018.03	05/31/2017 07:25:59 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	coventry-medicare.coventryhealthcare.com	Heartland Employer Group w/Rx (PPO)	01	04		1			H1608	819	0	2018	Heartland		1	16240	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(844)741-8423		(844)741-8423		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	822	0	1	04	01	H1608_822_0	1			1		05/31/2017	2018.03	05/31/2017 07:26:19 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://www.wv.chcadvantra.com	Advantra MA Only (PPO)	01	04		1			H1608	822	0	2018	West Virginia		1	58340	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(800)470-4272		(800)470-4272										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	823	0	1	04	01	H1608_823_0	1			1		05/31/2017	2018.03	05/31/2017 07:26:47 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://www.wv.chcadvantra.com	Advantra Gold (PPO)	01	04		1			H1608	823	0	2018	West Virginia		1	1880	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(800)470-4272		(800)470-4272		(844)741-8423		(844)741-8423		(800)470-4272		(800)470-4272		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1608	824	0	1	04	01	H1608_824_0	1			1		05/31/2017	2018.03	05/31/2017 07:27:10 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra (PPO)	01	04		1			H1608	824	0	2018	North Carolina		1	3550	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(800)470-4272		(800)470-4272		(844)741-8423		(844)741-8423		(800)470-4272		(800)470-4272		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H1609	001	0	1	01	01	H1609_001_0	4			1		08/02/2017	2018.03	08/02/2017 02:19:58 PM Eastern Daylight Time	08/03/2017 04:56:23 PM Eastern Daylight Time	07/31/2017 05:35:15 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Silver (HMO)	01	01		1			H1609	001	0	2018	Partial State of Iowa		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	009	0	1	01	01	H1609_009_0	4			1		08/02/2017	2018.03	08/02/2017 09:49:38 PM Eastern Daylight Time	08/03/2017 05:25:26 PM Eastern Daylight Time	07/31/2017 05:35:44 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (HMO)	01	01		1			H1609	009	0	2018	Dallas, Polk, Warren Counties Iowa		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	014	0	1	01	01	H1609_014_0	7			1		08/01/2017	2018.03	08/01/2017 04:55:19 PM Eastern Daylight Time	08/02/2017 01:00:34 PM Central Daylight Time	07/31/2017 04:35:24 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Vista Plan (HMO)	01	01		1			H1609	014	0	2018	South FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	015	0	1	01	01	H1609_015_0	7		1	1	2	08/01/2017	2018.03	08/01/2017 04:54:09 PM Eastern Daylight Time	08/02/2017 01:01:48 PM Central Daylight Time	07/31/2017 04:35:50 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Vista Plan (HMO SNP)	01	01		1			H1609	015	0	2018	South FL		2		2			1	3		2		2	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	016	0	1	01	01	H1609_016_0	5			1		08/01/2017	2018.03	08/01/2017 04:56:08 PM Eastern Daylight Time	08/02/2017 01:02:42 PM Central Daylight Time	07/31/2017 04:36:16 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO)	01	01		1			H1609	016	0	2018	South FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	017	0	1	01	01	H1609_017_0	7		1	1	2	07/27/2017	2018.03	07/27/2017 02:53:41 PM Central Daylight Time	08/02/2017 01:03:52 PM Central Daylight Time	07/31/2017 04:36:42 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO SNP)	01	01		1			H1609	017	0	2018	South FL		2		2			1	3		2		2	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	018	0	1	01	01	H1609_018_0	5			1		08/02/2017	2018.03	08/02/2017 11:11:41 AM Eastern Daylight Time	08/02/2017 01:05:28 PM Central Daylight Time	07/31/2017 04:37:07 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO)	01	01		1			H1609	018	0	2018	South FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	019	0	1	01	01	H1609_019_0	7		1	1	2	07/27/2017	2018.03	07/27/2017 02:53:59 PM Central Daylight Time	08/02/2017 01:06:23 PM Central Daylight Time	07/31/2017 04:37:33 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO SNP)	01	01		1			H1609	019	0	2018	South FL, Treasure Coast FL, West FL		2		2			1	3		2		2	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	020	0	1	01	01	H1609_020_0	4			1		08/01/2017	2018.03	08/01/2017 04:59:43 PM Eastern Daylight Time	08/02/2017 01:07:03 PM Central Daylight Time	07/31/2017 04:37:59 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO)	01	01		1			H1609	020	0	2018	South FL, Treasure Coast FL, West FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	021	0	1	01	01	H1609_021_0	4			1		08/01/2017	2018.03	08/01/2017 05:00:22 PM Eastern Daylight Time	08/02/2017 01:07:52 PM Central Daylight Time	07/31/2017 04:38:28 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO)	01	01		1			H1609	021	0	2018	North FL, Treasure Coast FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	022	0	1	01	01	H1609_022_0	4			1		08/01/2017	2018.03	08/01/2017 05:00:57 PM Eastern Daylight Time	08/02/2017 01:08:37 PM Central Daylight Time	07/31/2017 04:38:54 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Summit Plan (HMO)	01	01		1			H1609	022	0	2018	West FL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(800)847-3995		(800)847-3995		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	023	0	1	01	01	H1609_023_0	7		1	1	2	07/27/2017	2018.03	07/27/2017 02:54:35 PM Central Daylight Time	08/02/2017 01:09:23 PM Central Daylight Time	07/31/2017 04:39:20 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO SNP)	01	01		1			H1609	023	0	2018	Central FL		2		2			1	3		2		2	www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	024	0	1	01	01	H1609_024_0	4			1		08/01/2017	2018.03	08/01/2017 05:02:05 PM Eastern Daylight Time	08/02/2017 01:10:24 PM Central Daylight Time	07/31/2017 04:39:47 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H1609	024	0	2018	Central FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	025	0	1	01	01	H1609_025_0	4			1		08/01/2017	2018.03	08/01/2017 05:03:53 PM Eastern Daylight Time	08/02/2017 01:11:08 PM Central Daylight Time	07/31/2017 04:40:13 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H1609	025	0	2018	Southwest FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	026	0	1	01	01	H1609_026_0	5			1		08/02/2017	2018.03	08/02/2017 07:29:50 PM Eastern Daylight Time	08/02/2017 01:12:15 PM Central Daylight Time	07/31/2017 04:40:40 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H1609	026	0	2018	Southwest FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	027	0	1	01	01	H1609_027_0	4			1		08/02/2017	2018.03	08/02/2017 07:30:05 PM Eastern Daylight Time	08/02/2017 01:12:58 PM Central Daylight Time	07/31/2017 04:41:05 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H1609	027	0	2018	Southwest FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	028	0	1	02	01	H1609_028_0	4			1		08/01/2017	2018.03	08/01/2017 05:08:31 PM Eastern Daylight Time	08/02/2017 01:13:51 PM Central Daylight Time	07/31/2017 04:41:31 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnamedicare.com	Aetna Medicare Choice Plan (HMO-POS)	01	02		1			H1609	028	0	2018	North, Central, West, SW, Treasure Coast, South FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(855)423-9420		(855)423-9420		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1609	801	0	1	01	01	H1609_801_0	1			1		05/31/2017	2018.03	05/31/2017 07:59:08 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Silver EmpGrp/NoRx/Cyear (HMO)	01	01		1			H1609	801	0	2018	Partial State of Iowa		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-7027		(855)338-7027										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1609	802	0	1	01	01	H1609_802_0	1			1		05/31/2017	2018.03	05/31/2017 07:59:28 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Silver EmpGrp/Rx/Cyear (HMO)	01	01		1			H1609	802	0	2018	Partial State of Iowa		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-7027		(866)294-1211		(866)294-1211		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1609	807	0	1	01	01	H1609_807_0	1			1		05/31/2017	2018.03	05/31/2017 07:59:55 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnaretireeplans.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H1609	807	0	2018	Florida		1	16360	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicare.com/findprovider	(844)332-9495		(844)322-9495		(800)307-4830		(800)307-4830		(844)332-9495		(844)322-9495		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1609	808	0	1	01	01	H1609_808_0	1			1		05/31/2017	2018.03	05/31/2017 08:00:20 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (FL)	Coventry Health Care	www.aetnaretireeplans.com	Aetna Medicare (HMO)	01	01		1			H1609	808	0	2018	Florida		1	120	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-7027										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1610	001	0	1	01	01	H1610_001_0	7		1	1	2	07/25/2017	2018.03	07/25/2017 01:55:41 PM Central Daylight Time	08/03/2017 02:37:33 PM Central Daylight Time	07/31/2017 04:26:22 PM Central Daylight Time			08/04/2017 01:46:40 PM Central Daylight Time	AETNA BETTER HEALTH, INC. (VA)	Aetna Better Health of Virginia	www.aetnabetterhealth.com/virginia	Aetna Better Health, Inc. (VA) (HMO SNP)	01	01		1			H1610	001	0	2018	Virginia		2	102408	2			1	3		1		1	www.aetnabetterhealth.com/virginia	www.aetnabetterhealth.com/virginia	www.aetnabetterhealth.com/virginia	(855)652-8249		(855)652-8249		(855)652-8249		(855)652-8249		(855)652-8249		(855)652-8249		(855)652-8249		(855)652-8249		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1651	001	0	1	18	06	H1651_001_0	2			2		06/26/2017	2018.03	06/26/2017 08:55:36 AM Central Daylight Time					06/26/2017 11:19:25 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H1651	001	0	2018	Dubuque, Clayton, Delaware, Jackson,Jones Counties		2	68386	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	002	0	1	18	06	H1651_002_0	1			2		05/30/2017	2018.03	05/30/2017 10:32:58 AM Central Daylight Time					05/30/2017 12:19:46 PM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Basic Plan (Cost)	06	18		1			H1651	002	0	2018	Dubuque, Clayton, Delaware, Jackson,Jones Counties		2	24	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	003	0	1	18	06	H1651_003_0	3			2		06/26/2017	2018.03	06/26/2017 08:56:34 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H1651	003	0	2018	Jo Daviess County		2	14363	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	004	0	1	18	06	H1651_004_0	3			2		06/26/2017	2018.03	06/26/2017 11:14:29 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H1651	004	0	2018	Dubuque, Clayton, Delaware, Jackson,Jones Counties		2	38103	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	005	0	1	18	06	H1651_005_0	3			2		06/26/2017	2018.03	06/26/2017 08:57:39 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H1651	005	0	2018	Jo Daviess County		2	5198	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	008	0	1	18	06	H1651_008_0	3			2		06/26/2017	2018.03	06/26/2017 08:58:13 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H1651	008	0	2018	Dubuque, Clayton, Delaware, Jackson,Jones Counties		2	7482	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1651	009	0	1	18	06	H1651_009_0	3			2		06/26/2017	2018.03	06/26/2017 08:58:46 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H1651	009	0	2018	Jo Daviess County		2	1607	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H1659	001	0	1	04	01	H1659_001_0	4			1		07/14/2017	2018.03	07/14/2017 10:16:25 AM Eastern Daylight Time	08/02/2017 04:03:02 PM Eastern Daylight Time	08/02/2017 02:32:17 PM Eastern Daylight Time			08/04/2017 09:15:02 AM Eastern Daylight Time	PIEDMONT COMMUNITY HEALTHCARE, INC.	Piedmont Medicare Advantage	www.pchp.net	Piedmont Select Medicare Option One (PPO)	01	04		1			H1659	001	0	2018	Cities: LYH,BE Counties: AM,AP,BE,CA,CLT,HA,PE,PI		2	11944	2			2						www.pchp.net	www.pchp.net	www.pchp.net	(877)210-1719		(434)947-3671		(877)210-1719		(434)947-3671		(866)494-9927		(866)494-9927		(877)210-1719		(434)947-3671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1659	002	0	1	04	01	H1659_002_0	4			1		07/14/2017	2018.03	07/14/2017 10:19:38 AM Eastern Daylight Time	08/02/2017 04:02:06 PM Eastern Daylight Time	08/02/2017 02:33:41 PM Eastern Daylight Time			08/04/2017 09:15:02 AM Eastern Daylight Time	PIEDMONT COMMUNITY HEALTHCARE, INC.	Piedmont Medicare Advantage	www.pchp.net	Piedmont Select Medicare Option Two (PPO)	01	04		1			H1659	002	0	2018	Cities:LYH,BE Counties:AM,AP,BE,CA,CLT,HA,PE,PI		2	19379	2			2						www.pchp.net	www.pchp.net	www.pchp.net	(877)210-1719		(434)947-3671		(877)210-1719		(434)947-3671		(866)494-9927		(866)494-9927		(877)210-1719		(434)947-3671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1659	003	0	1	04	01	H1659_003_0	4			1		07/14/2017	2018.03	07/14/2017 10:18:20 AM Eastern Daylight Time	08/02/2017 04:04:28 PM Eastern Daylight Time	08/02/2017 02:35:03 PM Eastern Daylight Time			08/04/2017 09:15:02 AM Eastern Daylight Time	PIEDMONT COMMUNITY HEALTHCARE, INC.	Piedmont Medicare Advantage	www.pchp.net	Piedmont Select Medicare Option Three (PPO)	01	04		1			H1659	003	0	2018	Cities: LYH,BE Counties: AM,AP,BE,CA,CLT,HA,PE,PI		2	29995	2			2						www.pchp.net	www.pchp.net	www.pchp.net	(877)210-1719		(434)947-3671		(877)210-1719		(434)947-3671		(866)494-9927		(866)494-9927		(877)210-1719		(434)947-3671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1660	001	0	1	01	01	H1660_001_0	4			1		08/07/2017	2018.03	08/07/2017 01:53:58 AM Eastern Daylight Time	08/04/2017 03:17:08 PM Eastern Daylight Time	08/02/2017 02:23:56 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H1660	001	0	2018	Massachusetts		2	50146	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	005	0	1	01	01	H1660_005_0	4			1		08/07/2017	2018.03	08/07/2017 01:57:39 AM Eastern Daylight Time	08/04/2017 03:18:10 PM Eastern Daylight Time	08/02/2017 02:23:34 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H1660	005	0	2018	Southern Maine		2	4086	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	009	0	1	01	01	H1660_009_0	4			1		08/07/2017	2018.03	08/07/2017 02:01:55 AM Eastern Daylight Time	08/04/2017 03:20:00 PM Eastern Daylight Time	08/02/2017 02:24:14 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H1660	009	0	2018	Massachusetts		2	30481	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	012	0	1	01	01	H1660_012_0	4			1		08/07/2017	2018.03	08/07/2017 02:03:13 AM Eastern Daylight Time	08/04/2017 03:20:52 PM Eastern Daylight Time	08/02/2017 02:24:50 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H1660	012	0	2018	Worcester County MA		2	4193	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	013	0	1	01	01	H1660_013_0	4			1		08/07/2017	2018.03	08/07/2017 03:28:37 AM Eastern Daylight Time	08/04/2017 03:22:14 PM Eastern Daylight Time	08/02/2017 02:25:08 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H1660	013	0	2018	Southern Maine		2	18636	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	014	0	1	01	01	H1660_014_0	4			1		08/07/2017	2018.03	08/07/2017 02:23:27 AM Eastern Daylight Time	08/04/2017 03:28:50 PM Eastern Daylight Time	08/02/2017 02:25:26 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Basic Rx (HMO)	01	01		1			H1660	014	0	2018	Bristol and Plymouth Counties MA		2	3136	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	801	0	1	01	01	H1660_801_0	3			1		06/02/2017	2018.03	06/02/2017 11:37:02 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H1660	801	0	2018	Massachusetts & Maine		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	802	0	1	01	01	H1660_802_0	3			1		06/02/2017	2018.03	06/02/2017 11:33:37 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H1660	802	0	2018	Massachusetts & Maine		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	803	0	1	01	01	H1660_803_0	3			1		06/02/2017	2018.03	06/02/2017 11:30:27 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H1660	803	0	2018	Massachusetts & Maine		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1660	804	0	1	01	01	H1660_804_0	3			1		06/02/2017	2018.03	06/02/2017 11:26:23 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE INC.	Harvard Pilgrim Health Care, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H1660	804	0	2018	Massachusetts & Maine		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1664	001	0	1	01	01	H1664_001_0	2			1		08/01/2017	2018.03	08/01/2017 05:09:43 PM Pacific Daylight Time	08/04/2017 04:35:00 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/04/2017 08:08:37 PM Pacific Daylight Time	HOME STATE HEALTH PLAN, INC.	Allwell	www.allwell.homestatehealth.com	Allwell Medicare (HMO)	01	01		1			H1664	001	0	2018	Barry Christian Greene Jasper Lawerence Newton		2		2			2						www.centene.com	www.centene.com	https://advantage.homestatehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1664	002	0	1	01	01	H1664_002_0	2			1		08/01/2017	2018.03	08/01/2017 05:11:25 PM Pacific Daylight Time	08/04/2017 04:35:00 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/04/2017 08:08:37 PM Pacific Daylight Time	HOME STATE HEALTH PLAN, INC.	Allwell	www.allwell.homestatehealth.com	Allwell Medicare (HMO)	01	01		1			H1664	002	0	2018	Cass, Clay, Jackson, Platte		2		2			2						www.centene.com	www.centene.com	https://advantage.homestatehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H1666	001	0	1	04	01	H1666_001_0	10			1		08/04/2017	2018.03	08/04/2017 02:21:48 PM Central Daylight Time	08/07/2017 09:22:30 AM Central Daylight Time	08/01/2017 03:45:09 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Premier (PPO)	01	04		1			H1666	001	0	2018	Austin metro area		2	19995	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	002	0	1	04	01	H1666_002_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:06 PM Central Daylight Time	08/07/2017 09:21:33 AM Central Daylight Time	08/01/2017 03:45:41 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Premier (PPO)	01	04		1			H1666	002	0	2018	Dallas, Tarrant, Collin, and Denton counties		2	22428	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	003	0	1	04	01	H1666_003_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:16 PM Central Daylight Time	08/07/2017 09:20:27 AM Central Daylight Time	08/01/2017 03:46:12 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Premier (PPO)	01	04		1			H1666	003	0	2018	Harris, Fort Bend, and Montgomery counties		2	30201	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	004	0	1	04	01	H1666_004_0	7			1		08/04/2017	2018.03	08/04/2017 01:01:57 PM Central Daylight Time	08/07/2017 09:18:54 AM Central Daylight Time	08/01/2017 03:46:44 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H1666	004	0	2018	Austin Metro Area		2	21853	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	005	0	1	04	01	H1666_005_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:27 PM Central Daylight Time	08/07/2017 09:17:36 AM Central Daylight Time	08/01/2017 03:47:16 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H1666	005	0	2018	Dallas Metro Area		2	29954	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	006	0	1	04	01	H1666_006_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:38 PM Central Daylight Time	08/07/2017 09:16:31 AM Central Daylight Time	08/01/2017 03:47:48 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H1666	006	0	2018	Houston Metro Area		2	38311	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	008	0	1	04	01	H1666_008_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:48 PM Central Daylight Time	08/07/2017 09:13:38 AM Central Daylight Time	08/01/2017 03:48:20 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H1666	008	0	2018	San Antonio		2	3863	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	009	0	1	04	01	H1666_009_0	7			1		08/07/2017	2018.03	08/07/2017 04:00:57 PM Central Daylight Time	08/07/2017 09:15:36 AM Central Daylight Time	08/01/2017 03:48:52 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Choice Premier (PPO)	01	04		1			H1666	009	0	2018	San Antonio		2	2792	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1666	801	0	1	04	01	H1666_801_0	1			1		05/23/2017	2018.03	05/23/2017 11:49:47 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com	BlueCross Medicare Advantage (PPO)	01	04		1			H1666	801	0	2018	State of Texas		1	4890	2			2						www.getbluetx.com	www.getbluetx.com	www.getbluetx.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H1666	803	0	1	04	01	H1666_803_0	1			1		05/23/2017	2018.03	05/23/2017 11:50:33 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.getbluetx.com	BlueCross  Medicare Advantage (PPO)	01	04		1			H1666	803	0	2018	State of Texas		1	284	2			2						www.getbluetx.com	www.getbluetx.com	www.getbluetx.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H1666	805	0	1	04	01	H1666_805_0	1			1		05/23/2017	2018.03	05/23/2017 11:51:29 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.bcbstx.com	BlueCross  Medicare Advantage (PPO)	01	04		1			H1666	805	0	2018	State of Texas		1	85	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H1666	807	0	2	04	01	H1666_807_0	1			1		05/23/2017	2018.03	05/23/2017 11:52:03 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.bcbstx.com	Blue Cross Medicare Advantage (PPO)	01	04		2	2		H1666	807	0	2018	State of Texas		1	28	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H1666	808	0	2	04	01	H1666_808_0	1			1		05/23/2017	2018.03	05/23/2017 11:52:34 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	Blue Cross Blue Shield of Texas	www.bcbstx.com	Blue Cross Medicare Advantage (PPO)	01	04		2	2		H1666	808	0	2018	State of Texas		1	28	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H1692	002	0	1	01	01	H1692_002_0	4			1		07/13/2017	2018.03	07/13/2017 07:43:29 PM Eastern Daylight Time	08/03/2017 01:15:20 PM Eastern Daylight Time	07/31/2017 05:37:04 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra Silver (HMO)	01	01		1			H1692	002	0	2018	Southern West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1692	003	0	1	01	01	H1692_003_0	4			1		08/02/2017	2018.03	08/02/2017 11:22:13 AM Eastern Daylight Time	08/03/2017 01:16:41 PM Eastern Daylight Time	07/31/2017 05:37:27 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra Choice (HMO)	01	01		1			H1692	003	0	2018	Northern West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1692	004	0	1	01	01	H1692_004_0	3			1		08/02/2017	2018.03	08/02/2017 11:23:30 AM Eastern Daylight Time	08/03/2017 01:18:07 PM Eastern Daylight Time	07/31/2017 05:37:49 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra Choice (HMO)	01	01		1			H1692	004	0	2018	Southern West Virginia		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)365-6052		(888)365-6052		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1692	801	0	1	01	01	H1692_801_0	1			1		05/31/2017	2018.03	05/31/2017 08:00:46 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Coventry Health Care	http://www.wv.chcadvantra.com	Advantra MA Only (HMO)	01	01		1			H1692	801	0	2018	West Virginia		1	120	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1692	802	0	1	01	01	H1692_802_0	1			1		05/31/2017	2018.03	05/31/2017 08:01:02 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Coventry Health Care	http://www.wv.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H1692	802	0	2018	West Virginia		1	120	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(855)275-5888		(855)275-5888		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H1714	001	0	1	20	08	H1714_001_0	1			1		06/01/2017	2018.03	06/01/2017 10:53:13 AM Central Daylight Time		06/01/2017 10:28:17 AM Central Daylight Time			06/01/2017 10:56:01 AM Central Daylight Time	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	Via Christi HOPE	www.viachristi.org/HOPE	Via Christi HOPE (PACE)	08	20		1			H1714	001	0	2018	Sedgwick County		2		2			2						www.viachristihope.com	www.viachristihope.com										(316)858-1111		(316)858-1111		(316)858-1111		(316)858-1111										(180)076-6377		(180)076-6377		(180)076-6377		(180)076-6377																
H1714	002	0	1	20	08	H1714_002_0	1			1		06/01/2017	2018.03	06/01/2017 10:53:47 AM Central Daylight Time		06/01/2017 10:28:09 AM Central Daylight Time			06/01/2017 10:56:01 AM Central Daylight Time	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	Via Christi HOPE	www.viachristi.org/HOPE	Via Christi HOPE (PACE)	08	20		1			H1714	002	0	2018	Sedgwick County		2		2			2						www.viachristihope.com	www.viachristihope.com										(316)858-1111		(316)858-1111		(316)858-1111		(316)858-1111										(180)076-6377		(180)076-6377		(180)076-6377		(180)076-6377																
H1723	001	0	1	48	05	H1723_001_0	1			1		06/02/2017	2018.03	06/02/2017 06:12:22 PM Eastern Daylight Time					06/02/2017 07:26:43 PM Pacific Daylight Time	ABSOLUTE TOTAL CARE, INC.	Absolute Total Care	http://mmp.absolutetotalcare.com	Absolute Total Care (Medicare-Medicaid Plan)	05	48		1			H1723	001	0	2018	Statewide		2	2008	2			2						http://apps.absolutetotalcare.com/findadoc	http://mmp.absolutetotalcare.com/home/prescription-drug-part-d-benefit-information/	http://apps.absolutetotalcare.com/findadoc	(855)735-4398		(855)735-4398		(855)735-4398		(855)735-4398		(855)735-4398		(855)735-4398		(855)735-4398		(855)735-4398		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H1737	001	0	1	01	01	H1737_001_0	2			1		08/03/2017	2018.03	08/03/2017 12:39:55 PM Central Daylight Time	08/02/2017 03:35:14 PM Central Daylight Time	08/01/2017 02:42:51 PM Central Daylight Time			08/04/2017 02:38:36 PM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Health Alliance Medicare Guide HMO Rx (HMO)	01	01		1			H1737	001	0	2018	Scott County		2	3168	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1737	801	0	1	01	01	H1737_801_0	2			1		06/13/2017	2018.03	06/13/2017 09:36:39 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO (HMO)	01	01		1			H1737	801	0	2018	Health Alliance Medicare		1	120	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1737	802	0	1	01	01	H1737_802_0	2			1		06/13/2017	2018.03	06/13/2017 09:36:49 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO)	01	01		1			H1737	802	0	2018	Health Alliance Medicare		1	1200	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1737	803	0	1	01	01	H1737_803_0	1			1		04/25/2017	2018.03	04/25/2017 03:02:43 PM Central Daylight Time					06/03/2017 09:16:59 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO) - non calendar year (HMO)	01	01		1			H1737	803	0	2018	Health Alliance Medicare		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(877)917-8550		(877)917-8550		(877)925-0424		(877)925-0424		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1777	007	0	1	01	01	H1777_007_0	7		1	1		07/05/2017	2018.03	07/05/2017 11:08:25 AM Eastern Daylight Time	08/01/2017 02:01:31 PM Eastern Daylight Time	08/01/2017 02:09:16 PM Eastern Daylight Time			08/04/2017 11:06:42 AM Eastern Daylight Time	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage	www.archcareadvantage.org	ArchCare  Advantage (HMO SNP)	01	01		1			H1777	007	0	2018	NYC, Westchester, Putnam, Dutchess, Orange, Ononda		2	24598	2			1	1	3				www.archcareadvantage.org	www.archcareadvantage.org	www.archcareadvantage.org	(800)373-3177		(800)373-3177		(800)373-3177		(800)373-3177		(888)816-7977		(888)816-7977		(800)373-3177		(800)373-3177		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H1787	001	0	1	01	01	H1787_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:03:29 AM Central Daylight Time	08/07/2017 10:57:42 AM Central Daylight Time	08/07/2017 10:57:58 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	Good Samaritan Insurance Plan of South Dakota	www.goodsamaritaninsuranceplan.com	Good Samaritan Insurance Plan SD (HMO SNP)	01	01		1			H1787	001	0	2018	South Dakota (partial)		2	3712	2			1	1	1				www.gsipsd.com	www.gsipsd.com	www.goodsamaritaninsuranceplan.com	(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1846	004	0	1	04	01	H1846_004_0	4			1		08/04/2017	2018.03	08/04/2017 10:58:14 PM Eastern Daylight Time	08/04/2017 01:17:24 PM Eastern Daylight Time	08/04/2017 09:09:14 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.MediGold.com	MediGold Flexible Choice (PPO)	01	04		1			H1846	004	0	2018	Select Ohio Counties		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H1846	801	0	1	04	01	H1846_801_0	1			1		05/22/2017	2018.03	05/22/2017 10:37:18 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.MediGold.com	EGWP MediGold Network Choice (PPO)	01	04		1			H1846	801	0	2018	Greater Central Ohio and Dayton Area		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H1846	802	0	1	04	01	H1846_802_0	1			1		05/22/2017	2018.03	05/22/2017 10:37:34 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.MediGold.com	EGWP MediGold Network Choice Medical Only (PPO)	01	04		1			H1846	802	0	2018	Greater Central Ohio and Dayton Area		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H1894	001	0	1	01	01	H1894_001_0	8			1		08/04/2017	2018.03	08/04/2017 02:08:31 PM Pacific Daylight Time	08/07/2017 05:51:44 AM Pacific Daylight Time	08/06/2017 12:05:35 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP WASHINGTON, INC.	AMERIGROUP	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H1894	001	0	2018	King and Snohomish Counties		2	18142	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)288-5923		(844)288-5923		(866)805-4589		(866)805-4589		(844)288-7618		(844)288-7618		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1894	002	0	1	01	01	H1894_002_0	9		1	1	2	08/04/2017	2018.03	08/04/2017 02:09:18 PM Pacific Daylight Time	08/07/2017 05:51:44 AM Pacific Daylight Time	08/06/2017 12:05:35 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP WASHINGTON, INC.	AMERIGROUP	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H1894	002	0	2018	King and Snohomish Counties		2	2548	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)812-2275		(844)812-2275		(844)288-5923		(844)288-5923		(844)812-2275		(844)812-2275		(844)288-7618		(844)288-7618		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1904	001	0	1	20	08	H1904_001_0	1			1		05/26/2017	2018.03	05/26/2017 09:23:33 AM Central Daylight Time		05/26/2017 09:21:22 AM Central Daylight Time			05/26/2017 09:26:42 AM Central Daylight Time	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://pacegno.org/	PACE Greater New Orleans (PACE)	08	20		1			H1904	001	0	2018	PACE Greater New Orleans		2		2			2						http://www.pacegno.org	http://www.pacegno.org										(866)395-8509		(504)835-0006		(866)395-8509		(504)835-0006										(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277																
H1904	002	0	1	20	08	H1904_002_0	1			1		05/26/2017	2018.03	05/26/2017 09:24:30 AM Central Daylight Time		05/26/2017 09:21:06 AM Central Daylight Time			05/26/2017 09:26:42 AM Central Daylight Time	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://pacegno.org/	PACE Greater New Orleans (PACE)	08	20		1			H1904	002	0	2018	PACE Greter New Orleans		2		2			2						http://www.pacegno.org	http://www.pacegno.org										(866)395-8509		(504)835-0006		(866)395-8509		(504)835-0006										(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277																
H1944	001	0	1	01	01	H1944_001_0	3			1		08/02/2017	2018.03	08/02/2017 01:40:27 PM Central Daylight Time	08/03/2017 01:42:13 PM Central Daylight Time	08/01/2017 09:37:46 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	001	0	2018	Middlesex and Suffolk counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	004	0	1	01	01	H1944_004_0	3			1		06/01/2017	2018.03	06/01/2017 08:55:55 AM Central Daylight Time	08/03/2017 01:42:47 PM Central Daylight Time	08/01/2017 09:38:12 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	004	0	2018	Middlesex and Suffolk counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	005	0	1	01	01	H1944_005_0	3			1		08/02/2017	2018.03	08/02/2017 01:40:53 PM Central Daylight Time	08/03/2017 01:43:22 PM Central Daylight Time	08/01/2017 09:38:39 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	005	0	2018	Bristol, Hampden, Plymouth and Worcester Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	006	0	1	01	01	H1944_006_0	3			1		06/01/2017	2018.03	06/01/2017 08:58:43 AM Central Daylight Time	08/03/2017 01:44:00 PM Central Daylight Time	08/01/2017 09:39:05 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	006	0	2018	Bristol, Hampden, Plymouth and Worcester Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	009	0	1	01	01	H1944_009_0	3			1		06/01/2017	2018.03	06/01/2017 08:52:57 AM Central Daylight Time	08/03/2017 01:44:38 PM Central Daylight Time	08/01/2017 09:39:32 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1944	009	0	2018	Bucks and Chester Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	010	0	1	01	01	H1944_010_0	3			1		06/01/2017	2018.03	06/01/2017 08:53:24 AM Central Daylight Time	08/03/2017 01:45:14 PM Central Daylight Time	08/01/2017 09:39:58 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	010	0	2018	Pittsburgh and Southwest PA		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	011	0	1	01	01	H1944_011_0	3			1		06/01/2017	2018.03	06/01/2017 08:53:40 AM Central Daylight Time	08/03/2017 01:45:51 PM Central Daylight Time	08/01/2017 09:40:25 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	011	0	2018	Pittsburgh and Southwest PA		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	012	0	1	01	01	H1944_012_0	3			1		06/01/2017	2018.03	06/01/2017 08:53:55 AM Central Daylight Time	08/03/2017 01:46:27 PM Central Daylight Time	08/01/2017 09:40:51 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	012	0	2018	Northwest Pennsylvania		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	013	0	1	01	01	H1944_013_0	4			1		06/01/2017	2018.03	06/01/2017 08:54:11 AM Central Daylight Time	08/03/2017 01:47:05 PM Central Daylight Time	08/01/2017 09:41:18 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	013	0	2018	Northwest Pennsylvania		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	014	0	1	01	01	H1944_014_0	4			1		07/20/2017	2018.03	07/20/2017 10:56:26 AM Central Daylight Time	08/03/2017 01:47:41 PM Central Daylight Time	08/01/2017 09:41:44 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	014	0	2018	State of Rhode Island		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	015	0	1	01	01	H1944_015_0	2			1		05/25/2017	2018.03	05/25/2017 11:01:27 AM Central Daylight Time	06/01/2017 12:56:08 PM Central Daylight Time				07/06/2017 03:18:57 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H1944	015	0	2018	State of Rhode Island		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1944	016	0	1	01	01	H1944_016_0	3			1		08/02/2017	2018.03	08/02/2017 01:41:17 PM Central Daylight Time	08/03/2017 01:48:54 PM Central Daylight Time	08/01/2017 09:42:10 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	016	0	2018	State of Rhode Island		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	017	0	1	01	01	H1944_017_0	3			1		06/01/2017	2018.03	06/01/2017 08:54:30 AM Central Daylight Time	08/03/2017 01:49:32 PM Central Daylight Time	08/01/2017 09:42:37 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	017	0	2018	Select counties in New Hampshire		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	018	0	1	01	01	H1944_018_0	3			1		08/02/2017	2018.03	08/02/2017 01:46:04 PM Central Daylight Time	08/03/2017 01:50:08 PM Central Daylight Time	08/01/2017 09:43:05 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H1944	018	0	2018	Select counties in Vermont		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	019	0	1	01	01	H1944_019_0	3			1		06/01/2017	2018.03	06/01/2017 08:55:07 AM Central Daylight Time	08/03/2017 01:50:45 PM Central Daylight Time	08/01/2017 09:43:32 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	019	0	2018	Select counties in New Hampshire		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	020	0	1	01	01	H1944_020_0	4			1		07/20/2017	2018.03	07/20/2017 10:56:38 AM Central Daylight Time	08/03/2017 01:51:26 PM Central Daylight Time	08/01/2017 09:44:02 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	020	0	2018	State of Rhode Island		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	021	0	1	01	01	H1944_021_0	4			1		06/01/2017	2018.03	06/01/2017 09:00:51 AM Central Daylight Time	08/03/2017 01:52:13 PM Central Daylight Time	08/01/2017 09:44:30 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	021	0	2018	Middlesex and Suffolk County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	022	0	1	01	01	H1944_022_0	4			1		06/01/2017	2018.03	06/01/2017 09:01:52 AM Central Daylight Time	08/03/2017 01:52:52 PM Central Daylight Time	08/01/2017 09:44:57 AM Central Daylight Time			08/04/2017 12:09:09 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	022	0	2018	Plymouth, Bristol, Hampden and Worcester Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	024	0	1	01	01	H1944_024_0	4			1		06/01/2017	2018.03	06/01/2017 08:55:29 AM Central Daylight Time	08/03/2017 01:53:41 PM Central Daylight Time	08/01/2017 09:45:24 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1944	024	0	2018	Outside Philadelphia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	025	0	1	01	01	H1944_025_0	4			1		06/01/2017	2018.03	06/01/2017 08:55:51 AM Central Daylight Time	08/03/2017 01:54:26 PM Central Daylight Time	08/01/2017 09:45:51 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	025	0	2018	Pittsburgh and Surrounding Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	026	0	1	01	01	H1944_026_0	4			1		06/01/2017	2018.03	06/01/2017 08:56:28 AM Central Daylight Time	08/03/2017 01:55:09 PM Central Daylight Time	08/01/2017 09:46:19 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H1944	026	0	2018	Northwestern Pennsylvania		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	028	0	1	01	01	H1944_028_0	4			1		06/01/2017	2018.03	06/01/2017 09:08:55 AM Central Daylight Time	08/03/2017 01:55:59 PM Central Daylight Time	08/01/2017 09:46:45 AM Central Daylight Time			08/04/2017 12:08:31 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H1944	028	0	2018	Select counties in Vermont		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1944	805	0	1	01	01	H1944_805_0	2			1		06/08/2017	2018.03	06/08/2017 11:22:44 AM Central Daylight Time					06/13/2017 04:44:53 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1944	805	0	2018	Select counties in MA, PA, RI, VT		1	9132	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1944	806	0	1	01	01	H1944_806_0	1			1		05/25/2017	2018.03	05/25/2017 11:22:29 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1944	806	0	2018	Select counties in MA, PA, RI, VT		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H1944	807	0	1	01	01	H1944_807_0	1			1		05/25/2017	2018.03	05/25/2017 11:22:44 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1944	807	0	2018	Select counties in MA, PA, RI, VT		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H1951	013	0	1	01	01	H1951_013_0	3			1		05/27/2017	2018.03	05/27/2017 01:53:40 PM Eastern Daylight Time	08/04/2017 02:16:56 PM Eastern Daylight Time	08/04/2017 09:52:08 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-013 (HMO)	01	01		1			H1951	013	0	2018	Shreveport Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	024	0	1	01	01	H1951_024_0	3			1		05/30/2017	2018.03	05/30/2017 03:41:07 PM Eastern Daylight Time	08/04/2017 02:02:01 PM Eastern Daylight Time	08/04/2017 09:52:09 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-024 (HMO)	01	01		1			H1951	024	0	2018	Tangipahoa Parish		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	028	0	1	01	01	H1951_028_0	3			1		05/30/2017	2018.03	05/30/2017 03:41:25 PM Eastern Daylight Time	08/04/2017 02:02:58 PM Eastern Daylight Time	08/04/2017 09:52:09 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-028 (HMO)	01	01		1			H1951	028	0	2018	Washington and St. Tammany Parishes		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	030	0	1	01	01	H1951_030_0	2			1		05/30/2017	2018.03	05/30/2017 03:41:39 PM Eastern Daylight Time	06/01/2017 12:36:44 PM Eastern Daylight Time				06/02/2017 08:13:12 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana-medicare.com	Humana Gold Plus H1951-030 (HMO)	01	01		1			H1951	030	0	2018	Baton Rouge Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H1951	032	0	1	01	01	H1951_032_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 03:08:20 PM Eastern Daylight Time	08/04/2017 02:04:54 PM Eastern Daylight Time	08/04/2017 09:52:10 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1951-032 (HMO SNP)	01	01		1			H1951	032	0	2018	Baton Rouge Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	033	0	1	01	01	H1951_033_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:42:11 AM Eastern Daylight Time	08/04/2017 02:04:25 PM Eastern Daylight Time	08/04/2017 09:52:10 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1951-033 (HMO SNP)	01	01		1			H1951	033	0	2018	New Orleans Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	034	0	1	01	01	H1951_034_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:42:23 AM Eastern Daylight Time	08/04/2017 02:03:57 PM Eastern Daylight Time	08/04/2017 09:52:11 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1951-034 (HMO SNP)	01	01		1			H1951	034	0	2018	Washington and St. Tammany Parishes		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	038	0	1	01	01	H1951_038_0	3			1		08/02/2017	2018.03	08/02/2017 02:55:04 PM Eastern Daylight Time	08/04/2017 02:05:50 PM Eastern Daylight Time	08/04/2017 09:52:11 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Total Care Advantage H1951-038 (HMO)	01	01		1			H1951	038	0	2018	New Orleans Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	039	0	1	01	01	H1951_039_0	3			1		08/02/2017	2018.03	08/02/2017 02:54:49 PM Eastern Daylight Time	08/04/2017 02:05:21 PM Eastern Daylight Time	08/04/2017 09:52:12 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Total Care Advantage H1951-039 (HMO)	01	01		1			H1951	039	0	2018	Baton Rouge Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	041	0	1	01	01	H1951_041_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 10:42:36 AM Eastern Daylight Time	08/04/2017 02:08:13 PM Eastern Daylight Time	08/04/2017 09:52:12 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H1951-041 (HMO SNP)	01	01		1			H1951	041	0	2018	Select Louisiana Parishes		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	044	0	1	01	01	H1951_044_0	3		1	1		08/02/2017	2018.03	08/02/2017 02:53:16 PM Eastern Daylight Time	08/04/2017 02:07:16 PM Eastern Daylight Time	08/04/2017 09:52:13 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H1951	044	0	2018	Jefferson and Orleans Parishes		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	047	1	1	01	01	H1951_047_1	2			1		08/03/2017	2018.03	08/03/2017 10:28:42 AM Eastern Daylight Time	08/04/2017 02:10:38 PM Eastern Daylight Time	08/04/2017 09:52:13 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-047 (HMO)	01	01		1			H1951	047	1	2018	New Orleans Area	Jefferson, Orleans, and St. Charles Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	047	2	1	01	01	H1951_047_2	2			1		05/30/2017	2018.03	05/30/2017 03:43:16 PM Eastern Daylight Time	08/04/2017 02:10:09 PM Eastern Daylight Time	08/04/2017 09:52:14 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-047 (HMO)	01	01		1			H1951	047	2	2018	New Orleans Area	Select Louisiana Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	048	1	1	01	01	H1951_048_1	2			1		08/02/2017	2018.03	08/02/2017 02:52:16 PM Eastern Daylight Time	08/04/2017 02:09:39 PM Eastern Daylight Time	08/04/2017 09:52:14 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-048 (HMO)	01	01		1			H1951	048	1	2018	Baton Rouge Area	Baton Rouge Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	048	2	1	01	01	H1951_048_2	2			1		05/30/2017	2018.03	05/30/2017 03:43:43 PM Eastern Daylight Time	08/04/2017 02:09:12 PM Eastern Daylight Time	08/04/2017 09:52:15 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-048 (HMO)	01	01		1			H1951	048	2	2018	Baton Rouge Area	Select Louisiana Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	049	1	1	01	01	H1951_049_1	2			1		08/02/2017	2018.03	08/02/2017 02:49:03 PM Eastern Daylight Time	08/04/2017 02:12:32 PM Eastern Daylight Time	08/04/2017 09:52:15 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-049 (HMO)	01	01		1			H1951	049	1	2018	Select Louisiana Parishes	Select Louisiana Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	049	2	1	01	01	H1951_049_2	2			1		08/02/2017	2018.03	08/02/2017 02:50:28 PM Eastern Daylight Time	08/04/2017 02:14:59 PM Eastern Daylight Time	08/04/2017 09:52:16 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-049 (HMO)	01	01		1			H1951	049	2	2018	Select Louisiana Parishes	Select Louisiana Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	049	3	1	01	01	H1951_049_3	2			1		08/02/2017	2018.03	08/02/2017 02:51:40 PM Eastern Daylight Time	08/04/2017 02:15:27 PM Eastern Daylight Time	08/04/2017 09:52:17 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Gold Plus H1951-049 (HMO)	01	01		1			H1951	049	3	2018	Select Louisiana Parishes	Select Louisiana Parishes	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1951	801	0	1	01	01	H1951_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:12:24 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1951	801	0	2018	Select parishes in Louisiana		1	79620	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1951	804	0	1	01	01	H1951_804_0	3			1		06/13/2017	2018.03	06/13/2017 10:18:05 AM Eastern Daylight Time					06/13/2017 12:37:41 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H1951	804	0	2018	Select parishes in Louisiana		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H1961	003	0	1	01	01	H1961_003_0	4		1	1	2	07/21/2017	2018.03	07/21/2017 04:28:12 PM Central Daylight Time	08/07/2017 10:30:43 AM Central Daylight Time	08/07/2017 10:41:03 AM Central Daylight Time			08/07/2017 10:49:18 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Secure Health (HMO SNP)	01	01		1			H1961	003	0	2018	South Louisiana		2	234433	2			1	3		2		2	www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	007	0	1	01	01	H1961_007_0	8			1		07/28/2017	2018.03	07/28/2017 04:24:33 PM Central Daylight Time	08/07/2017 10:32:31 AM Central Daylight Time	08/07/2017 10:42:16 AM Central Daylight Time			08/07/2017 10:51:16 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices Select (HMO)	01	01		1			H1961	007	0	2018	Tangipahoa and Washington parishes		2	14535	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	011	0	1	01	01	H1961_011_0	4		1	1	2	08/07/2017	2018.03	08/07/2017 09:08:37 AM Central Daylight Time	08/07/2017 10:34:17 AM Central Daylight Time	08/07/2017 10:43:29 AM Central Daylight Time			08/07/2017 10:53:04 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Secure Choice #011 (HMO SNP)	01	01		1			H1961	011	0	2018	North and Central Louisiana		2	264	2			1	3		2		2	www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	014	1	1	01	01	H1961_014_1	8			1		08/07/2017	2018.03	08/07/2017 10:10:21 AM Central Daylight Time	08/07/2017 10:36:04 AM Central Daylight Time	08/07/2017 10:44:32 AM Central Daylight Time			08/07/2017 10:55:11 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices 65 #14 (HMO)	01	01		1			H1961	014	1	2018	New Orleans Metro Area and St. Tammany parish	Southeast Louisiana	2	423824	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	014	2	1	01	01	H1961_014_2	8			1		08/07/2017	2018.03	08/07/2017 10:10:47 AM Central Daylight Time	08/07/2017 10:38:07 AM Central Daylight Time	08/07/2017 10:46:06 AM Central Daylight Time			08/07/2017 10:58:07 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices 65 #14 (HMO)	01	01		1			H1961	014	2	2018	New Orleans Metro Area and St. Tammany parish	St. Tammany Parish	2	67825	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	017	0	1	01	01	H1961_017_0	4			1		08/07/2017	2018.03	08/07/2017 10:11:08 AM Central Daylight Time	08/07/2017 10:39:51 AM Central Daylight Time	08/07/2017 10:47:54 AM Central Daylight Time			08/07/2017 10:59:39 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices Gold (HMO)	01	01		1			H1961	017	0	2018	Lafayette and Lake Charles area		2	18984	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	801	0	1	02	01	H1961_801_0	1			1		06/01/2017	2018.03	06/01/2017 11:34:19 AM Central Daylight Time					06/05/2017 11:06:57 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO-POS)	01	02		1			H1961	801	0	2018	Nationwide		1	28800	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	802	0	1	02	01	H1961_802_0	1			1		06/01/2017	2018.03	06/01/2017 11:34:41 AM Central Daylight Time					06/05/2017 11:08:41 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO-POS)	01	02		1			H1961	802	0	2018	Nationwide		1	28800	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	803	0	1	01	01	H1961_803_0	1			1		06/01/2017	2018.03	06/01/2017 11:35:06 AM Central Daylight Time					06/05/2017 11:10:38 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO)	01	01		1			H1961	803	0	2018	Nationwide		1	1200	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1961	804	0	1	01	01	H1961_804_0	1			1		06/01/2017	2018.03	06/01/2017 11:35:26 AM Central Daylight Time					06/05/2017 11:12:15 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO)	01	01		1			H1961	804	0	2018	Nationwide		1	1200	2			2						www.peopleshealth.com/pharmacies	www.peopleshealth.com/formulary	www.peopleshealth.com/physicians	(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)222-8600		(504)849-4685		(866)301-8865		(504)712-7504		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		(800)846-5277		2					2					2	2			
H1969	002	0	1	01	01	H1969_002_0	9			1		08/10/2017	2018.03	08/10/2017 12:53:05 PM Mountain Daylight Time	08/04/2017 04:47:45 PM Mountain Daylight Time	08/01/2017 06:43:59 PM Mountain Daylight Time			08/10/2017 02:34:37 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield of Idaho	www.regence.com/medicare	Regence Blue MedAdvantage HMO (HMO)	01	01		1			H1969	002	0	2018	Ada and Canyon Counties		2	30787	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1969	004	0	1	01	01	H1969_004_0	10			1		07/07/2017	2018.03	07/07/2017 01:18:38 PM Mountain Daylight Time	08/04/2017 04:49:32 PM Mountain Daylight Time	08/01/2017 06:44:56 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield of Idaho	www.regence.com/medicare	Regence Blue MedAdvantage HMO Plus (HMO)	01	01		1			H1969	004	0	2018	Ada and Canyon Counties		2	4788	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1969	801	0	1	01	01	H1969_801_0	3			1		05/23/2017	2018.03	05/23/2017 03:27:37 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO	Regence BlueShield of Idaho	www.regence.com/medicare	Regence Blue MedAdvantage HMO (HMO)	01	01		1			H1969	801	0	2018	Ada and Canyon Counties		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	1	7d;7f;7g;	1					1				
H1977	001	0	1	48	05	H1977_001_0	5			1		08/28/2017	2018.03	08/28/2017 10:46:29 AM Eastern Daylight Time					08/28/2017 10:47:45 AM Eastern Daylight Time	UPPER PENINSULA HEALTH PLAN, LLC	Upper Peninsula Health Plan (UPHP) MI Health Link	www.uphp.com/medicare	Upper Peninsula Health Plan MI Health Link (Medicare-Medicaid Plan)	05	48		1			H1977	001	0	2018	Upper Peninsula of Michigan		2	48000	2			2						http://www.uphp.com/medicare	http://www.uphp.com/medicare	www.uphp.com/medicare	(877)349-9324		(877)349-9324		(877)349-9324		(877)349-9324		(855)380-0275		(855)380-0275		(877)349-9324		(877)349-9324		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H1994	001	0	1	01	01	H1994_001_0	5			1		08/04/2017	2018.03	08/04/2017 11:42:38 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage Essential (HMO)	01	01		1			H1994	001	0	2018	Counties: Dav, Mor, SLC, Sum, Uta, Was, Web		2	215000	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		2					2					2	2			
H1994	002	0	1	01	01	H1994_002_0	5			1		07/19/2017	2018.03	07/19/2017 10:29:02 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	002	0	2018	Garfield, Iron, Sanpete, Sevier, and Washington Co		2	69338	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		2					2					2	2			
H1994	003	0	1	01	01	H1994_003_0	4			1		06/26/2017	2018.03	06/26/2017 10:52:30 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage Essential (HMO)	01	01		1			H1994	003	0	2018	Counties: Ada, Adams, Boi, Can, Elm, Gem, Owy, Was		2	110121	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(208)429-9900		(855)442-9940		(855)442-9940		(855)442-9900		(208)429-9900		(855)442-9940		(855)442-9940		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		2					2					2	2			
H1994	004	0	1	01	01	H1994_004_0	5			1		06/26/2017	2018.03	06/26/2017 10:52:48 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	004	0	2018	Blaine, Cassia, Minidoka, Jerome, Twin Falls		2	44335	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		2					2					2	2			
H1994	005	0	1	01	01	H1994_005_0	5			1		07/19/2017	2018.03	07/19/2017 10:30:00 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	005	0	2018	Box Elder, Cache, Franklin, and Rich Counties		2	6214	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		2					2					2	2			
H1994	007	0	1	01	01	H1994_007_0	5			1		06/22/2017	2018.03	06/22/2017 12:09:19 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage Enhanced (HMO)	01	01		1			H1994	007	0	2018	Counties: Dav, Mor, SLC, Sum, Uta, Was, Web		2	15742	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		(800)346-4128		(711)-		2					2					2	2			
H1994	008	0	1	01	01	H1994_008_0	4			1		06/26/2017	2018.03	06/26/2017 10:53:08 AM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time	08/04/2017 03:42:18 PM Mountain Daylight Time			08/04/2017 03:49:23 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage Enhanced (HMO)	01	01		1			H1994	008	0	2018	Counties: Ada, Adams, Boi, Can, Elm, Gem, Owy, Was		2	31580	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(801)442-9900		(855)442-9940		(855)442-9940		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		(800)377-3529		(711)-		2					2					2	2			
H1994	801	0	1	01	01	H1994_801_0	1			1		06/01/2017	2018.03	06/01/2017 03:09:26 PM Mountain Daylight Time					06/05/2017 01:16:57 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	801	0	2018	Utah and Idaho		1	300	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;9a;9b;10a;11a;11b;15;	2		1					1				
H1994	802	0	1	01	01	H1994_802_0	1			1		06/01/2017	2018.03	06/01/2017 03:08:20 PM Mountain Daylight Time					06/05/2017 01:16:57 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	802	0	2018	Utah and Idaho		1	300	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;9a;9b;10a;11a;11b;15;	2		1					1				
H1994	803	0	1	01	01	H1994_803_0	1			1		06/01/2017	2018.03	06/01/2017 03:05:50 PM Mountain Daylight Time					06/05/2017 01:16:57 PM Mountain Daylight Time	SELECTHEALTH, INC.	SelectHealth	www.selecthealthadvantage.org	SelectHealth Advantage (HMO)	01	01		1			H1994	803	0	2018	Utah and Idaho		1	300	2			2						www.selecthealthadvantage.org	www.selecthealthadvantage.org	www.selecthealthadvantage.org	(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(855)442-9900		(855)442-9900		(855)442-9940		(855)442-9940		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;9a;9b;10a;11a;11b;15;	2		1					1				
H1997	002	0	1	01	01	H1997_002_0	10			1		07/07/2017	2018.03	07/07/2017 02:06:59 PM Mountain Daylight Time	08/04/2017 04:51:19 PM Mountain Daylight Time	08/01/2017 06:45:53 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence BlueAdvantage HMO Plus (HMO)	01	01		1			H1997	002	0	2018	King, Pierce, and Snohomish counties		2	30878	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1997	006	0	1	01	01	H1997_006_0	9			1		08/03/2017	2018.03	08/03/2017 03:34:55 PM Mountain Daylight Time	08/04/2017 04:53:07 PM Mountain Daylight Time	08/01/2017 06:46:52 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence BlueAdvantage HMO (HMO)	01	01		1			H1997	006	0	2018	King, Pierce, and Snohomish counties		2	9747	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H1997	803	0	1	01	01	H1997_803_0	3			1		05/23/2017	2018.03	05/23/2017 03:01:48 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence BlueAdvantage HMO (HMO)	01	01		1			H1997	803	0	2018	King, Pierce, and Snohomish counties		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	1	7d;7f;7g;	1					1				
H2001	001	0	1	04	01	H2001_001_0	3			1		08/03/2017	2018.03	08/03/2017 08:47:55 AM Central Daylight Time	08/03/2017 01:56:45 PM Central Daylight Time	08/01/2017 09:47:11 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H2001	001	0	2018	Southwest Maine		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2001	010	0	1	04	01	H2001_010_0	3			1		06/01/2017	2018.03	06/01/2017 09:02:44 AM Central Daylight Time	08/03/2017 01:57:37 PM Central Daylight Time	08/01/2017 09:47:38 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H2001	010	0	2018	Southwest Maine		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2001	017	0	1	04	01	H2001_017_0	3			1		05/25/2017	2018.03	05/25/2017 02:24:07 PM Central Daylight Time	08/03/2017 01:58:27 PM Central Daylight Time	08/01/2017 09:48:05 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice (PPO)	01	04		1			H2001	017	0	2018	Washington County		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2001	816	0	1	04	01	H2001_816_0	2			1		06/08/2017	2018.03	06/08/2017 11:23:12 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	816	0	2018	National Service Area		1	5725776	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	817	0	1	04	01	H2001_817_0	2			1		06/08/2017	2018.03	06/08/2017 11:23:31 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	817	0	2018	National Service Area		1	5391120	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2001	818	0	1	04	01	H2001_818_0	2			1		06/08/2017	2018.03	06/08/2017 11:23:48 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	818	0	2018	National Service Area		1	33804	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	819	0	2	04	01	H2001_819_0	2			1		06/08/2017	2018.03	06/08/2017 11:24:20 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	819	0	2018	National Service Area		1	10524	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	820	0	2	04	01	H2001_820_0	2			1		06/08/2017	2018.03	06/08/2017 11:24:40 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	820	0	2018	National Service Area		1	26952	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2001	821	0	2	04	01	H2001_821_0	1			1		05/25/2017	2018.03	05/25/2017 11:43:32 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	821	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	822	0	1	04	01	H2001_822_0	2			1		06/08/2017	2018.03	06/08/2017 11:25:01 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	822	0	2018	Select Counties		1	4464	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	823	0	1	04	01	H2001_823_0	2			1		06/08/2017	2018.03	06/08/2017 11:25:19 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	823	0	2018	Select Counties		1	780	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2001	824	0	1	04	01	H2001_824_0	1			1		05/25/2017	2018.03	05/25/2017 11:44:47 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	824	0	2018	Select Counties		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	825	0	1	04	01	H2001_825_0	2			1		06/08/2017	2018.03	06/08/2017 11:25:43 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	825	0	2018	Select Counties		1	45540	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	826	0	1	04	01	H2001_826_0	2			1		06/08/2017	2018.03	06/08/2017 11:26:38 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	826	0	2018	Select Counties		1	61152	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	827	0	1	04	01	H2001_827_0	2			1		06/08/2017	2018.03	06/08/2017 11:27:07 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	827	0	2018	National Service Area		1	1467768	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	828	0	1	04	01	H2001_828_0	2			1		06/08/2017	2018.03	06/08/2017 11:27:27 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	828	0	2018	National Service Area		1	277800	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	829	0	1	04	01	H2001_829_0	1			1		05/25/2017	2018.03	05/25/2017 11:47:47 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	829	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	830	0	1	04	01	H2001_830_0	2			1		06/08/2017	2018.03	06/08/2017 11:27:53 AM Central Daylight Time					06/13/2017 04:48:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	830	0	2018	National Service Area		1	61404	2			2						9999	www.UHCMedicareSolutions.com	610494	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2001	831	0	1	04	01	H2001_831_0	1			1		05/25/2017	2018.03	05/25/2017 11:48:45 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	831	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	832	0	2	04	01	H2001_832_0	1			1		05/25/2017	2018.03	05/25/2017 11:49:01 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	832	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	833	0	2	04	01	H2001_833_0	1			1		05/25/2017	2018.03	05/25/2017 11:49:15 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	833	0	2018	National Service Area		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2001	834	0	2	04	01	H2001_834_0	1			1		05/25/2017	2018.03	05/25/2017 11:49:23 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2001	834	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	835	0	1	04	01	H2001_835_0	1			1		05/25/2017	2018.03	05/25/2017 11:49:32 AM Pacific Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	835	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	836	0	1	04	01	H2001_836_0	1			1		05/30/2017	2018.03	05/30/2017 08:11:29 AM Central Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	836	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	837	0	1	04	01	H2001_837_0	1			1		05/30/2017	2018.03	05/30/2017 08:20:06 AM Central Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	837	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2001	838	0	1	04	01	H2001_838_0	1			1		05/30/2017	2018.03	05/30/2017 08:20:07 AM Central Daylight Time					06/01/2017 04:27:06 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2001	838	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2029	001	0	1	04	01	H2029_001_0	4			1		08/02/2017	2018.03	08/02/2017 03:05:33 PM Eastern Daylight Time	08/06/2017 01:10:19 PM Eastern Daylight Time	08/04/2017 09:52:17 AM Eastern Daylight Time			08/06/2017 01:32:19 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	HumanaChoice Value H2029-001 (PPO)	01	04		1			H2029	001	0	2018	Puerto Rico Island Wide		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2029	801	0	1	04	01	H2029_801_0	3			1		06/13/2017	2018.03	06/13/2017 09:59:23 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H2029	801	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2029	802	0	1	04	01	H2029_802_0	3			1		06/13/2017	2018.03	06/13/2017 09:56:56 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H2029	802	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2029	803	0	1	04	01	H2029_803_0	3			1		06/13/2017	2018.03	06/13/2017 09:58:49 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		1			H2029	803	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2029	805	0	2	04	01	H2029_805_0	3			1		06/13/2017	2018.03	06/13/2017 10:00:05 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H2029	805	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2029	806	0	2	04	01	H2029_806_0	3			1		06/13/2017	2018.03	06/13/2017 10:01:47 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H2029	806	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2029	807	0	2	04	01	H2029_807_0	3			1		06/13/2017	2018.03	06/13/2017 10:02:40 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		2	1		H2029	807	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2032	001	0	1	04	01	H2032_001_0	9			1		07/13/2017	2018.03	07/13/2017 11:19:48 AM Central Daylight Time	08/03/2017 07:17:56 PM Central Daylight Time	08/01/2017 07:36:08 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	INSURANCE COMPANY OF SCOTT AND WHITE	Baylor Scott & White Health Plan	advantage.swhp.org	SeniorCare Advantage (PPO)	01	04		1			H2032	001	0	2018	Dallas/Ft. Worth Metro Area		2	5424	2			2						www.swhp.org	www.swhp.org	https://portal.swhp.org/#/search	(866)334-3141		(866)334-3141		(800)782-5068		(800)782-5068		(888)423-7633		(888)423-7633		(877)845-3903		(877)845-3903		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2						2			
H2032	002	0	1	04	01	H2032_002_0	9			1		07/13/2017	2018.03	07/13/2017 11:20:42 AM Central Daylight Time	08/03/2017 08:17:14 PM Central Daylight Time	08/01/2017 08:07:06 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	INSURANCE COMPANY OF SCOTT AND WHITE	Baylor Scott & White Health Plan	advantage.swhp.org	SeniorCare Advantage (PPO)	01	04		1			H2032	002	0	2018	Central Texas		2	5424	2			2						www.swhp.org	www.swhp.org	https://portal.swhp.org/#/search	(866)334-3141		(866)334-3141		(800)782-5068		(800)782-5068		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2						2			
H2034	001	0	1	01	01	H2034_001_0	4		1	1	2	08/09/2017	2018.03	08/09/2017 09:25:41 AM Central Daylight Time	08/04/2017 04:15:21 PM Central Daylight Time	08/04/2017 04:15:25 PM Central Daylight Time			08/09/2017 10:59:48 AM Central Daylight Time	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	Community Care's  Partnership Program (HMO SNP)	01	01		1			H2034	001	0	2018	Eastern Wisconsin		2	394	2			1	3		1		1	www.communitycareinc.org	www.communitycareinc.org	www.communitycareinc.org	(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					1					1	2			
H2034	002	0	1	01	01	H2034_002_0	5		1	1	2	08/09/2017	2018.03	08/09/2017 09:26:48 AM Central Daylight Time	08/04/2017 04:15:16 PM Central Daylight Time	08/04/2017 04:15:23 PM Central Daylight Time			08/09/2017 10:59:48 AM Central Daylight Time	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	Community Care's Partnership Program Disabled (HMO SNP)	01	01		1			H2034	002	0	2018	Eastern Wisconsin		2	106	2			1	3		1		1	www.communitycareinc.org	www.communitycareinc.org	www.communitycareinc.org	(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					1					1	2			
H2064	001	0	1	20	08	H2064_001_0	1			1		06/02/2017	2018.03	06/02/2017 02:21:36 PM Eastern Daylight Time		06/02/2017 02:26:59 PM Eastern Daylight Time			06/02/2017 02:28:16 PM Eastern Daylight Time	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	LIFE Geisinger (PACE)	08	20		1			H2064	001	0	2018	LIFE Geisinger		2		2			2						www.lifegeisinger.org	www.lifegeisinger.org										(570)214-9790		(570)214-9790		(570)214-9790		(570)214-9790										(570)214-9790		(570)214-9790		(570)214-9790		(570)214-9790																
H2064	002	0	1	20	08	H2064_002_0	1			1		06/02/2017	2018.03	06/02/2017 02:22:13 PM Eastern Daylight Time		06/02/2017 02:26:46 PM Eastern Daylight Time			06/02/2017 02:28:16 PM Eastern Daylight Time	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	LIFE Geisinger (PACE)	08	20		1			H2064	002	0	2018	LIFE Geisinger		2		2			2						www.lifegeisinger.org	www.lifegeisinger.org										(570)214-9790		(570)214-9790		(570)214-9790		(570)214-9790										(570)214-9790		(570)214-9790		(570)214-9790		(570)214-9790																
H2108	001	0	1	01	01	H2108_001_0	4		1	1	2	05/17/2017	2018.03	05/17/2017 01:12:30 PM Central Daylight Time	08/03/2017 11:46:35 AM Central Daylight Time	08/01/2017 02:02:38 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H2108	001	0	2018	Maryland, Washington DC and Delaware Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	020	0	1	01	01	H2108_020_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:38:54 PM Central Daylight Time	08/03/2017 11:46:58 AM Central Daylight Time	08/01/2017 02:02:59 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Traditions (HMO SNP)	01	01		1			H2108	020	0	2018	Maryland, Washington DC, and Delaware Counties		2		2			1	1	1				www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	022	0	1	01	01	H2108_022_0	5			1		08/02/2017	2018.03	08/02/2017 04:40:02 PM Central Daylight Time	08/03/2017 11:47:19 AM Central Daylight Time	08/01/2017 02:03:23 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H2108	022	0	2018	Select Maryland Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	028	0	1	01	01	H2108_028_0	5			1		08/02/2017	2018.03	08/02/2017 04:41:12 PM Central Daylight Time	08/03/2017 11:47:41 AM Central Daylight Time	08/01/2017 02:03:45 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H2108	028	0	2018	Maryland, Washington DC and Delaware Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	029	0	1	01	01	H2108_029_0	5		1	1		06/28/2017	2018.03	06/28/2017 09:17:52 PM Central Daylight Time	08/03/2017 11:48:03 AM Central Daylight Time	08/01/2017 02:04:07 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Achieve (HMO SNP)	01	01		1			H2108	029	0	2018	Maryland, Washington DC and Delaware Counties		2		2			1	4			00000010000000000000		www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	030	0	1	01	01	H2108_030_0	5		1	1		06/28/2017	2018.03	06/28/2017 09:18:05 PM Central Daylight Time	08/03/2017 11:48:25 AM Central Daylight Time	08/01/2017 02:04:28 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Achieve (HMO SNP)	01	01		1			H2108	030	0	2018	Select Maryland Counties		2		2			1	4			00000010000000000000		www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	032	0	1	01	01	H2108_032_0	4			1		05/31/2017	2018.03	05/31/2017 01:06:02 PM Central Daylight Time	08/03/2017 11:48:47 AM Central Daylight Time	08/01/2017 02:04:49 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring PreventiveCare (HMO)	01	01		1			H2108	032	0	2018	Maryland, Washington DC, and Delaware Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	033	0	1	01	01	H2108_033_0	4			1		05/31/2017	2018.03	05/31/2017 01:06:13 PM Central Daylight Time	08/03/2017 11:49:09 AM Central Daylight Time	08/01/2017 02:05:10 PM Central Daylight Time			08/04/2017 03:48:12 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring PreventiveCare (HMO)	01	01		1			H2108	033	0	2018	Select Maryland Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(800)668-3813		(800)668-3813		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2108	801	0	1	01	01	H2108_801_0	3			1		05/23/2017	2018.03	05/23/2017 03:19:00 PM Central Daylight Time					06/02/2017 06:34:20 AM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H2108	801	0	2018	Statewide MD, DC and DE		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(800)313-0973		(800)313-0973		(888)281-7867		(888)281-7867		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14e1;15;16b;17a;	1	1a;3-1;3-2;3-3;7b;7d;7f;12;	1					1				
H2108	807	0	1	02	01	H2108_807_0	2			1		05/23/2017	2018.03	05/23/2017 03:41:10 PM Central Daylight Time					06/02/2017 06:34:20 AM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier Rx CY (HMO-POS)	01	02		1			H2108	807	0	2018	Statewide MD, DC & DE		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(800)313-0973		(800)313-0973		(888)281-7867		(888)281-7867		(800)313-0973		(800)313-0973		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14e1;15;16b;17a;	1	1a;3-1;3-2;3-3;7b;7d;7f;12;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;3-1;3-2;3-3;7b;7d;7f;12;	1				
H2109	001	0	1	20	08	H2109_001_0	1			1		05/25/2017	2018.03	05/25/2017 09:31:52 AM Eastern Daylight Time		05/25/2017 09:27:27 AM Eastern Daylight Time			05/25/2017 09:35:51 AM Eastern Daylight Time	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	Hopkins ElderPlus	www.hopkinsbayview.org/hopkinselderplus	The Johns Hopkins Health System Corporation. (PACE)	08	20		1			H2109	001	0	2018	Parts of Baltimore City and County, Maryland		2	1716	2			2						http://www.hopkinsbayview.org/hopkinselderplus	http://www.hopkinsbayview.org/hopkinselderplus												(410)550-7044				(410)550-7044												(410)550-0316				(410)550-0316																
H2109	002	0	1	20	08	H2109_002_0	1			1		05/25/2017	2018.03	05/25/2017 09:32:22 AM Eastern Daylight Time		05/25/2017 09:27:29 AM Eastern Daylight Time			05/25/2017 09:35:51 AM Eastern Daylight Time	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	Hopkins ElderPlus	www.hopkinsbayview.org/hopkinselderplus	The Johns Hopkins Health System Corporation (PACE)	08	20		1			H2109	002	0	2018	Parts of Baltimore City and County, Maryland		2	60	2			2						http://www.hopkinsbayview.org/hopkinselderplus	http://www.hopkinsbayview.org/hopkinselderplus												(410)550-7044				(410)550-7044												(410)550-0316				(410)550-0316																
H2150	002	0	1	18	06	H2150_002_0	8			1		08/02/2017	2018.03	08/02/2017 10:16:04 PM Eastern Daylight Time		08/02/2017 01:30:42 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost)	06	18		1			H2150	002	0	2018	DC, MD, VA		2	193618	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2150	009	0	1	18	06	H2150_009_0	8			1		08/02/2017	2018.03	08/02/2017 10:16:11 PM Eastern Daylight Time		08/02/2017 01:35:28 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost)	06	18		1			H2150	009	0	2018	DC, MD, VA		2	324750	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2150	017	0	1	18	06	H2150_017_0	7			1		06/02/2017	2018.03	06/02/2017 03:16:25 PM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Basic w/o D (AB) (Cost)	06	18		1			H2150	017	0	2018	DC, MD, VA		2	3411	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2150	021	0	1	18	06	H2150_021_0	7			1		06/02/2017	2018.03	06/02/2017 03:16:45 PM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus High w/o D (AB) (Cost)	06	18		1			H2150	021	0	2018	DC, MD, VA		2	5514	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2150	022	0	1	18	06	H2150_022_0	7			1		06/02/2017	2018.03	06/02/2017 03:17:13 PM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Std w/o D (AB) (Cost)	06	18		1			H2150	022	0	2018	DC, MD, VA		2	16945	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2150	029	0	2	18	06	H2150_029_0	7			1		08/02/2017	2018.03	08/02/2017 10:16:50 PM Eastern Daylight Time		08/02/2017 01:42:22 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Std w/Part D (B) (Cost)	06	18		2	1		H2150	029	0	2018	DC, MD, VA		2	526	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2150	030	0	2	18	06	H2150_030_0	7			1		06/02/2017	2018.03	06/02/2017 03:18:04 PM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Basic w/o D (B) (Cost)	06	18		2	1		H2150	030	0	2018	DC, MD, VA		2	37	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2150	033	0	1	18	06	H2150_033_0	9			1		08/02/2017	2018.03	08/02/2017 10:17:08 PM Eastern Daylight Time		08/02/2017 01:50:44 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Basic w/D (AB) (Cost)	06	18		1			H2150	033	0	2018	DC, MD, VA		2	4475	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2150	034	0	2	18	06	H2150_034_0	5			1		08/02/2017	2018.03	08/02/2017 10:17:17 PM Eastern Daylight Time		08/02/2017 01:57:49 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus Basic w/D (B) (Cost)	06	18		2	1		H2150	034	0	2018	DC, MD, VA		2	12	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2150	801	0	1	18	06	H2150_801_0	7			1		06/01/2017	2018.03	06/01/2017 11:50:12 AM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus GRP w/Part D (AB) (Cost)	06	18		1			H2150	801	0	2018	DC, MD, VA		1	167967	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2150	805	0	2	18	06	H2150_805_0	7			1		06/01/2017	2018.03	06/01/2017 11:50:21 AM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus GRP w/Part D (B) (Cost)	06	18		2	1		H2150	805	0	2018	DC, MD, VA		1	1	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2150	806	0	1	18	06	H2150_806_0	7			1		06/01/2017	2018.03	06/01/2017 11:50:31 AM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus FED w/Part D (AB) (Cost)	06	18		1			H2150	806	0	2018	DC, MD, VA		1	151763	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2150	807	0	2	18	06	H2150_807_0	7			1		06/01/2017	2018.03	06/01/2017 11:50:41 AM Eastern Daylight Time					06/05/2017 03:02:02 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Plus FED w/Part D (B) (Cost)	06	18		2	1		H2150	807	0	2018	DC, MD, VA		1	1685	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2161	002	0	1	01	01	H2161_002_0	4			1		08/04/2017	2018.03	08/04/2017 12:58:43 PM Eastern Daylight Time	08/07/2017 04:12:16 PM Eastern Daylight Time	08/07/2017 04:12:17 PM Eastern Daylight Time			08/07/2017 04:17:17 PM Eastern Daylight Time	UPPER PENINSULA HEALTH PLAN, LLC	Upper Peninsula Health Plan	www.uphp.com/medicare	Upper Peninsula Health Plan Advantage (HMO)	01	01		1			H2161	002	0	2018	Upper Peninsula of Michigan		2	6000	2			2						uphp.com/medicare	uphp.com/medicare	www.uphp.com/medicare	(877)349-9324		(877)349-9324		(877)349-9324		(877)349-9324		(844)827-0182		(844)827-0182		(877)349-9324		(877)349-9324		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2161	003	0	1	01	01	H2161_003_0	5			1		08/04/2017	2018.03	08/04/2017 01:01:24 PM Eastern Daylight Time	08/07/2017 04:12:18 PM Eastern Daylight Time	08/07/2017 04:12:18 PM Eastern Daylight Time			08/07/2017 04:22:27 PM Eastern Daylight Time	UPPER PENINSULA HEALTH PLAN, LLC	Upper Peninsula Health Plan	www.uphp.com/medicare	Upper Peninsula Health Plan Edge (HMO)	01	01		1			H2161	003	0	2018	Upper Peninsula of Michigan		2	6000	2			2						uphp.com/medicare	uphp.com/medicare	www.uphp.com/medicare	(877)349-9324		(877)349-9324		(877)349-9324		(877)349-9324		(844)827-0182		(844)827-0182		(877)349-9324		(877)349-9324		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2168	001	0	1	02	01	H2168_001_0	6		1	1	2	08/07/2017	2018.03	08/07/2017 10:35:43 PM Eastern Daylight Time	08/07/2017 10:28:36 PM Eastern Daylight Time	08/04/2017 03:30:40 PM Eastern Daylight Time			08/07/2017 10:36:36 PM Eastern Daylight Time	VILLAGE SENIOR SERVICES CORPORATION	VillageCareMAX	www.villagecaremax.org	VillageCareMAX Medicare Health Advantage (HMO-POS SNP)	01	02		1			H2168	001	0	2018	Bronx, Kings, New York, Queens		2	12861	2			1	3		2		1	www.villagecaremax.org	www.villagecaremax.org	www.villagecaremax.org	(800)469-6292		(800)469-6292		(800)469-6292		(800)469-6292		(888)807-6806		(888)807-6806		(800)469-6292		(800)469-6292		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2168	002	0	1	02	01	H2168_002_0	6		1	1	2	06/05/2017	2018.03	06/05/2017 05:58:30 PM Eastern Daylight Time	08/07/2017 10:28:40 PM Eastern Daylight Time	08/04/2017 03:30:43 PM Eastern Daylight Time			08/07/2017 10:36:36 PM Eastern Daylight Time	VILLAGE SENIOR SERVICES CORPORATION	VillageCareMAX	www.villagecaremax.org	VillageCareMAX Medicare Total Advantage (HMO-POS SNP)	01	02		1			H2168	002	0	2018	Bronx, Kings, New York, Queens		2	2525	2			1	3		1		1	www.villagecaremax.org	www.villagecaremax.org	www.villagecaremax.org	(800)469-6292		(800)469-6292		(800)469-6292		(800)469-6292		(888)807-6806		(888)807-6806		(800)469-6292		(800)469-6292		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2171	001	0	1	01	01	H2171_001_0	5			1		08/07/2017	2018.03	08/07/2017 11:06:27 AM Eastern Daylight Time	08/07/2017 02:26:16 PM Eastern Daylight Time	08/04/2017 02:41:11 PM Eastern Daylight Time			08/07/2017 04:46:30 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Insurance Company	www.cnchealthplan.com	Care N' Care Classic (HMO)	01	01		1			H2171	001	0	2018	Dallas Fort Worth Metro Area		2	7900	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2171	801	0	1	01	01	H2171_801_0	1			1		05/25/2017	2018.03	05/25/2017 10:29:24 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Insurance Company	www.cnchealthplan.com	Care N' Care Classic CY - MAPD (HMO)	01	01		1			H2171	801	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2171	802	0	1	01	01	H2171_802_0	1			1		05/25/2017	2018.03	05/25/2017 10:29:33 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Insurance Company	www.cnchealthplan.com	Care N' Care Classic NCY - MAPD (HMO)	01	01		1			H2171	802	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2171	803	0	1	01	01	H2171_803_0	1			1		05/25/2017	2018.03	05/25/2017 10:29:38 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Insurance Company	www.cnchealthplan.com	Care N' Care Classic CY - MA-Only (HMO)	01	01		1			H2171	803	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2171	804	0	1	01	01	H2171_804_0	1			1		05/25/2017	2018.03	05/25/2017 10:29:44 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Insurance Company	www.cnchealthplan.com	Care N' Care Classic NCY - MA-Only (HMO)	01	01		1			H2171	804	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2172	001	0	1	01	01	H2172_001_0	12			1		08/02/2017	2018.03	08/02/2017 10:18:01 PM Eastern Daylight Time	08/04/2017 12:34:20 PM Eastern Daylight Time	08/04/2017 01:22:12 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Advantage High DC (HMO)	01	01		1			H2172	001	0	2018	DC		2	76	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2172	002	0	1	01	01	H2172_002_0	11			1		08/02/2017	2018.03	08/02/2017 10:18:08 PM Eastern Daylight Time	08/04/2017 12:48:35 PM Eastern Daylight Time	08/04/2017 01:31:50 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Advantage High MD (HMO)	01	01		1			H2172	002	0	2018	MD		2	1596	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2172	003	0	1	01	01	H2172_003_0	11			1		08/02/2017	2018.03	08/02/2017 10:18:17 PM Eastern Daylight Time	08/04/2017 12:42:59 PM Eastern Daylight Time	08/04/2017 01:26:07 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Advantage Standard DC (HMO)	01	01		1			H2172	003	0	2018	DC		2	3570	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2172	004	0	1	01	01	H2172_004_0	11			1		08/02/2017	2018.03	08/02/2017 10:18:26 PM Eastern Daylight Time	08/04/2017 01:03:17 PM Eastern Daylight Time	08/04/2017 01:36:37 PM Eastern Daylight Time			08/04/2017 02:32:11 PM Eastern Daylight Time	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Advantage Standard MD (HMO)	01	01		1			H2172	004	0	2018	MD		2	39510	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2172	801	0	1	01	01	H2172_801_0	6			1		06/01/2017	2018.03	06/01/2017 11:52:04 AM Eastern Daylight Time					06/05/2017 08:35:21 AM Eastern Daylight Time	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Medicare Advantage for Groups (HMO)	01	01		1			H2172	801	0	2018	DC, MD		1	76	2			2						kp.org/directory	kp.org/seniorrx	kp.org/directory	(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(888)777-5536		(888)777-5536		(877)408-8607		(877)408-8607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					2				
H2174	001	0	1	01	01	H2174_001_0	4		1	1	2	06/02/2017	2018.03	06/02/2017 05:49:36 PM Pacific Daylight Time	08/04/2017 04:34:29 PM Pacific Daylight Time	08/04/2017 04:34:29 PM Pacific Daylight Time			08/10/2017 10:25:12 AM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Medicare Advantage	https://www.trilliumadvantage.com	Trillium Advantage Dual (HMO SNP)	01	01		1			H2174	001	0	2018	Lane County		2		2			1	3		2		2	https://www.trilliumadvantage.com/findadoctor	https://www.trilliumadvantage.com/partdformulary	https://www.trilliumadvantage.com/findadoctor	(844)867-1156		(844)867-1156		(877)826-5519		(877)826-5519		(844)867-1156		(844)867-1156		(877)826-5519		(877)826-5519		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2185	001	0	1	01	01	H2185_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:04:48 AM Central Daylight Time	08/07/2017 10:57:43 AM Central Daylight Time	08/07/2017 10:57:59 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	LIFEWORKS ADVANTAGE, LLC	LifeWorks Advantage (HMO SNP)	www.lifeworksadvantage.com	LifeWorks Advantage I-SNP (HMO SNP)	01	01		1			H2185	001	0	2018	Western and Central Virginia		2	6240	2			1	1	1				www.lifeworksadvantage.com	www.lifeworksadvantage.com	www.lifeworksadvantage.com	(844)854-6883		(844)854-6883		(844)854-6883		(844)854-6883		(844)854-6883		(844)854-6883		(844)854-6883		(844)854-6883		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2218	001	0	1	20	08	H2218_001_0	1			1		05/31/2017	2018.03	05/31/2017 02:38:34 PM Eastern Daylight Time		05/31/2017 02:46:58 PM Eastern Daylight Time			05/31/2017 02:51:31 PM Eastern Daylight Time	HARBOR HEALTH SERVICES, INC.	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	Harbor Health Elder Service Plan, Dual Eligible (PACE)	08	20		1			H2218	001	0	2018	Norfolk, Suffolk, Plymouth, and Middlesex Counties		2		2			2						www.eatonapothecary.com	www.elderserviceplan.org												(617)533-2400				(617)533-2400												(617)533-2404				(617)533-2404																
H2218	002	0	1	20	08	H2218_002_0	1			1		05/31/2017	2018.03	05/31/2017 02:39:19 PM Eastern Daylight Time		05/31/2017 02:31:25 PM Eastern Daylight Time			05/31/2017 02:51:31 PM Eastern Daylight Time	HARBOR HEALTH SERVICES, INC.	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	Harbor Health Elder Service Plan, Medicare only (PACE)	08	20		1			H2218	002	0	2018	Norfolk, Suffolk, Middlesex, and Plymouth Counties		2		2			2						www.eatonapothecary.com	www.elderserviceplan.org												(617)533-2400				(617)533-2400												(617)533-2404				(617)533-2404																
H2219	001	0	1	20	08	H2219_001_0	1			1		05/26/2017	2018.03	05/26/2017 03:39:01 PM Eastern Daylight Time		06/05/2017 03:46:38 PM Eastern Daylight Time			06/05/2017 04:01:31 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Summit ElderCare or Fallon Health	www.fallonhealth.org/summit	Summit ElderCare (PACE)	08	20		1			H2219	001	0	2018	Full: Worc,Hampden Part: Essex,Hampshire,Middlesex		2	15599	2			2						Not Applicable	Not Applicable										(800)698-7566		(508)368-9690		(800)698-7566		(508)368-9690										(711)-		(711)-		(711)-		(711)-																
H2219	002	0	1	20	08	H2219_002_0	1			1		05/26/2017	2018.03	05/26/2017 03:39:06 PM Eastern Daylight Time		06/05/2017 03:46:45 PM Eastern Daylight Time			06/05/2017 04:01:31 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Summit ElderCare or Fallon Health	www.fallonhealth.org/summit	Summit ElderCare (PACE)	08	20		1			H2219	002	0	2018	Full: Worc,Hampden Part: Essex,Hampshire,Middlesex		2	141	2			2						Not Applicable	Not Applicable										(800)698-7566		(508)368-9690		(800)698-7566		(508)368-9690										(711)-		(711)-		(711)-		(711)-																
H2220	001	0	1	20	08	H2220_001_0	1			1		05/25/2017	2018.03	05/25/2017 10:24:23 AM Eastern Daylight Time		05/25/2017 10:20:36 AM Eastern Daylight Time			05/25/2017 10:50:29 AM Eastern Daylight Time	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	www.uphamselderserviceplan.org	Upham's Corner Health Committee (PACE)	08	20		1			H2220	001	0	2018	Upham's Elder Service Plan, inner city of Boston		2		2			2						http://www.uphamscornerhealthctr.com/	http://www.uphamscornerhealthctr.com/										(617)288-0970		(617)288-0970		(617)288-0970		(617)288-0970										(617)287-8000		(617)287-8000		(617)287-8000		(617)287-8000																
H2220	002	0	1	20	08	H2220_002_0	1			1		05/25/2017	2018.03	05/25/2017 10:25:14 AM Eastern Daylight Time		05/25/2017 11:09:00 AM Eastern Daylight Time			05/25/2017 11:11:56 AM Eastern Daylight Time	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	www.uphamselderserviceplan.org	Uphams Corner Health Committee (PACE)	08	20		1			H2220	002	0	2018	Upham's Elder Service Plan, inner city of Boston		2		2			2						http://www.uphamscornerhealthctr.com/	http://www.uphamscornerhealthctr.com/										(617)288-0970		(617)288-0970		(617)288-0970		(617)288-0970										(617)287-8000		(617)287-8000		(617)287-8000		(617)287-8000																
H2221	001	0	1	20	08	H2221_001_0	1			1		05/25/2017	2018.03	05/25/2017 04:57:15 PM Eastern Daylight Time		05/25/2017 05:10:45 PM Eastern Daylight Time			05/25/2017 05:11:41 PM Eastern Daylight Time	CAMBRIDGE PUBLIC HEALTH COMMISSION	Elder Srvc Pln/Cambridge Health Alliance	http://www.challiance.org/esp/elder-service-plan.a	Cambridge Public Health Commission (PACE)	08	20		1			H2221	001	0	2018	Counties: Middlesex and Suffolk		2		2			2						http://www.challiance.org/Services/Pharmacy.aspx	none												(617)575-5850		(617)575-5850		(617)575-5850										(617)575-5850		(617)575-5850		(617)575-5850		(617)575-5850																
H2221	002	0	1	20	08	H2221_002_0	1			1		05/25/2017	2018.03	05/25/2017 04:57:22 PM Eastern Daylight Time		05/25/2017 05:10:33 PM Eastern Daylight Time			05/25/2017 05:11:41 PM Eastern Daylight Time	CAMBRIDGE PUBLIC HEALTH COMMISSION	Elder Srvc Pln/Cambridge Health Alliance	http://www.challiance.org/esp	Cambridge Public Health Commission (PACE)	08	20		1			H2221	002	0	2018	Counties:  Middlesex and Suffolk		2		2			2						http://www.challiance.org/Services/Pharmacy.aspx	none												(617)575-5850		(617)575-5850		(617)575-5850												(617)575-5850		(617)575-5850		(617)575-5850																
H2222	002	0	1	20	08	H2222_002_0	1			1		05/26/2017	2018.03	05/26/2017 10:30:02 AM Eastern Daylight Time		05/24/2017 12:36:07 PM Eastern Daylight Time			05/26/2017 10:34:45 AM Eastern Daylight Time	ELEMENT CARE, INC.	Element Care, Inc	www.elementcare.org	Element Care (PACE)	08	20		1			H2222	002	0	2018	Essex, Middlesex counties		2		2			2						www.eatonapothecary.com	None										(877)803-5564		(781)715-6608		(877)803-5564		(781)715-6608										(711)-		(711)-		(711)-		(711)-																
H2222	003	0	1	20	08	H2222_003_0	3			1		05/31/2017	2018.03	05/31/2017 08:39:23 AM Eastern Daylight Time		05/30/2017 11:09:52 AM Eastern Daylight Time			05/31/2017 08:39:56 AM Eastern Daylight Time	ELEMENT CARE, INC.	Element Care, Inc	www.elementcare.org	Element Care (PACE)	08	20		1			H2222	003	0	2018	Essex, Middlesex counties		2		2			2						www.eatonapothecary.com	None										(877)803-5564		(781)715-6608		(877)803-5564		(781)715-6608										(711)-		(711)-		(711)-		(711)-																
H2223	001	0	1	20	08	H2223_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:07:52 PM Eastern Daylight Time		05/24/2017 10:46:52 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	ELDER SVC PLN/E BOSTON HEALTH CENTER	Neighborhood PACE	www.ebnhc.org/elderservice.php	East Boston Elder Service Plan (PACE)	08	20		1			H2223	001	0	2018	02108, 02128, 02148 - 02152, 02155, 02176, 02180		2		2			2						www.ebnhc.org	www.ebnhc.org										(617)568-6377		(617)568-6377		(617)568-6377		(617)568-6377										(800)720-3480		(800)720-3480		(800)720-3480		(800)720-3480																
H2223	002	0	1	20	08	H2223_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:41 PM Eastern Daylight Time		05/24/2017 10:46:46 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	ELDER SVC PLN/E BOSTON HEALTH CENTER	Neighborhood PACE	www.ebnhc.org/elderservice.php	East Boston Elder Service Plan (PACE)	08	20		1			H2223	002	0	2018	02108, 02128, 02148 - 02152, 02155, 02176, 02180		2		2			2						www.ebnhc.org	www.ebnhc.org										(617)568-6377		(617)568-6377		(617)568-6377		(617)568-6377										(800)720-3480		(800)720-3480		(800)720-3480		(800)720-3480																
H2224	001	0	1	01	01	H2224_001_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 10:04:05 AM Eastern Daylight Time	08/03/2017 12:28:00 PM Eastern Daylight Time	08/03/2017 12:33:58 PM Eastern Daylight Time			08/06/2017 12:42:55 AM Eastern Daylight Time	SENIOR WHOLE HEALTH, LLC	Senior Whole Health	www.seniorwholehealth.com	Senior Whole Health (HMO SNP)	01	01		1			H2224	001	0	2018	Brstl, Essx, Hmpdn, Mdlsx, Nrflk, Plmth, Sflk, Wor		2	91774	2			1	3		2		1	www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(888)794-7268		(888)794-7268		(888)566-3526		(888)566-3526		(888)794-7268		(888)794-7268		(888)566-3526		(888)566-3526		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2224	003	0	1	01	01	H2224_003_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 09:51:02 AM Eastern Daylight Time	08/03/2017 12:30:30 PM Eastern Daylight Time	08/03/2017 12:36:04 PM Eastern Daylight Time			08/06/2017 12:42:55 AM Eastern Daylight Time	SENIOR WHOLE HEALTH, LLC	Senior Whole Health	www.seniorwholehealth.com	Senior Whole Health NHC (HMO SNP)	01	01		1			H2224	003	0	2018	Brstl, Essx, Hmpdn, Mdlsx, Nrflk, Plmth, Sflk, Wor		2	68904	2			1	3		2		1	www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(888)794-7268		(888)794-7268		(888)566-3526		(888)566-3526		(888)794-7268		(888)794-7268		(888)566-3526		(888)566-3526		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2225	001	0	1	01	01	H2225_001_0	5		1	1	2	08/03/2017	2018.03	08/03/2017 09:01:30 AM Eastern Daylight Time	08/03/2017 08:51:14 AM Eastern Daylight Time	08/03/2017 08:51:14 AM Eastern Daylight Time			08/03/2017 09:47:32 AM Eastern Daylight Time	COMMONWEALTH CARE ALLIANCE, INC.	Commonwealth Care Alliance, Inc.	www.commonwealthcaresco.org	Senior Care Options Program (HMO SNP)	01	01		1			H2225	001	0	2018	BRI, ESS, FRA, HMD, HMP, MID, NOR, PLY, SUF, WOR		2		2			1	3		1		1	www.commonwealthcaresco.org/pharmacy-program/overview	www.commonwealthcaresco.org/pharmacy-program/formulary	www.commonwealthcare.org	(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(866)610-2273		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H2226	001	0	1	01	01	H2226_001_0	3		1	1	2	05/30/2017	2018.03	05/30/2017 12:48:02 PM Central Daylight Time	08/03/2017 02:23:43 PM Central Daylight Time	08/01/2017 09:48:34 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Senior Care Options (HMO SNP)	01	01		1			H2226	001	0	2018	Boston, Springfield and Worcester Metro Areas		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(888)867-5511		(888)867-5511		(800)555-5757		(800)555-5757		(888)867-5511		(888)867-5511		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2228	001	0	1	04	01	H2228_001_0	4		1	1		07/07/2017	2018.03	07/07/2017 11:35:52 AM Central Daylight Time	08/03/2017 01:46:52 PM Central Daylight Time	08/01/2017 09:49:00 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H2228	001	0	2018	Boston, Springfield and Worcester Metro Areas		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	002	0	1	04	01	H2228_002_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:01:56 PM Central Daylight Time	08/03/2017 01:47:23 PM Central Daylight Time	08/01/2017 09:49:28 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 1 (PPO SNP)	01	04		1			H2228	002	0	2018	State of Rhode Island		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	010	0	1	04	01	H2228_010_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:02:52 PM Central Daylight Time	08/03/2017 01:47:53 PM Central Daylight Time	08/01/2017 09:49:56 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 1 (PPO SNP)	01	04		1			H2228	010	0	2018	Select Counties in Delaware, Maryland and Virginia		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	011	0	1	04	01	H2228_011_0	4		1	1		06/28/2017	2018.03	06/28/2017 10:02:28 AM Central Daylight Time	08/03/2017 01:48:24 PM Central Daylight Time	08/01/2017 09:50:23 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H2228	011	0	2018	Select Counties in Maryland and DC		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	012	0	1	04	01	H2228_012_0	4		1	1		06/28/2017	2018.03	06/28/2017 10:02:49 AM Central Daylight Time	08/03/2017 01:48:55 PM Central Daylight Time	08/01/2017 09:50:50 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H2228	012	0	2018	Kent and New Castle counties		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	013	0	1	04	01	H2228_013_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:04:48 PM Central Daylight Time	08/03/2017 01:49:25 PM Central Daylight Time	08/01/2017 09:51:18 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 1 (PPO SNP)	01	04		1			H2228	013	0	2018	Select Counties in Georgia		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	016	0	1	04	01	H2228_016_0	5		1	1		08/03/2017	2018.03	08/03/2017 01:07:13 PM Central Daylight Time	08/03/2017 01:49:56 PM Central Daylight Time	08/01/2017 09:51:46 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 1 (PPO SNP)	01	04		1			H2228	016	0	2018	Select Counties in Oregon		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	017	0	1	04	01	H2228_017_0	3		1	1		08/02/2017	2018.03	08/02/2017 04:07:44 PM Central Daylight Time	08/03/2017 01:50:27 PM Central Daylight Time	08/01/2017 09:52:15 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan 1 (PPO SNP)	01	04		1			H2228	017	0	2018	Select Counties in Oregon		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	018	0	1	04	01	H2228_018_0	3			1		07/19/2017	2018.03	07/19/2017 02:35:31 PM Central Daylight Time	08/03/2017 01:50:58 PM Central Daylight Time	08/01/2017 09:52:41 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	018	0	2018	Select counties in North Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	019	0	1	04	01	H2228_019_0	3			1		08/02/2017	2018.03	08/02/2017 04:13:52 PM Central Daylight Time	08/03/2017 01:51:29 PM Central Daylight Time	08/01/2017 09:53:09 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	019	0	2018	Northern Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	020	0	1	04	01	H2228_020_0	4			1		08/02/2017	2018.03	08/02/2017 01:42:12 PM Central Daylight Time	08/03/2017 01:52:00 PM Central Daylight Time	08/01/2017 09:53:37 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (PPO)	01	04		1			H2228	020	0	2018	Fort Wayne area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	021	0	1	04	01	H2228_021_0	3			1		06/01/2017	2018.03	06/01/2017 08:54:10 AM Central Daylight Time	08/03/2017 01:52:32 PM Central Daylight Time	08/01/2017 09:54:04 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	021	0	2018	Indianapolis and Central Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	022	0	1	04	01	H2228_022_0	4			1		07/20/2017	2018.03	07/20/2017 11:12:57 AM Central Daylight Time	08/03/2017 01:53:02 PM Central Daylight Time	08/01/2017 09:54:32 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	022	0	2018	Evansville area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	023	0	1	04	01	H2228_023_0	5			1		08/02/2017	2018.03	08/02/2017 01:57:42 PM Central Daylight Time	08/03/2017 01:53:32 PM Central Daylight Time	08/01/2017 09:54:58 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	023	0	2018	El Paso and Southwest New Mexico		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	024	0	1	04	01	H2228_024_0	3			1		08/02/2017	2018.03	08/02/2017 04:23:14 PM Central Daylight Time	08/03/2017 01:54:02 PM Central Daylight Time	08/01/2017 09:55:24 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H2228	024	0	2018	Honolulu County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	025	0	1	04	01	H2228_025_0	2			1		05/10/2017	2018.03	05/10/2017 04:13:26 PM Central Daylight Time	06/01/2017 02:02:36 PM Central Daylight Time				07/06/2017 03:08:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Essential (PPO)	01	04		1			H2228	025	0	2018	Honolulu County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2						2			
H2228	029	0	1	04	01	H2228_029_0	3			1		05/25/2017	2018.03	05/25/2017 11:30:23 AM Central Daylight Time	08/03/2017 01:54:33 PM Central Daylight Time	08/01/2017 09:55:52 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	029	0	2018	Portland, Salem, and Eugene Metro Areas		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	030	0	1	04	01	H2228_030_0	4			1		06/01/2017	2018.03	06/01/2017 08:50:28 AM Central Daylight Time	08/03/2017 01:55:03 PM Central Daylight Time	08/01/2017 09:56:19 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H2228	030	0	2018	Select counties in Illinois and Missouri		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	031	0	1	04	01	H2228_031_0	3			1		05/30/2017	2018.03	05/30/2017 02:46:53 PM Central Daylight Time	08/03/2017 01:53:42 PM Central Daylight Time	08/01/2017 09:56:46 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	031	0	2018	Ada and Canyon counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	032	0	1	04	01	H2228_032_0	3			1		05/26/2017	2018.03	05/26/2017 02:17:28 PM Central Daylight Time	08/03/2017 01:54:18 PM Central Daylight Time	08/01/2017 09:57:14 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H2228	032	0	2018	Ada and Canyon counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	033	0	1	04	01	H2228_033_0	3			1		05/25/2017	2018.03	05/25/2017 11:30:33 AM Central Daylight Time	08/03/2017 01:54:55 PM Central Daylight Time	08/01/2017 09:57:41 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	033	0	2018	Tampa and Fort Myers Metro Areas		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	035	0	1	04	01	H2228_035_0	4			1		07/20/2017	2018.03	07/20/2017 08:54:38 AM Central Daylight Time	08/03/2017 01:55:31 PM Central Daylight Time	08/01/2017 09:58:09 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H2228	035	0	2018	Erie, Lehigh, Northampton, Lancaster and York Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	036	0	1	04	01	H2228_036_0	3			1		06/01/2017	2018.03	06/01/2017 09:03:19 AM Central Daylight Time	08/03/2017 01:56:09 PM Central Daylight Time	08/01/2017 09:58:37 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H2228	036	0	2018	Erie, Lehigh, Northampton, Lancaster and York Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	037	0	1	04	01	H2228_037_0	3			1		06/01/2017	2018.03	06/01/2017 09:03:41 AM Central Daylight Time	08/03/2017 01:56:47 PM Central Daylight Time	08/01/2017 09:59:04 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	037	0	2018	Chester and Philadelphia County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)393-0993		(800)393-0993		(800)555-5757		(800)555-5757		(800)393-0993		(800)393-0993		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	039	0	1	04	01	H2228_039_0	4		1	1		06/02/2017	2018.03	06/02/2017 09:02:38 AM Central Daylight Time	08/03/2017 01:57:24 PM Central Daylight Time	08/01/2017 09:59:32 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (PPO SNP)	01	04		1			H2228	039	0	2018	State of Rhode Island		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	041	0	1	04	01	H2228_041_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:21:55 AM Central Daylight Time	08/03/2017 01:58:00 PM Central Daylight Time	08/01/2017 10:00:01 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	041	0	2018	El Paso County		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	042	0	1	04	01	H2228_042_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:22:32 AM Central Daylight Time	08/03/2017 01:58:37 PM Central Daylight Time	08/01/2017 10:00:29 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	042	0	2018	Dona Ana, Grant, Hidalgo, Luna and Sierra counties		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	043	0	1	04	01	H2228_043_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:23:03 AM Central Daylight Time	08/03/2017 01:59:13 PM Central Daylight Time	08/01/2017 10:00:56 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	043	0	2018	Honolulu County		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	044	0	1	04	01	H2228_044_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:23:32 AM Central Daylight Time	08/03/2017 01:59:49 PM Central Daylight Time	08/01/2017 10:01:25 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	044	0	2018	Atlanta and Macon Metro Areas		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	045	0	1	04	01	H2228_045_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:24:13 AM Central Daylight Time	08/03/2017 02:00:27 PM Central Daylight Time	08/01/2017 10:01:53 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	045	0	2018	Washington, DC		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	046	0	1	04	01	H2228_046_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 01:34:23 PM Central Daylight Time	08/03/2017 02:01:07 PM Central Daylight Time	08/01/2017 10:02:21 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2228	046	0	2018	Bernalillo, Sandoval, Santa Fe, Valencia Counties		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	047	0	1	04	01	H2228_047_0	4			1		07/20/2017	2018.03	07/20/2017 08:31:10 AM Central Daylight Time	08/03/2017 02:01:49 PM Central Daylight Time	08/01/2017 10:02:48 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	047	0	2018	Bernalillo, Sandoval, and Valencia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	048	0	1	04	01	H2228_048_0	5			1		06/01/2017	2018.03	06/01/2017 08:50:03 AM Central Daylight Time	08/03/2017 02:02:26 PM Central Daylight Time	08/01/2017 10:03:16 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H2228	048	0	2018	St. Louis Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	049	0	1	04	01	H2228_049_0	4			1		06/01/2017	2018.03	06/01/2017 09:04:15 AM Central Daylight Time	08/03/2017 02:03:04 PM Central Daylight Time	08/01/2017 10:03:43 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2228	049	0	2018	Santa Fe Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2228	805	0	1	04	01	H2228_805_0	1			1		05/25/2017	2018.03	05/25/2017 11:59:38 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	805	0	2018	National Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	807	0	1	04	01	H2228_807_0	1			1		05/25/2017	2018.03	05/25/2017 11:59:50 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	807	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2228	808	0	1	04	01	H2228_808_0	1			1		05/25/2017	2018.03	05/25/2017 11:59:55 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	808	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	809	0	2	04	01	H2228_809_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:01 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	809	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	810	0	2	04	01	H2228_810_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:07 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	810	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2228	811	0	2	04	01	H2228_811_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:18 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	811	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	812	0	1	04	01	H2228_812_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:24 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	812	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	813	0	1	04	01	H2228_813_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:38 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	813	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	814	0	1	04	01	H2228_814_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:48 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	814	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	815	0	1	04	01	H2228_815_0	1			1		05/25/2017	2018.03	05/25/2017 12:00:54 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	815	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2228	816	0	1	04	01	H2228_816_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:00 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	816	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	817	0	2	04	01	H2228_817_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:07 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	817	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	818	0	2	04	01	H2228_818_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:13 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	818	0	2018	Nationwide		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2228	819	0	2	04	01	H2228_819_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:21 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2228	819	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	820	0	1	04	01	H2228_820_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:27 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	820	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	821	0	1	04	01	H2228_821_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:34 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	821	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	822	0	1	04	01	H2228_822_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:41 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	822	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2228	823	0	1	04	01	H2228_823_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:48 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	823	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	824	0	1	04	01	H2228_824_0	1			1		05/25/2017	2018.03	05/25/2017 12:01:55 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	824	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	825	0	1	04	01	H2228_825_0	1			1		05/25/2017	2018.03	05/25/2017 12:02:02 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	825	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	826	0	1	04	01	H2228_826_0	1			1		05/25/2017	2018.03	05/25/2017 12:02:11 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	826	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	827	0	1	04	01	H2228_827_0	1			1		05/25/2017	2018.03	05/25/2017 12:02:17 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	827	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2228	828	0	1	04	01	H2228_828_0	1			1		05/25/2017	2018.03	05/25/2017 12:02:25 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2228	828	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2230	002	0	1	04	01	H2230_002_0	8	1		1		07/10/2017	2018.03	07/10/2017 12:38:55 PM Eastern Daylight Time	08/04/2017 02:12:00 PM Eastern Daylight Time	08/01/2017 08:57:36 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue PlusRx (PPO)	01	04		1			H2230	002	0	2018	Massachusetts except Berkshire Dukes and Nantucket		2	98909	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2230	017	0	1	04	01	H2230_017_0	7	1		1		08/07/2017	2018.03	08/07/2017 09:43:10 AM Eastern Daylight Time	08/04/2017 02:12:56 PM Eastern Daylight Time	08/01/2017 08:58:04 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue SaverRx (PPO)	01	04		1			H2230	017	0	2018	Massachusetts except Berkshire Dukes and Nantucket		2	97329	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2230	018	1	1	04	01	H2230_018_1	7	1		1		07/10/2017	2018.03	07/10/2017 12:11:24 PM Eastern Daylight Time	08/04/2017 02:13:56 PM Eastern Daylight Time	08/01/2017 08:58:30 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue ValueRx (PPO)	01	04		1			H2230	018	1	2018	Massachusetts except Berkshire Dukes and Nantucket	Massachusetts except BER, DUK, NAN, WOR	2	225716	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2230	018	2	1	04	01	H2230_018_2	7	1		1		07/10/2017	2018.03	07/10/2017 12:25:17 PM Eastern Daylight Time	08/04/2017 02:14:50 PM Eastern Daylight Time	08/01/2017 08:58:58 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue ValueRx (PPO)	01	04		1			H2230	018	2	2018	Massachusetts except Berkshire Dukes and Nantucket	Worcester, MA	2	54068	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2230	801	0	1	04	01	H2230_801_0	5			1		05/24/2017	2018.03	05/24/2017 10:17:33 AM Eastern Daylight Time					06/05/2017 10:55:06 PM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue (PPO)	01	04		1			H2230	801	0	2018	National Network		1	720	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7d;7e;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;14a;15;	2		1									
H2230	809	0	1	04	01	H2230_809_0	5			1		05/24/2017	2018.03	05/24/2017 10:19:42 AM Eastern Daylight Time					06/05/2017 10:55:06 PM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue (PPO)	01	04		1			H2230	809	0	2018	National Network		1	50	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7d;7e;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;14a;15;	2		1									
H2237	001	0	1	01	01	H2237_001_0	11		1	1	2	07/19/2017	2018.03	07/19/2017 02:35:23 PM Central Daylight Time	08/01/2017 01:34:59 PM Central Daylight Time	08/01/2017 01:47:13 PM Central Daylight Time			08/04/2017 03:23:09 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	iCare Medicare Plan (HMO SNP)	01	01		1			H2237	001	0	2018	Eastern, South Central and Western Wisconsin		2	86171	2			1	3		2		2	www.icare-wi.org	www.icare-wi.org	www.icare-wi.org	(800)777-4376		(414)223-4847		(800)777-4376		(414)223-4847		(800)777-4376		(414)223-4847		(855)689-7690		(414)223-4847		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2					2	2			
H2237	007	0	1	01	01	H2237_007_0	9		1	1	2	07/19/2017	2018.03	07/19/2017 02:35:37 PM Central Daylight Time	08/01/2017 01:39:05 PM Central Daylight Time	08/01/2017 01:49:06 PM Central Daylight Time			08/04/2017 03:23:09 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	iCare Family Care Partnership (HMO SNP)	01	01		1			H2237	007	0	2018	Milwaukee, Racine, Kenosha and Dane Counties		2	6731	2			1	3		1		2	www.icare-wi.org	www.icare-wi.org	www.icare-wi.org	(800)777-4376		(414)223-4847		(888)241-9637		(414)223-4847		(800)777-4376		(414)223-4847		(855)689-7690		(414)223-4847		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2					2	2			
H2237	009	0	1	01	01	H2237_009_0	11		1	1	2	07/19/2017	2018.03	07/19/2017 02:35:51 PM Central Daylight Time	08/01/2017 01:41:16 PM Central Daylight Time	08/01/2017 01:50:42 PM Central Daylight Time			08/04/2017 03:23:09 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.auroraicare.org	Aurora Special Needs Plan (HMO SNP)	01	01		1			H2237	009	0	2018	Milwaukee, Waukesha and SE Wis. Counties		2	12278	2			1	3		2		2	www.auroraicare.org	www.auroraicare.org	www.auroraicare.org	(855)818-1129		(414)299-5549		(888)241-9637		(414)223-4847		(855)818-1129		(414)299-5549		(855)689-7690		(414)223-4847		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2					2	2			
H2237	010	0	1	01	01	H2237_010_0	9		1	1	2	07/19/2017	2018.03	07/19/2017 02:36:05 PM Central Daylight Time	08/01/2017 01:43:21 PM Central Daylight Time	08/01/2017 01:51:57 PM Central Daylight Time			08/04/2017 03:23:09 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	Lakeland Care Special Needs Plan (HMO SNP)	01	01		1			H2237	010	0	2018	Northeast Wisconsin		2	11297	2			1	3		2		2	www.icare-wi.org	www.icare-wi.org	www.icare-wi.org	(800)777-4376		(414)223-4847		(888)241-9637		(414)223-4847		(800)777-4376		(414)223-4847		(855)689-7690		(414)223-4847		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2					2	2			
H2241	007	1	1	01	01	H2241_007_1	7			1		08/04/2017	2018.03	08/04/2017 12:07:23 PM Pacific Daylight Time	08/07/2017 04:49:11 PM Pacific Daylight Time	08/10/2017 11:16:04 AM Pacific Daylight Time			08/10/2017 11:16:59 AM Pacific Daylight Time	GOLDEN STATE MEDICARE HEALTH PLAN	Golden State Medicare Health Plan	www.GoldenStateMHP.com	Golden State Medicare Gold (HMO)	01	01		1			H2241	007	1	2018	LA*/OC*/RV*/STA/SLO/CC* Counties-Partial*	LA*/OC*/RV*/STA Counties-Partial*	2	21600	2			2						www.goldenstatemhp.com	www.goldenstatemhp.com	www.GoldenStateMHP.com	(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		2					2					2	2			
H2241	007	2	1	01	01	H2241_007_2	7			1		07/14/2017	2018.03	07/14/2017 11:07:11 AM Pacific Daylight Time	08/07/2017 04:49:12 PM Pacific Daylight Time	08/10/2017 11:16:04 AM Pacific Daylight Time			08/10/2017 11:16:59 AM Pacific Daylight Time	GOLDEN STATE MEDICARE HEALTH PLAN	Golden State Medicare Health Plan	www.GoldenStateMHP.com	Golden State Medicare Gold (HMO)	01	01		1			H2241	007	2	2018	LA*/OC*/RV*/STA/SLO/CC* Counties-Partial*	San Luis Obispo County	2	48600	2			2						www.goldenstatemhp.com	www.goldenstatemhp.com	www.GoldenStateMHP.com	(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		2					2					2	2			
H2241	007	3	1	01	01	H2241_007_3	7			1		08/04/2017	2018.03	08/04/2017 12:07:42 PM Pacific Daylight Time	08/07/2017 04:49:11 PM Pacific Daylight Time	08/10/2017 11:16:04 AM Pacific Daylight Time			08/10/2017 11:16:59 AM Pacific Daylight Time	GOLDEN STATE MEDICARE HEALTH PLAN	Golden State Medicare Health Plan	www.GoldenStateMHP.com	Golden State Medicare Gold (HMO)	01	01		1			H2241	007	3	2018	LA*/OC*/RV*/STA/SLO/CC* Counties-Partial*	Contra Costa County-Partial*	2	61800	2			2						www.goldenstatemhp.com	www.goldenstatemhp.com	www.GoldenStateMHP.com	(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)541-4111		(562)799-0319		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		(877)551-4111		2					2					2	2			
H2247	001	0	1	01	01	H2247_001_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:28:33 AM Central Daylight Time	08/03/2017 01:34:04 PM Central Daylight Time	08/01/2017 10:04:12 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H2247	001	0	2018	Select Counties in MI		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2256	001	1	1	01	01	H2256_001_1	7	1		1		07/24/2017	2018.03	08/02/2017 03:15:27 PM Eastern Daylight Time	08/04/2017 10:54:32 AM Eastern Daylight Time	08/01/2017 09:44:44 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	24201	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	001	2	1	01	01	H2256_001_2	7	1		1		07/13/2017	2018.03	07/13/2017 05:08:56 PM Eastern Daylight Time	08/04/2017 10:55:42 AM Eastern Daylight Time	08/01/2017 09:45:34 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	2	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	129026	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	001	6	1	01	01	H2256_001_6	7	1		1		07/13/2017	2018.03	07/13/2017 05:09:01 PM Eastern Daylight Time	08/04/2017 10:56:50 AM Eastern Daylight Time	08/01/2017 09:46:30 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	6	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	21274	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	015	1	1	01	01	H2256_015_1	7	1		1		07/13/2017	2018.03	07/13/2017 05:13:52 PM Eastern Daylight Time	08/04/2017 10:58:00 AM Eastern Daylight Time	08/01/2017 09:47:30 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	39050	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	015	2	1	01	01	H2256_015_2	7	1		1		07/13/2017	2018.03	07/13/2017 05:14:20 PM Eastern Daylight Time	08/04/2017 10:59:12 AM Eastern Daylight Time	08/01/2017 09:48:40 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	2	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	159793	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	015	6	1	01	01	H2256_015_6	7	1		1		07/13/2017	2018.03	07/13/2017 05:14:24 PM Eastern Daylight Time	08/04/2017 11:00:22 AM Eastern Daylight Time	08/01/2017 09:49:34 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	6	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	20177	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	016	1	1	01	01	H2256_016_1	6	1		1		07/13/2017	2018.03	07/13/2017 05:16:12 PM Eastern Daylight Time	06/05/2017 12:21:52 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime No Rx (HMO)	01	01		1			H2256	016	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	1094	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	016	2	1	01	01	H2256_016_2	6	1		1		07/13/2017	2018.03	07/13/2017 05:45:01 PM Eastern Daylight Time	06/05/2017 12:22:30 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime No Rx (HMO)	01	01		1			H2256	016	2	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	5290	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	016	6	1	01	01	H2256_016_6	6	1		1		07/13/2017	2018.03	07/13/2017 05:45:56 PM Eastern Daylight Time	06/05/2017 12:23:06 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime No Rx (HMO)	01	01		1			H2256	016	6	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	862	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	018	1	1	01	01	H2256_018_1	7	1		1		07/13/2017	2018.03	07/13/2017 05:22:20 PM Eastern Daylight Time	08/04/2017 11:01:28 AM Eastern Daylight Time	08/01/2017 09:50:20 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	16366	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	018	7	1	01	01	H2256_018_7	7	1		1		07/13/2017	2018.03	07/13/2017 05:23:00 PM Eastern Daylight Time	08/04/2017 11:02:38 AM Eastern Daylight Time	08/01/2017 09:52:02 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	7	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	50431	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	018	8	1	01	01	H2256_018_8	7	1		1		07/13/2017	2018.03	07/13/2017 05:23:05 PM Eastern Daylight Time	08/04/2017 11:03:48 AM Eastern Daylight Time	08/01/2017 09:53:26 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	8	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	7189	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	019	1	1	01	01	H2256_019_1	6	1		1		07/13/2017	2018.03	07/13/2017 05:24:56 PM Eastern Daylight Time	06/05/2017 12:25:34 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value No Rx (HMO)	01	01		1			H2256	019	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	715	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	019	7	1	01	01	H2256_019_7	6	1		1		07/13/2017	2018.03	07/13/2017 05:25:40 PM Eastern Daylight Time	06/05/2017 12:26:14 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value No Rx (HMO)	01	01		1			H2256	019	7	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	2372	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	019	8	1	01	01	H2256_019_8	6	1		1		07/13/2017	2018.03	07/13/2017 05:25:45 PM Eastern Daylight Time	06/05/2017 12:26:52 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value No Rx (HMO)	01	01		1			H2256	019	8	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	551	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	026	1	1	01	01	H2256_026_1	7	1		1		07/13/2017	2018.03	07/13/2017 05:27:05 PM Eastern Daylight Time	08/04/2017 11:04:58 AM Eastern Daylight Time	08/01/2017 09:55:00 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	026	1	2018	Most of Massachusetts	Essex and Suffolk Counties	2	42712	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	026	2	1	01	01	H2256_026_2	7	1		1		07/13/2017	2018.03	07/13/2017 05:27:42 PM Eastern Daylight Time	08/04/2017 11:06:14 AM Eastern Daylight Time	08/01/2017 09:55:54 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	026	2	2018	Most of Massachusetts	BARN, BRIS, MIDD, NORF, PLYM Counties	2	141775	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	026	3	1	01	01	H2256_026_3	7	1		1		07/13/2017	2018.03	07/13/2017 05:27:47 PM Eastern Daylight Time	08/04/2017 11:07:22 AM Eastern Daylight Time	08/01/2017 09:56:56 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	026	3	2018	Most of Massachusetts	Hampden and Hampshire Counties	2	20203	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	028	0	1	01	01	H2256_028_0	7	1		1		08/04/2017	2018.03	08/04/2017 10:18:09 AM Eastern Daylight Time	08/04/2017 11:08:44 AM Eastern Daylight Time	08/01/2017 09:57:44 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Saver Rx (HMO)	01	01		1			H2256	028	0	2018	BARN, BRIS, MIDD, NORF, PLYM, ESSEX, SUFF, WORC		2	184414	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	029	0	1	01	01	H2256_029_0	7	2	1	1	2	08/03/2017	2018.03	08/03/2017 05:52:16 PM Eastern Daylight Time	08/03/2017 01:38:08 PM Eastern Daylight Time	08/03/2017 01:36:52 PM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org/sco	Tufts Health Plan Senior Care Options (HMO SNP)	01	01		1			H2256	029	0	2018	Most of Massachusetts		2	47327	2			1	3		1		1	tufts-sco.prismisp.com	tuftsmedicarepreferred.org/drug-coverage	tufts-sco.prismisp.com	(855)670-5934		(855)670-5934		(855)670-5935		(855)670-5935		(855)670-5934		(855)670-5934		(855)670-5935		(855)670-5935		(855)670-5936		(855)670-5936		(855)670-5940		(855)670-5940		(855)670-5936		(855)670-5936		(855)670-5940		(855)670-5940		2					2					2	2			
H2256	033	0	1	01	01	H2256_033_0	7	1		1		07/13/2017	2018.03	07/13/2017 05:32:07 PM Eastern Daylight Time	08/04/2017 11:10:00 AM Eastern Daylight Time	08/01/2017 09:58:32 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	033	0	2018	Worcester County		2	55425	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	034	0	1	01	01	H2256_034_0	7	1		1		07/13/2017	2018.03	07/13/2017 05:33:14 PM Eastern Daylight Time	08/04/2017 11:11:12 AM Eastern Daylight Time	08/01/2017 09:59:20 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	034	0	2018	Worcester County		2	24825	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	036	0	1	01	01	H2256_036_0	7	1		1		07/13/2017	2018.03	07/13/2017 05:36:02 PM Eastern Daylight Time	08/04/2017 11:12:24 AM Eastern Daylight Time	08/01/2017 10:00:04 AM Eastern Daylight Time			08/04/2017 01:05:42 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	036	0	2018	Worcester County		2	75577	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	039	0	1	01	01	H2256_039_0	6	1		1		07/13/2017	2018.03	07/13/2017 05:38:15 PM Eastern Daylight Time	06/05/2017 12:31:58 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime No Rx (HMO)	01	01		1			H2256	039	0	2018	Worcester County		2	727	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	040	0	1	01	01	H2256_040_0	6	1		1		07/13/2017	2018.03	07/13/2017 05:39:25 PM Eastern Daylight Time	06/05/2017 12:32:38 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value No Rx (HMO)	01	01		1			H2256	040	0	2018	Worcester County		2	2265	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	041	0	1	01	01	H2256_041_0	6	1		1		07/13/2017	2018.03	07/13/2017 05:40:42 PM Eastern Daylight Time	06/05/2017 12:33:20 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic No Rx (HMO)	01	01		1			H2256	041	0	2018	Worcester County		2	5037	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	042	0	1	01	01	H2256_042_0	6	1		1		07/13/2017	2018.03	07/13/2017 05:42:54 PM Eastern Daylight Time	06/05/2017 12:33:58 PM Eastern Daylight Time				07/14/2017 08:58:01 AM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic No Rx (HMO)	01	01		1			H2256	042	0	2018	Essex and Suffolk Counties		2	2154	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	801	0	1	01	01	H2256_801_0	4			1		06/05/2017	2018.03	06/05/2017 02:31:05 PM Eastern Daylight Time					06/05/2017 02:48:05 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org/plans/employer-plans	Tufts Medicare Preferred HMO Rx (HMO)	01	01		1			H2256	801	0	2018	Most of Massachusetts		1	156911	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2256	802	0	1	01	01	H2256_802_0	4			1		06/05/2017	2018.03	06/05/2017 02:31:28 PM Eastern Daylight Time					06/05/2017 02:48:05 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org/plans/employer-plans	Tufts Medicare Preferred HMO (HMO)	01	01		1			H2256	802	0	2018	Most of Massachusetts		1	9205	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977										2					2					2	2			
H2256	803	0	1	01	01	H2256_803_0	4			1		06/05/2017	2018.03	06/05/2017 02:33:12 PM Eastern Daylight Time					06/05/2017 02:48:05 PM Eastern Daylight Time	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Tufts Health Plan	tuftsmedicarepreferred.org/plans/employer-plans	Tufts Medicare Preferred HMO Rx (HMO)	01	01		1			H2256	803	0	2018	Most of Massachusetts		1	12	2			2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage	tuftsmedicarepreferred.org/find-doctor	(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977		2					2					2	2			
H2261	005	0	1	01	01	H2261_005_0	7	1		1		07/10/2017	2018.03	07/10/2017 03:15:39 PM Eastern Daylight Time	08/04/2017 02:15:46 PM Eastern Daylight Time	08/01/2017 08:59:26 AM Eastern Daylight Time			08/07/2017 10:14:24 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue PlusRx (HMO)	01	01		1			H2261	005	0	2018	Massachusetts except Berkshire Dukes and Nantucket		2	39069	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2261	022	1	1	01	01	H2261_022_1	6	1		1		07/10/2017	2018.03	07/10/2017 11:51:28 AM Eastern Daylight Time	08/04/2017 02:16:42 PM Eastern Daylight Time	08/01/2017 08:59:52 AM Eastern Daylight Time			08/07/2017 10:14:24 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue ValueRx (HMO)	01	01		1			H2261	022	1	2018	Massachusetts except Berkshire, Dukes, Nantucket	Massachusetts except BER, DUK, NAN, WOR	2	44609	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2261	022	2	1	01	01	H2261_022_2	6	1		1		07/10/2017	2018.03	07/10/2017 11:52:28 AM Eastern Daylight Time	08/04/2017 02:17:38 PM Eastern Daylight Time	08/01/2017 09:00:20 AM Eastern Daylight Time			08/07/2017 10:14:24 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue ValueRx (HMO)	01	01		1			H2261	022	2	2018	Massachusetts except Berkshire, Dukes, Nantucket	Worcester county	2	8760	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2261	023	1	1	02	01	H2261_023_1	7	1		1		07/10/2017	2018.03	07/10/2017 12:49:44 PM Eastern Daylight Time	08/04/2017 02:18:40 PM Eastern Daylight Time	08/01/2017 09:00:48 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue FlexRx (HMO-POS)	01	02		1			H2261	023	1	2018	Massachusetts except Berkshire Dukes and Nantucket	Massachusetts except BER, DUK, NAN, WOR	2	29087	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2261	023	2	1	02	01	H2261_023_2	7	1		1		07/10/2017	2018.03	07/10/2017 12:56:47 PM Eastern Daylight Time	08/04/2017 02:19:36 PM Eastern Daylight Time	08/01/2017 09:01:16 AM Eastern Daylight Time			08/07/2017 10:46:32 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue FlexRx (HMO-POS)	01	02		1			H2261	023	2	2018	Massachusetts except Berkshire Dukes and Nantucket	Worcester, MA	2	5976	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2261	801	0	1	01	01	H2261_801_0	4			1		05/24/2017	2018.03	05/24/2017 10:27:15 AM Eastern Daylight Time					06/05/2017 08:16:41 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue (HMO)	01	01		1			H2261	801	0	2018	Massachusetts except Berkshire Dukes and Nantucket		1	20040	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;9a;9b;10a;11a;12;14a;15;	1	7d;7f;7i;	1					1				
H2261	809	0	1	01	01	H2261_809_0	5			1		05/24/2017	2018.03	05/24/2017 10:28:44 AM Eastern Daylight Time					06/05/2017 08:16:41 AM Eastern Daylight Time	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue (HMO)	01	01		1			H2261	809	0	2018	Massachusetts except Berkshire Dukes and Nantucket		1	120	2			2						http://www.bluecrossma.com/pharmacyfinder	http://www.bluecrossma.com/formularies/medicare	www.bcbsma.com	(800)200-4255		(800)200-4255		(800)678-2265		(800)678-2265										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7c;7h;7i;8a;8b1;8b2;10a;11a;12;15;	1	7d;7f;7i;	1					1				
H2318	001	0	1	20	08	H2318_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:18:29 PM Eastern Daylight Time		05/24/2017 01:08:33 PM Eastern Daylight Time			05/24/2017 01:20:25 PM Eastern Daylight Time	PACE SOUTHEAST MICHIGAN	PACE Southeast Michigan	www.pacesemi.org	PACE Southeast Michigan (PACE)	08	20		1			H2318	001	0	2018	Michigan, Macomb, Oakland, Wayne Counties		2		2			2						www.henryford.com	Milwaukee.PACE@milliman.com										(855)445-4554		(855)445-4554		(855)445-4554		(855)445-4554										(711)-		(711)-		(711)-		(711)-																
H2318	002	0	1	20	08	H2318_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:18:58 PM Eastern Daylight Time		05/24/2017 01:11:00 PM Eastern Daylight Time			05/24/2017 01:20:25 PM Eastern Daylight Time	PACE SOUTHEAST MICHIGAN	PACE Southeast Michigan	www.pacesemi.org	PACE Southeast Michigan (PACE)	08	20		1			H2318	002	0	2018	Michigan, Macomb, Oakland, Wayne Counties		2		2			2						www.henryford.com	Milwaukee.PACE@milliman.com										(855)445-4554		(855)445-4554		(855)445-4554		(855)445-4554										(711)-		(711)-		(711)-		(711)-																
H2320	007	0	1	02	01	H2320_007_0	4			1		08/04/2017	2018.03	08/04/2017 10:49:11 AM Eastern Daylight Time	08/04/2017 11:50:50 AM Eastern Daylight Time	08/01/2017 11:02:20 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	007	0	2018	Region 2		2	37705	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	008	0	1	02	01	H2320_008_0	5			1		08/04/2017	2018.03	08/04/2017 10:52:26 AM Eastern Daylight Time	08/04/2017 11:51:36 AM Eastern Daylight Time	08/01/2017 11:02:48 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	008	0	2018	Region 3		2	17086	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)870-1090		(616)464-8850		(888)389-6648		(616)464-8820		(888)870-1090		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	011	0	1	02	01	H2320_011_0	4			1		07/20/2017	2018.03	07/20/2017 11:12:28 AM Eastern Daylight Time	08/04/2017 11:52:24 AM Eastern Daylight Time	08/01/2017 11:03:16 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	011	0	2018	Region 2		2	113088	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	012	0	1	02	01	H2320_012_0	5			1		07/24/2017	2018.03	07/24/2017 03:45:39 PM Eastern Daylight Time	08/04/2017 11:53:10 AM Eastern Daylight Time	08/01/2017 11:03:42 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	012	0	2018	Region 3		2	35049	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	013	0	1	02	01	H2320_013_0	5			1		08/04/2017	2018.03	08/04/2017 10:52:54 AM Eastern Daylight Time	08/04/2017 11:53:56 AM Eastern Daylight Time	08/01/2017 11:04:10 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	013	0	2018	Region 1		2	161091	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	015	0	1	02	01	H2320_015_0	5			1		07/24/2017	2018.03	07/24/2017 03:58:18 PM Eastern Daylight Time	08/04/2017 11:54:42 AM Eastern Daylight Time	08/01/2017 11:04:38 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	015	0	2018	Region 1		2	464203	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	016	0	1	02	01	H2320_016_0	5			1		08/04/2017	2018.03	08/04/2017 10:53:21 AM Eastern Daylight Time	08/04/2017 11:55:28 AM Eastern Daylight Time	08/01/2017 11:05:06 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	016	0	2018	Region 4		2	5956	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	018	0	1	02	01	H2320_018_0	5			1		07/24/2017	2018.03	07/24/2017 04:07:33 PM Eastern Daylight Time	08/04/2017 11:56:14 AM Eastern Daylight Time	08/01/2017 11:05:34 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	018	0	2018	Region 4		2	27200	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	019	0	1	02	01	H2320_019_0	5			1		08/04/2017	2018.03	08/04/2017 10:53:46 AM Eastern Daylight Time	08/04/2017 11:57:00 AM Eastern Daylight Time	08/01/2017 11:06:02 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	019	0	2018	Region 5		2	9615	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	021	0	1	02	01	H2320_021_0	5			1		07/24/2017	2018.03	07/24/2017 04:13:16 PM Eastern Daylight Time	08/04/2017 11:57:46 AM Eastern Daylight Time	08/01/2017 11:06:28 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	021	0	2018	Region 5		2	40256	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	022	1	1	02	01	H2320_022_1	4			1		08/04/2017	2018.03	08/04/2017 10:54:31 AM Eastern Daylight Time	08/04/2017 11:58:32 AM Eastern Daylight Time	08/01/2017 11:06:56 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Key (HMO-POS)	01	02		1			H2320	022	1	2018	68 lower peninsula Michigan counties	Region 1	2	11983	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	022	2	1	02	01	H2320_022_2	4			1		08/04/2017	2018.03	08/04/2017 10:57:52 AM Eastern Daylight Time	08/04/2017 11:59:18 AM Eastern Daylight Time	08/01/2017 11:07:22 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Key (HMO-POS)	01	02		1			H2320	022	2	2018	68 lower peninsula Michigan counties	Region 2	2	26674	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	022	3	1	02	01	H2320_022_3	4			1		08/04/2017	2018.03	08/04/2017 10:58:17 AM Eastern Daylight Time	08/04/2017 12:00:04 PM Eastern Daylight Time	08/01/2017 11:07:50 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Key (HMO-POS)	01	02		1			H2320	022	3	2018	68 lower peninsula Michigan counties	Region 3	2	23829	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	022	4	1	02	01	H2320_022_4	4			1		08/04/2017	2018.03	08/04/2017 10:58:42 AM Eastern Daylight Time	08/04/2017 12:00:50 PM Eastern Daylight Time	08/01/2017 11:08:18 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Key (HMO-POS)	01	02		1			H2320	022	4	2018	68 lower peninsula Michigan counties	Region 4	2	16290	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	022	5	1	02	01	H2320_022_5	4			1		08/04/2017	2018.03	08/04/2017 10:59:06 AM Eastern Daylight Time	08/04/2017 12:01:38 PM Eastern Daylight Time	08/01/2017 11:08:46 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Key (HMO-POS)	01	02		1			H2320	022	5	2018	68 lower peninsula Michigan counties	Region 5	2	37288	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	802	0	1	02	01	H2320_802_0	3			1		07/20/2017	2018.03	07/20/2017 07:56:30 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG Non-Calendar Year (HMO-POS)	01	02		1			H2320	802	0	2018	National		1	6296	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	803	0	1	02	01	H2320_803_0	4			1		07/20/2017	2018.03	07/20/2017 08:01:24 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG Calendar Year (HMO-POS)	01	02		1			H2320	803	0	2018	National		1	201649	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	804	0	1	01	01	H2320_804_0	4			1		07/20/2017	2018.03	07/20/2017 08:05:44 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO w PD Non-Cal Year (HMO)	01	01		1			H2320	804	0	2018	State of Michigan		1	3585	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	805	0	1	01	01	H2320_805_0	3			1		07/20/2017	2018.03	07/20/2017 08:10:17 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO w PD Cal Year (HMO)	01	01		1			H2320	805	0	2018	State of Michigan		1	1116	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2320	810	0	1	01	01	H2320_810_0	3			1		07/20/2017	2018.03	07/20/2017 08:14:07 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO Cal Year (HMO) (HMO)	01	01		1			H2320	810	0	2018	State of Michigan		1	18	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2320	811	0	1	01	01	H2320_811_0	3			1		07/20/2017	2018.03	07/20/2017 08:31:56 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO Non-Cal Year (HMO) (HMO)	01	01		1			H2320	811	0	2018	State of Michigan		1	18	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2322	004	0	1	04	01	H2322_004_0	9			1		08/03/2017	2018.03	08/03/2017 11:22:58 AM Eastern Daylight Time	08/03/2017 04:28:47 PM Eastern Daylight Time	08/01/2017 02:11:07 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Option 3 (PPO)	01	04		1			H2322	004	0	2018	Mid and Southeast Michigan Counties		2	2259	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2322	008	0	1	04	01	H2322_008_0	9			1		06/30/2017	2018.03	06/30/2017 02:01:18 PM Eastern Daylight Time	08/03/2017 12:54:09 PM Eastern Daylight Time	08/01/2017 02:10:07 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Option 2 (PPO)	01	04		1			H2322	008	0	2018	Mid and Southeast Michigan Counties		2	1358	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2322	011	0	1	04	01	H2322_011_0	9			1		08/03/2017	2018.03	08/03/2017 11:21:09 AM Eastern Daylight Time	08/03/2017 04:29:38 PM Eastern Daylight Time	08/01/2017 02:12:48 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Option 1 (PPO)	01	04		1			H2322	011	0	2018	Mid and Southeast Michigan Counties		2	1358	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2322	801	0	1	04	01	H2322_801_0	4			1		05/30/2017	2018.03	05/30/2017 08:07:56 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Group (PPO)	01	04		1			H2322	801	0	2018	Michigan		1	1408	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2322	803	0	1	04	01	H2322_803_0	4			1		05/30/2017	2018.03	05/30/2017 08:08:32 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Group (PPO)	01	04		1			H2322	803	0	2018	Michigan		1	704	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2322	809	0	1	04	01	H2322_809_0	4			1		05/30/2017	2018.03	05/30/2017 08:08:54 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	HAP Senior Plus (PPO)	www.hap.org/medicare	HAP Senior Plus Group (PPO)	01	04		1			H2322	809	0	2018	Michigan		1	704	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(888)658-2536		(313)664-9050		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2334	001	0	1	04	01	H2334_001_0	9		1	1		08/04/2017	2018.03	08/04/2017 11:59:46 AM Eastern Daylight Time	08/04/2017 10:10:50 AM Eastern Daylight Time	08/03/2017 03:45:00 PM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (SC)	Eon Health	www.eonhealthplan.com	EON GOLD (PPO SNP)	01	04		1			H2334	001	0	2018	Select South Carolina Counties		2	2065	2			1	4			00000000000000000010		www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2334	003	0	1	04	01	H2334_003_0	9			1		08/04/2017	2018.03	08/04/2017 12:52:36 PM Eastern Daylight Time	08/04/2017 10:14:51 AM Eastern Daylight Time	08/04/2017 08:54:24 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (SC)	Eon Health	www.eonhealthplan.com	EON CHOICE (PPO)	01	04		1			H2334	003	0	2018	Select South Carolina Counties		2	722	2			2						www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2354	015	0	1	01	01	H2354_015_0	9			1		08/03/2017	2018.03	08/03/2017 11:03:58 AM Eastern Daylight Time	08/03/2017 12:57:23 PM Eastern Daylight Time	08/01/2017 02:14:10 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus (HMO)	01	01		1			H2354	015	0	2018	Mid and Southeast Michigan Counties		2	2598	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2354	018	0	1	01	01	H2354_018_0	11			1		08/03/2017	2018.03	08/03/2017 11:11:41 AM Eastern Daylight Time	08/03/2017 04:30:46 PM Eastern Daylight Time	08/01/2017 02:17:33 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Henry Ford Tiered Access (HMO)	01	01		1			H2354	018	0	2018	Southeast Michigan (Wayne, Oakland & Macomb)		2	12140	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	3-1;3-2;3-3;5;7a;7c;7d;7e1;7e2;7f;7g;7h1;7h2;7i;8a1;8a2;8b1;8b2;8b3;9a;9b;9c;11a;11b1;11b2;11c1;11c2;12;16b;17a;18a;	14c3;17a1;18a1;
H2354	019	0	1	01	01	H2354_019_0	7			1		07/20/2017	2018.03	07/20/2017 10:54:10 AM Eastern Daylight Time	05/31/2017 10:33:18 AM Eastern Daylight Time				07/20/2017 12:49:49 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Medical Only (HMO)	01	01		1			H2354	019	0	2018	Mid and Southeast Michigan Counties		2	347	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2354	020	0	1	02	01	H2354_020_0	13			1		08/03/2017	2018.03	08/03/2017 11:12:22 AM Eastern Daylight Time	08/03/2017 01:00:22 PM Eastern Daylight Time	08/01/2017 02:19:14 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Option 1 (HMO-POS)	01	02		1			H2354	020	0	2018	Mid and Southeast Michigan Counties		2	1683	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2354	021	0	1	02	01	H2354_021_0	11			1		08/03/2017	2018.03	08/03/2017 11:19:03 AM Eastern Daylight Time	08/03/2017 04:32:17 PM Eastern Daylight Time	08/01/2017 02:15:02 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Option 2 (HMO-POS)	01	02		1			H2354	021	0	2018	Mid and Southeast Michigan Counties		2	12835	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2354	022	0	1	02	01	H2354_022_0	11			1		08/03/2017	2018.03	08/03/2017 11:19:41 AM Eastern Daylight Time	08/03/2017 04:34:15 PM Eastern Daylight Time	08/01/2017 02:21:32 PM Eastern Daylight Time			08/04/2017 10:10:18 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Option 3 (HMO-POS)	01	02		1			H2354	022	0	2018	Mid and Southeast Michigan Counties		2	1227	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2354	801	0	1	01	01	H2354_801_0	4			1		05/26/2017	2018.03	05/26/2017 08:58:05 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Group (HMO)	01	01		1			H2354	801	0	2018	United States EG Area		1	316308	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153										(711)-		(711)-		(711)-		(711)-										1	2		2		1					2				
H2354	802	0	1	02	01	H2354_802_0	4			1		05/26/2017	2018.03	05/26/2017 08:58:42 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus Group (HMO-POS)	01	02		1			H2354	802	0	2018	United States EG Area		1	63655	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		2				
H2354	805	0	1	02	01	H2354_805_0	4			1		05/26/2017	2018.03	05/26/2017 08:59:28 AM Eastern Daylight Time					06/01/2017 01:39:35 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/medicare	HAP Senior Plus (HMO-POS)	01	02		1			H2354	805	0	2018	United States EG Area		1	63655	2			2						www.hap.org/medicare	www.hap.org/medicare	www.hap.org/medicare	(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(800)801-1770		(313)664-7015		(800)868-3153		(800)868-3153		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		2				
H2386	001	0	1	20	08	H2386_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:06:57 PM Eastern Daylight Time		05/24/2017 07:47:49 AM Eastern Daylight Time			05/24/2017 01:12:27 PM Eastern Daylight Time	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.allcareforseniors.org	AllCARE for Seniors - Duals (PACE)	08	20		1			H2386	001	0	2018	Counties:  Buchanan, Dickenson, Russell, Tazewell		2		2			2						www.seniorscript.com	www.aasc.org										(866)828-7723		(276)964-7176		(866)828-7723		(276)964-7176										(800)656-2272		(276)964-5765		(800)656-2272		(276)964-5765																
H2386	002	0	1	20	08	H2386_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:12 PM Eastern Daylight Time		05/24/2017 07:48:47 AM Eastern Daylight Time			05/24/2017 01:12:27 PM Eastern Daylight Time	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.allcareforseniors.org	AllCARE for Seniors - Medicare only (PACE)	08	20		1			H2386	002	0	2018	Counties:  Buchanan, Dickenson, Russell, Tazewell		2		2			2						www.seniorscript.com	www.aasc.org										(866)828-7723		(276)964-7176		(866)828-7723		(276)964-7176										(800)656-2272		(276)964-5765		(800)656-2272		(276)964-5765																
H2392	001	0	1	01	01	H2392_001_0	5		1	1		06/02/2017	2018.03	06/02/2017 07:57:49 AM Central Daylight Time	08/04/2017 12:06:41 PM Central Daylight Time	08/04/2017 12:06:41 PM Central Daylight Time			08/04/2017 12:08:07 PM Central Daylight Time	KANSAS SUPERIOR SELECT, INC.	Kansas Superior Select	www.kansassuperiorselect.com	Kansas Superior Select Skilled Care Plan (HMO SNP)	01	01		1			H2392	001	0	2018	Eastern Kansas		2	8190	2			1	1	1				www.kansassuperiorselect.com	www.kansassuperiorselect.com	www.kansassuperiorselect.com	(800)399-7524		(800)399-7524		(800)399-7524		(800)399-7524		(800)399-7524		(800)399-7524		(800)399-7524		(800)399-7524		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H2400	001	0	1	01	01	H2400_001_0	4		1	1		08/07/2017	2018.03	08/07/2017 11:04:57 AM Central Daylight Time	08/07/2017 10:57:44 AM Central Daylight Time	08/07/2017 10:57:59 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SIGNATURE ADVANTAGE, LLC	Signature Advantage (HMO SNP)	www.signatureadvantageplan.com	Signature Advantage (HMO SNP)	01	01		1			H2400	001	0	2018	KY (partial)		2	4166	2			1	1	1				www.signatureadvantageplan.com	www.signatureadvantageplan.com	www.signatureadvantageplan.com	(844)214-8633		(844)214-8633		(844)214-8633		(844)214-8633		(844)214-8633		(844)214-8633		(844)214-8633		(844)214-8633		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2406	001	0	1	04	01	H2406_001_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:23:29 PM Central Daylight Time	08/03/2017 01:34:39 PM Central Daylight Time	08/01/2017 10:04:39 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan 1 (PPO SNP)	01	04		1			H2406	001	0	2018	Select Counties in Ohio		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2406	008	0	1	04	01	H2406_008_0	4			1		08/03/2017	2018.03	08/03/2017 09:41:54 AM Central Daylight Time	08/03/2017 01:35:14 PM Central Daylight Time	08/01/2017 10:05:05 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2406	008	0	2018	Select Counties in the Pan Handle of Florida		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2406	009	0	1	04	01	H2406_009_0	4			1		08/03/2017	2018.03	08/03/2017 09:44:05 AM Central Daylight Time	08/03/2017 01:35:49 PM Central Daylight Time	08/01/2017 10:05:33 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2406	009	0	2018	Collier, Manatee, and Sarasota Counties		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2406	010	0	1	04	01	H2406_010_0	4			1		08/03/2017	2018.03	08/03/2017 09:45:45 AM Central Daylight Time	08/03/2017 01:36:24 PM Central Daylight Time	08/01/2017 10:06:01 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2406	010	0	2018	Brevard, Osceola, Seminole, and Volusia counties		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2406	011	0	1	04	01	H2406_011_0	4			1		08/03/2017	2018.03	08/03/2017 09:48:02 AM Central Daylight Time	08/03/2017 01:36:58 PM Central Daylight Time	08/01/2017 10:06:30 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2406	011	0	2018	Polk County		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2406	805	0	1	04	01	H2406_805_0	3			1		06/08/2017	2018.03	06/08/2017 11:29:03 AM Central Daylight Time					06/13/2017 04:50:27 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	805	0	2018	Nationwide		1	13212	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	806	0	1	04	01	H2406_806_0	2			1		05/25/2017	2018.03	05/25/2017 12:03:33 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	806	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2406	807	0	1	04	01	H2406_807_0	2			1		05/24/2017	2018.03	05/24/2017 12:51:45 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	807	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	808	0	2	04	01	H2406_808_0	2			1		05/25/2017	2018.03	05/25/2017 12:04:05 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	808	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	809	0	2	04	01	H2406_809_0	2			1		05/25/2017	2018.03	05/25/2017 10:55:54 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	809	0	2018	Nationwide		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2406	810	0	2	04	01	H2406_810_0	2			1		05/25/2017	2018.03	05/25/2017 10:56:06 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	810	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	811	0	1	04	01	H2406_811_0	2			1		05/24/2017	2018.03	05/24/2017 12:52:15 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	811	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	812	0	1	04	01	H2406_812_0	2			1		05/24/2017	2018.03	05/24/2017 12:52:25 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	812	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	813	0	1	04	01	H2406_813_0	2			1		05/24/2017	2018.03	05/24/2017 12:52:33 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	813	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	814	0	1	04	01	H2406_814_0	2			1		05/24/2017	2018.03	05/24/2017 12:52:47 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	814	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2406	815	0	1	04	01	H2406_815_0	2			1		05/24/2017	2018.03	05/24/2017 12:52:57 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	815	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	816	0	2	04	01	H2406_816_0	2			1		05/25/2017	2018.03	05/25/2017 10:56:25 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	816	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	817	0	2	04	01	H2406_817_0	2			1		05/25/2017	2018.03	05/25/2017 10:56:37 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	817	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2406	818	0	2	04	01	H2406_818_0	2			1		05/25/2017	2018.03	05/25/2017 10:56:51 AM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H2406	818	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	819	0	1	04	01	H2406_819_0	2			1		05/24/2017	2018.03	05/24/2017 12:53:14 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	819	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	820	0	1	04	01	H2406_820_0	2			1		05/24/2017	2018.03	05/24/2017 12:53:21 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	820	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	821	0	1	04	01	H2406_821_0	2			1		05/24/2017	2018.03	05/24/2017 12:53:41 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	821	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2406	822	0	1	04	01	H2406_822_0	2			1		05/24/2017	2018.03	05/24/2017 12:54:02 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	822	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	823	0	1	04	01	H2406_823_0	2			1		05/24/2017	2018.03	05/24/2017 12:54:15 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	823	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	824	0	1	04	01	H2406_824_0	2			1		05/24/2017	2018.03	05/24/2017 12:54:31 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	824	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	825	0	1	04	01	H2406_825_0	2			1		05/24/2017	2018.03	05/24/2017 12:54:40 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	825	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	826	0	1	04	01	H2406_826_0	2			1		05/24/2017	2018.03	05/24/2017 12:54:51 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	826	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2406	827	0	1	04	01	H2406_827_0	2			1		05/24/2017	2018.03	05/24/2017 12:55:03 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H2406	827	0	2018	Nationwide		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2416	001	0	1	01	01	H2416_001_0	3		1	1	2	05/29/2017	2018.03	05/29/2017 01:13:47 PM Central Daylight Time	08/07/2017 09:45:37 AM Central Daylight Time	08/07/2017 09:47:57 AM Central Daylight Time			08/07/2017 10:02:10 AM Central Daylight Time	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	PrimeWest Health	www.primewest.org/pwshc	PrimeWest Senior Health Complete (HMO SNP)	01	01		1			H2416	001	0	2018	Northern, west central, and southwestern Minnesota		2	24084	2			1	3		1		1	https://primewest.org/drug-search	https://primewest.org/pharmacy-search	https://www.primewest.org/find-a-health-care-provider	(800)366-2906		(320)335-5243		(800)366-2906		(320)335-5243		(800)366-2906		(320)335-5243		(800)366-2906		(320)335-5243		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		1	1	8a;8b1;8b2;9a;9b;9c;11a;11b;	2		1					1				
H2417	001	0	1	01	01	H2417_001_0	4		1	1	2	05/29/2017	2018.03	05/29/2017 12:40:39 PM Central Daylight Time	08/02/2017 01:14:09 PM Central Daylight Time	08/02/2017 01:17:08 PM Central Daylight Time			08/02/2017 01:19:43 PM Central Daylight Time	ITASCA MEDICAL CARE	Itasca Medical Care/IMCare Classic	www.imcare.org	IMCare Classic (HMO SNP)	01	01		1			H2417	001	0	2018	Itasca County		2	5680	2			1	3		1		1	http://www.caremark.com/wps/portal	http://www.imcare.org	http://www.imcare.org	(800)843-9536		(218)327-6188		(800)843-9536		(218)327-6188		(800)843-9536		(218)327-6188		(800)843-9536		(218)327-6188		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7f;7g;7h;7i;9b;9c;9d;10a;11a;11b;11c;12;18a;	1	1b;2;5;6;7c;7d;7e;7f;7g;7h;7i;9b;9c;9d;12;18a;	1					1				
H2419	001	0	1	01	01	H2419_001_0	8		1	1	2	06/05/2017	2018.03	06/05/2017 10:37:24 AM Central Daylight Time	08/01/2017 10:14:12 AM Central Daylight Time	08/01/2017 10:19:44 AM Central Daylight Time			08/01/2017 10:51:11 AM Central Daylight Time	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	SeniorCare Complete (HMO SNP)	01	01		1			H2419	001	0	2018	Select Counties in Minnesota		2	22686	1	1		1	3		1		1	www.mnscha.org	www.mnscha.org	www.mnscha.org	(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2422	002	0	1	01	01	H2422_002_0	10		1	1	2	08/11/2017	2018.03	08/11/2017 03:30:32 PM Central Daylight Time	08/11/2017 03:44:01 PM Central Daylight Time	08/01/2017 10:40:23 AM Central Daylight Time			08/11/2017 03:46:16 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners	healthpartners.com/msho	HealthPartners Minnesota Senior Health Options (HMO SNP)	01	01		1			H2422	002	0	2018	Minneapolis/St. Paul Metro Area		2	37992	2			1	3		1		1	healthpartners.com/msho	healthpartners.com/medicarerx	healthpartners.com/msho	(888)820-4285		(952)967-7029		(877)713-8215		(952)883-5050		(888)820-4285		(952)967-7029		(877)713-8215		(952)883-5050		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2425	001	0	1	01	01	H2425_001_0	5		1	1	2	07/05/2017	2018.03	07/05/2017 01:31:45 PM Central Daylight Time	08/03/2017 12:26:54 PM Central Daylight Time	08/03/2017 12:21:16 PM Central Daylight Time			08/04/2017 11:19:52 AM Central Daylight Time	BLUE PLUS	Blue Plus	www.bluecrossmn.com/secureblue	SecureBlue (HMO SNP)	01	01		1			H2425	001	0	2018	62 Counties within the State of Minnesota		2	100320	2			1	3		1		1	www.myprime.com	www.myprime.com	www.bluecrossmn.com/secureblue	(888)740-6013		(651)662-6013		(866)477-1584		(651)662-3584		(888)740-6013		(651)662-6013		(866)477-1584		(651)662-3584		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	001	0	1	18	06	H2450_001_0	2			1		05/30/2017	2018.03	05/30/2017 01:59:13 PM Central Daylight Time		08/02/2017 04:26:40 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Basic w/Rx 2 (Cost)	06	18		1			H2450	001	0	2018	All of MN		2	108475	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	002	0	1	18	06	H2450_002_0	2			1		05/30/2017	2018.03	05/30/2017 02:05:06 PM Central Daylight Time		08/02/2017 04:26:41 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Enhanced w/Rx 2 (Cost)	06	18		1			H2450	002	0	2018	All of MN		2	101842	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	007	0	1	18	06	H2450_007_0	4			1		06/02/2017	2018.03	06/02/2017 03:04:50 PM Central Daylight Time		08/02/2017 04:26:43 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Thrift w/Rx (Cost)	06	18		1			H2450	007	0	2018	All of MN, plus select counties in ND, SD and WI		2	7550	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	016	0	1	18	06	H2450_016_0	3			1		06/01/2017	2018.03	06/01/2017 09:25:09 AM Central Daylight Time		08/02/2017 04:26:44 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Basic w/Rx (Cost)	06	18		1			H2450	016	0	2018	All of MN		2	238781	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	017	0	1	18	06	H2450_017_0	2			1		05/30/2017	2018.03	05/30/2017 02:13:32 PM Central Daylight Time		08/02/2017 04:26:46 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Enhanced w/Rx (Cost)	06	18		1			H2450	017	0	2018	All of MN		2	63658	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	022	0	1	18	06	H2450_022_0	3			1		06/01/2017	2018.03	06/01/2017 09:29:37 AM Central Daylight Time		08/02/2017 04:26:47 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Value w/Rx (Cost)	06	18		1			H2450	022	0	2018	All of MN		2	29818	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	023	0	1	18	06	H2450_023_0	2			1		05/30/2017	2018.03	05/30/2017 02:21:28 PM Central Daylight Time		08/02/2017 04:26:49 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Value w/Rx 2 (Cost)	06	18		1			H2450	023	0	2018	All of MN		2	10762	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	030	0	1	18	06	H2450_030_0	2			1		06/02/2017	2018.03	06/02/2017 03:06:20 PM Central Daylight Time					06/02/2017 03:23:55 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Thrift (Cost)	06	18		1			H2450	030	0	2018	All of MN, plus select counties in ND, SD and WI		2	15547	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	031	0	1	18	06	H2450_031_0	1			1		05/26/2017	2018.03	05/26/2017 03:50:45 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Value (Cost)	06	18		1			H2450	031	0	2018	All of MN		2	44698	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	032	0	1	18	06	H2450_032_0	1			1		05/26/2017	2018.03	05/26/2017 02:18:21 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Basic (Cost)	06	18		1			H2450	032	0	2018	All of MN		2	249124	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	033	0	1	18	06	H2450_033_0	1			1		05/25/2017	2018.03	05/25/2017 03:24:35 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Enhanced (Cost)	06	18		1			H2450	033	0	2018	All of MN		2	100411	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	034	0	1	18	06	H2450_034_0	2			1		06/02/2017	2018.03	06/02/2017 03:01:31 PM Central Daylight Time					06/02/2017 03:23:55 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Core (Cost)	06	18		1			H2450	034	0	2018	Select counties in ND and SD		2	365078	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	035	0	1	18	06	H2450_035_0	3			1		06/01/2017	2018.03	06/01/2017 09:37:59 AM Central Daylight Time		08/02/2017 04:26:51 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Core w/Rx (Cost)	06	18		1			H2450	035	0	2018	Select counties in ND and SD		2	63091	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	036	0	1	18	06	H2450_036_0	1			1		05/25/2017	2018.03	05/25/2017 03:43:19 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Premier (Cost)	06	18		1			H2450	036	0	2018	Select counties in ND and SD		2	167406	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	037	0	1	18	06	H2450_037_0	2			1		05/30/2017	2018.03	05/30/2017 04:04:25 PM Central Daylight Time		08/02/2017 04:26:32 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Premier w/Rx (Cost)	06	18		1			H2450	037	0	2018	Select counties in ND and SD		2	19317	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	038	0	1	18	06	H2450_038_0	2			1		06/02/2017	2018.03	06/02/2017 03:50:27 PM Central Daylight Time					06/02/2017 03:54:08 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Focus (Cost)	06	18		1			H2450	038	0	2018	Select counties in WI		2	149256	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	039	0	1	18	06	H2450_039_0	3			1		06/02/2017	2018.03	06/02/2017 03:51:48 PM Central Daylight Time		08/02/2017 04:26:34 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Focus w/Rx (Cost)	06	18		1			H2450	039	0	2018	Select counties in WI		2	85092	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	040	0	1	18	06	H2450_040_0	1			1		05/31/2017	2018.03	05/31/2017 03:39:53 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Total (Cost)	06	18		1			H2450	040	0	2018	Select counties in WI		2	37356	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2450	041	0	1	18	06	H2450_041_0	2			1		05/31/2017	2018.03	05/31/2017 03:45:52 PM Central Daylight Time		08/02/2017 04:26:35 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Prime Solution Total w/Rx (Cost)	06	18		1			H2450	041	0	2018	Select counties in WI		2	25512	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(800)234-8755		(952)992-2300		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2450	801	0	1	18	06	H2450_801_0	1			1		05/30/2017	2018.03	05/30/2017 12:22:49 PM Central Daylight Time					05/31/2017 05:17:30 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	medica.com	Medica Group Prime Solution w/Rx (Cost)	06	18		1			H2450	801	0	2018	All of MN, plus select Counties in ND, SD and WI		1	73296	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(800)575-2330		(952)992-2330		(800)575-2330		(952)992-2330		(800)575-2330		(952)992-2330		(800)575-2330		(952)992-2330		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2456	002	0	1	01	01	H2456_002_0	7		1	1	2	06/19/2017	2018.03	06/19/2017 04:18:00 PM Central Daylight Time	08/02/2017 10:56:06 AM Central Daylight Time	08/02/2017 10:57:57 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare's MSHO	www.ucare.org	UCare's Minnesota Senior Health Options (HMO SNP)	01	01		1			H2456	002	0	2018	Twin Cities Metropolitan area and Greater MN		2		2			1	3		1		1	www.ucare.org	www.ucare.org	www.ucare.org	(866)280-7202		(612)676-6868		(800)707-1711		(612)676-3554		(866)280-7202		(612)676-6868		(800)707-1711		(612)676-3554		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2458	002	0	1	01	01	H2458_002_0	10		1	1	2	08/07/2017	2018.03	08/07/2017 03:18:42 PM Central Daylight Time	08/07/2017 05:24:33 PM Central Daylight Time	08/02/2017 04:26:37 PM Central Daylight Time			08/07/2017 05:51:53 PM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	medica.com	Medica DUAL Solution (HMO SNP)	01	01		1			H2458	002	0	2018	Specific Minnesota Counties		2	139411	1	1		1	3		1		1	www.medica.com/pharmacy/medicaid/medica-dual-solution	medica.com/Members	medica.com/Medicare	(888)347-3630		(952)992-2580		(800)266-2157		(952)992-2030		(888)347-3630		(952)992-2580		(800)266-2157		(952)992-2030		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2459	001	0	1	02	01	H2459_001_0	8			1		06/30/2017	2018.03	06/30/2017 11:44:56 AM Central Daylight Time	06/04/2017 04:43:37 PM Central Daylight Time				06/30/2017 02:07:09 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Value (HMO-POS)	01	02		1			H2459	001	0	2018	Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500										(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810										2					2					2	2			
H2459	020	0	1	02	01	H2459_020_0	5			1		06/05/2017	2018.03	06/05/2017 02:41:49 PM Central Daylight Time	08/01/2017 04:20:43 PM Central Daylight Time	08/01/2017 09:03:20 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Prime (HMO-POS)	01	02		1			H2459	020	0	2018	Twin City Metropolitan Area		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	021	1	1	02	01	H2459_021_1	10			1		07/10/2017	2018.03	07/10/2017 05:12:40 PM Central Daylight Time	08/01/2017 03:45:30 PM Central Daylight Time	08/01/2017 09:06:59 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Classic (HMO-POS)	01	02		1			H2459	021	1	2018	44 Counties	Twin Cities Metropolitan Area	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	021	2	1	02	01	H2459_021_2	8			1		06/30/2017	2018.03	06/30/2017 12:15:30 PM Central Daylight Time	08/01/2017 03:53:57 PM Central Daylight Time	08/01/2017 09:10:54 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Classic (HMO-POS)	01	02		1			H2459	021	2	2018	44 Counties	Northern Minnesota	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	021	3	1	02	01	H2459_021_3	8			1		06/30/2017	2018.03	06/30/2017 12:18:31 PM Central Daylight Time	08/01/2017 03:57:01 PM Central Daylight Time	08/01/2017 09:15:11 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Classic (HMO-POS)	01	02		1			H2459	021	3	2018	44 Counties	Southern Minnesota	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	022	1	1	02	01	H2459_022_1	8			1		06/30/2017	2018.03	06/30/2017 12:21:28 PM Central Daylight Time	08/01/2017 03:59:55 PM Central Daylight Time	08/01/2017 09:18:27 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Value Plus (HMO-POS)	01	02		1			H2459	022	1	2018	Twin Cities Metro Area and Northern Minnesota	Twin Cities Metropolitan Area	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	022	2	1	02	01	H2459_022_2	8			1		06/30/2017	2018.03	06/30/2017 12:24:43 PM Central Daylight Time	08/01/2017 04:03:03 PM Central Daylight Time	08/01/2017 09:22:21 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Value Plus (HMO-POS)	01	02		1			H2459	022	2	2018	Twin Cities Metro Area and Northern Minnesota	Northern Minnesota	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	023	1	1	02	01	H2459_023_1	9			1		06/30/2017	2018.03	06/30/2017 12:27:48 PM Central Daylight Time	08/01/2017 04:08:55 PM Central Daylight Time	08/01/2017 09:31:06 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Essentials Rx (HMO-POS)	01	02		1			H2459	023	1	2018	Twin Cities Metro Area and Northern Minnesota	Twin Cities Metropolitan Area	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	023	2	1	02	01	H2459_023_2	9			1		06/30/2017	2018.03	06/30/2017 12:30:22 PM Central Daylight Time	08/01/2017 04:12:21 PM Central Daylight Time	08/01/2017 09:34:36 AM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Essentials Rx (HMO-POS)	01	02		1			H2459	023	2	2018	Twin Cities Metro Area and Northern Minnesota	Northern Minnesota	2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	024	0	1	02	01	H2459_024_0	10			1		06/30/2017	2018.03	06/30/2017 11:47:59 AM Central Daylight Time	08/06/2017 08:43:28 PM Central Daylight Time	08/01/2017 09:38:18 AM Central Daylight Time			08/07/2017 02:00:38 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Standard (HMO-POS)	01	02		1			H2459	024	0	2018	Southern Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(877)523-1515		(612)676-3600		(877)523-1518		(612)676-3500		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H2459	801	0	1	02	01	H2459_801_0	5			1		06/05/2017	2018.03	06/05/2017 09:40:01 AM Central Daylight Time					06/05/2017 04:47:34 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	Group UCare for Seniors (HMO-POS)	01	02		1			H2459	801	0	2018	Minnesota and 26 Wisconsin Counties		1	67708	2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)447-4385		(612)676-6840		(877)598-6574		(612)676-6900		(877)447-4385		(612)676-6840		(877)598-6574		(612)676-6900		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					1	2		2		1	2			
H2461	005	0	1	18	06	H2461_005_0	1			1		06/01/2017	2018.03	06/01/2017 10:45:12 AM Central Daylight Time					06/01/2017 01:34:33 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Core Plan (Cost)	06	18		1			H2461	005	0	2018	State of Minnesota		2	73497	2			2						www.myprime.com	www.myprime.com	www.bluecrossmnonline.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2461	006	0	1	18	06	H2461_006_0	2			1		06/02/2017	2018.03	06/02/2017 09:56:23 AM Central Daylight Time					06/02/2017 10:10:18 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Choice Plan (Cost)	06	18		1			H2461	006	0	2018	State of Minnesota		2	705983	2			2						www.myprime.com	www.myprime.com	www.bluecrossmnonline.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2461	007	0	1	18	06	H2461_007_0	3			1		08/28/2017	2018.03	08/28/2017 02:56:27 PM Central Daylight Time					08/28/2017 03:01:51 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Complete Plan (Cost)	06	18		1			H2461	007	0	2018	State of Minnesota		2	1447644	2			2						www.myprime.com	www.myprime.com	www.bluecrossmnonline.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2461	008	0	1	18	06	H2461_008_0	4			1		06/01/2017	2018.03	06/01/2017 10:27:53 AM Central Daylight Time		08/03/2017 12:34:10 PM Central Daylight Time			08/04/2017 11:35:05 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Core Plan with Rx (Cost)	06	18		1			H2461	008	0	2018	State of Minnesota		2	35444	2			2						www.myprime.com	www.myprime.com	www.bluecrossmn.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2461	009	0	1	18	06	H2461_009_0	4			1		06/02/2017	2018.03	06/02/2017 09:58:27 AM Central Daylight Time		08/03/2017 12:34:12 PM Central Daylight Time			08/04/2017 11:42:12 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Choice Plan with Rx (Cost)	06	18		1			H2461	009	0	2018	State of Minnesota		2	304541	2			2						www.myprime.com	www.myprime.com	www.bluecrossmn.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2461	010	0	1	18	06	H2461_010_0	5			1		08/28/2017	2018.03	08/28/2017 02:59:32 PM Central Daylight Time		08/03/2017 12:34:12 PM Central Daylight Time			08/28/2017 03:17:34 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmnonline.com	Platinum Blue Complete Plan with Rx (Cost)	06	18		1			H2461	010	0	2018	State of Minnesota		2	408687	2			2						www.myprime.com	www.myprime.com	www.bluecrossmn.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	004	0	1	18	06	H2462_004_0	10			1		08/04/2017	2018.03	08/04/2017 09:03:08 AM Central Daylight Time					08/04/2017 03:56:40 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Basic (Cost)	06	18		1			H2462	004	0	2018	State of Minnesota		2	888	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	007	0	1	18	06	H2462_007_0	8			1		07/10/2017	2018.03	07/10/2017 04:56:03 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Balance (Cost)	06	18		1			H2462	007	0	2018	State of Minnesota		2	13428	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	008	0	1	18	06	H2462_008_0	6			1		07/10/2017	2018.03	07/10/2017 02:51:04 PM Central Daylight Time		08/01/2017 10:41:38 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Balance with Rx (Cost)	06	18		1			H2462	008	0	2018	State of Minnesota		2	120456	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	010	0	1	18	06	H2462_010_0	6			1		07/10/2017	2018.03	07/10/2017 02:51:15 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate (Cost)	06	18		1			H2462	010	0	2018	State of Minnesota		2	13020	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	011	0	1	18	06	H2462_011_0	6			1		07/10/2017	2018.03	07/10/2017 02:51:31 PM Central Daylight Time		08/01/2017 10:43:11 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate with Rx (Cost)	06	18		1			H2462	011	0	2018	State of Minnesota		2	65850	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	012	0	1	18	06	H2462_012_0	6			1		07/10/2017	2018.03	07/10/2017 02:51:44 PM Central Daylight Time		08/01/2017 10:44:37 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate with Enhanced Rx (Cost)	06	18		1			H2462	012	0	2018	State of Minnesota		2	9390	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	015	0	1	18	06	H2462_015_0	4			1		08/04/2017	2018.03	08/04/2017 09:03:34 AM Central Daylight Time					08/04/2017 03:56:40 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Basic (Cost)	06	18		1			H2462	015	0	2018	Western Wisconsin		2	456	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	016	0	1	18	06	H2462_016_0	3			1		07/10/2017	2018.03	07/10/2017 02:52:16 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Balance (Cost)	06	18		1			H2462	016	0	2018	Western Wisconsin		2	756	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	017	0	1	18	06	H2462_017_0	7			1		07/10/2017	2018.03	07/10/2017 02:52:30 PM Central Daylight Time		08/01/2017 10:47:08 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Balance with Rx (Cost)	06	18		1			H2462	017	0	2018	Western Wisconsin		2	1692	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	018	0	1	18	06	H2462_018_0	6			1		07/10/2017	2018.03	07/10/2017 02:52:45 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Vital (Cost)	06	18		1			H2462	018	0	2018	State of Minnesota		2	19332	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	019	0	1	18	06	H2462_019_0	8			1		07/10/2017	2018.03	07/10/2017 02:53:56 PM Central Daylight Time		08/01/2017 10:50:58 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Vital with Rx (Cost)	06	18		1			H2462	019	0	2018	State of Minnesota		2	102864	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	020	0	1	18	06	H2462_020_0	6			1		07/10/2017	2018.03	07/10/2017 05:06:17 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Active (Cost)	06	18		1			H2462	020	0	2018	State of Minnesota		2	12696	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	021	0	1	18	06	H2462_021_0	6			1		07/10/2017	2018.03	07/10/2017 05:05:59 PM Central Daylight Time		08/01/2017 10:53:03 AM Central Daylight Time			08/07/2017 09:35:17 AM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Active with Rx (Cost)	06	18		1			H2462	021	0	2018	State of Minnesota		2	22344	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(800)233-9645		(952)883-7979		(800)247-7015		(952)883-5601		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2462	022	0	1	18	06	H2462_022_0	5			1		08/04/2017	2018.03	08/04/2017 09:04:00 AM Central Daylight Time					08/04/2017 03:56:40 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Sanford Basic (Cost)	06	18		1			H2462	022	0	2018	Certain counties in North Dakota and South Dakota		2	500	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(800)233-9645		(800)247-7015		(800)247-7015										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	023	0	1	18	06	H2462_023_0	4			1		07/10/2017	2018.03	07/10/2017 02:54:48 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Sanford Vital (Cost)	06	18		1			H2462	023	0	2018	Certain counties in North Dakota and South Dakota		2	1900	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(800)233-9645		(800)247-7015		(800)247-7015										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	024	0	1	18	06	H2462_024_0	4			1		07/10/2017	2018.03	07/10/2017 02:55:00 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Sanford Active (Cost)	06	18		1			H2462	024	0	2018	Certain counties in North Dakota and South Dakota		2	1900	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(800)233-9645		(800)247-7015		(800)247-7015										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	025	0	1	18	06	H2462_025_0	4			1		07/10/2017	2018.03	07/10/2017 02:55:11 PM Central Daylight Time					07/10/2017 05:30:12 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Sanford Ultimate (Cost)	06	18		1			H2462	025	0	2018	Certain counties in North Dakota and South Dakota		2	1900	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(800)233-9645		(800)247-7015		(800)247-7015										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2462	801	0	1	18	06	H2462_801_0	1			1		05/30/2017	2018.03	05/30/2017 03:42:49 PM Central Daylight Time					05/31/2017 01:21:52 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Calendar Year (Cost)	06	18		1			H2462	801	0	2018	State of MN Western Wisconsin		1	303802	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(866)993-7428		(952)883-7428		(800)233-9645		(952)883-7979		(866)993-7428		(952)883-7428		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2462	802	0	1	18	06	H2462_802_0	1			1		05/30/2017	2018.03	05/30/2017 03:42:43 PM Central Daylight Time					05/31/2017 01:21:52 PM Central Daylight Time	GROUP HEALTH PLAN, INC. (MN)	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Non-Calendar Year (Cost)	06	18		1			H2462	802	0	2018	State of MN Western Wisconsin		1	0	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx		(800)233-9645		(952)883-7979		(866)993-7428		(952)883-7428		(800)233-9645		(952)883-7979		(866)993-7428		(952)883-7428		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2486	003	0	1	01	01	H2486_003_0	6			1		08/04/2017	2018.03	08/04/2017 05:04:15 PM Eastern Daylight Time	08/04/2017 05:17:55 PM Eastern Daylight Time	08/04/2017 09:52:18 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah, Inc.	www.humana.com/medicare	Humana Gold Plus H2486-003 (HMO)	01	01		1			H2486	003	0	2018	Davis, Salt Lake, Utah and Weber counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2486	801	0	1	01	01	H2486_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:18:26 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2486	801	0	2018	Select counties in Utah		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2486	802	0	1	01	01	H2486_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:20:34 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2486	802	0	2018	Select counties in Utah		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2491	004	0	1	01	01	H2491_004_0	2		1	1	2	08/03/2017	2018.03	08/03/2017 10:14:42 AM Eastern Daylight Time	08/03/2017 04:23:15 PM Eastern Daylight Time	07/31/2017 07:08:57 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare Health Plan	www.ohanahealthplan.com/medicare	'Ohana Liberty (HMO SNP)	01	01		1			H2491	004	0	2018	Hawaii, Honolulu, Kauai, Maui Counties		2	62573	2			1	3		1		1	www.ohanahealthplan.com/medicare	www.ohanahealthplan.com/medicare	www.ohanahealthplan.com/medicare	(877)457-7621		(877)457-7621		(800)265-8171		(800)265-8171		(877)457-7621		(877)457-7621		(800)265-8171		(800)265-8171		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H2491	006	0	1	01	01	H2491_006_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 08:34:09 AM Eastern Daylight Time	08/04/2017 03:02:00 PM Eastern Daylight Time	07/31/2017 07:09:20 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare Health Plan	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H2491	006	0	2018	Select Counties in LA		2	91011	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)530-9488		(866)530-9488		(866)527-0056		(866)527-0056		(866)530-9488		(866)530-9488		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H2491	007	0	1	01	01	H2491_007_0	4			1		08/04/2017	2018.03	08/04/2017 12:32:35 PM Eastern Daylight Time	08/03/2017 04:25:43 PM Eastern Daylight Time	07/31/2017 07:09:42 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare Health Plan	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H2491	007	0	2018	Select Counties in LA		2	56746	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)804-5926		(866)804-5926		(866)527-0056		(866)527-0056		(866)804-5926		(866)804-5926		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H2491	008	0	1	01	01	H2491_008_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 08:36:42 AM Eastern Daylight Time	08/03/2017 04:26:58 PM Eastern Daylight Time	07/31/2017 07:10:05 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare Health Plan	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H2491	008	0	2018	Select Counties in LA		2	28395	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)530-9488		(866)530-9488		(866)527-0056		(866)527-0056		(866)530-9488		(866)530-9488		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H2506	001	0	1	48	05	H2506_001_0	5			1		09/18/2017	2018.03	09/18/2017 10:45:50 AM Central Daylight Time					09/18/2017 10:48:28 AM Central Daylight Time	AETNA BETTER HEALTH, INC. (IL)	Aetna Better Health Premier Plan	www.aetnabetterhealth.com/illinois	Aetna Better Health Premier Plan (Medicare-Medicaid Plan)	05	48		1			H2506	001	0	2018	Illinois		2	7000	2			2						http://www.aetnabetterhealth.com/illinois	http://www.aetnabetterhealth.com/illinois	http://www.aetnabetterhealth.com/illinois	(866)600-2139		(866)600-2139		(866)600-2139		(866)600-2139		(866)600-2139		(866)600-2139		(866)600-2139		(866)600-2139		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2531	001	0	1	48	05	H2531_001_0	4			1		08/25/2017	2018.03	08/25/2017 12:48:25 PM US Mountain Standard Time					08/25/2017 12:53:24 PM US Mountain Standard Time	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	UnitedHealthcare Community Plan	www.uhccommunityplan.com	UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)	05	48		1			H2531	001	0	2018	Select Counties in Ohio		2		2			2						www.optumrx.com	www.uhccommunityplan.com	www.uhccommunityplan.com	(877)542-9236		(877)542-9236		(877)542-9236		(877)542-9236		(877)542-9236		(877)542-9236		(877)542-9236		(877)542-9236		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2533	001	0	1	48	05	H2533_001_0	3			1		08/11/2017	2018.03	08/11/2017 02:52:55 PM Pacific Daylight Time					08/11/2017 03:01:16 PM Pacific Daylight Time	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	Molina Healthcare of South Carolina	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H2533	001	0	2018	South Carolina		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(855)735-5831		(855)735-5831		(855)701-4887		(855)701-4887		(855)735-5831		(855)735-5831		(855)701-4887		(855)701-4887		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H2537	001	0	1	20	08	H2537_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:58 PM Eastern Daylight Time		05/24/2017 01:32:25 PM Eastern Daylight Time			05/24/2017 01:37:13 PM Eastern Daylight Time	SPIRITTRUST LUTHERAN LIFE	SpiriTrust Lutheran LIFE	www.spiritrustlutheranlife.org	SpiriTrust Lutheran LIFE - Dual (PACE)	08	20		1			H2537	001	0	2018	Franklin, Cumberland Counties		2		2			2						www.norlandavenuepharmacy.com	www.lifelutheranservices.org										(800)840-9081		(717)264-5433		(800)840-9081		(717)264-5433										(800)840-9081		(717)264-5433		(800)840-9081		(717)264-5433																
H2537	002	0	1	20	08	H2537_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:05 PM Eastern Daylight Time		05/24/2017 01:32:08 PM Eastern Daylight Time			05/24/2017 01:37:13 PM Eastern Daylight Time	SPIRITTRUST LUTHERAN LIFE	SpiriTrust Lutheran LIFE	www.spiritrustlutheranlife.org	SpiriTrust Lutheran LIFE  - Medicare Only (PACE)	08	20		1			H2537	002	0	2018	Franklin, Cumberland Counties		2		2			2						www.norlandavenuepharmacy.com	www.lifelutheranservices.org										(800)840-9081		(717)264-5433		(800)840-9081		(717)264-5433										(800)840-9081		(717)264-5433		(800)840-9081		(717)264-5433																
H2563	003	0	1	01	01	H2563_003_0	6			1		08/03/2017	2018.03	08/03/2017 05:07:09 PM Eastern Daylight Time	08/03/2017 04:37:04 PM Eastern Daylight Time	08/03/2017 05:00:49 PM Eastern Daylight Time			08/07/2017 03:08:04 PM Eastern Daylight Time	OPTIMA HEALTH PLAN	Optima Medicare	www.optimahealth.com/medicare	Optima Medicare Value (HMO)	01	01		1			H2563	003	0	2018	Hampton Roads, Virginia		2	22439	2			2						www.optimahealth.com	www.optimahealth.com/medicare	HTTP://optimahealth.prismisp.com/	(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		2					2					2	2			
H2563	004	0	1	01	01	H2563_004_0	5		1	1	2	08/09/2017	2018.03	08/09/2017 02:07:54 PM Eastern Daylight Time	08/09/2017 01:58:57 PM Eastern Daylight Time	08/03/2017 04:59:33 PM Eastern Daylight Time			08/10/2017 10:41:57 AM Eastern Daylight Time	OPTIMA HEALTH PLAN	Optima Medicare	www.optimahealth.com/medicare	Optima Community Complete (HMO SNP)	01	01		1			H2563	004	0	2018	Virginia		2	24000	2			1	3		1		2	www.optimahealth.com	www.optimahealth.com/medicare	HTTP://optimahealth.prismisp.com/	(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		2					2					2	2			
H2563	005	1	1	01	01	H2563_005_1	6			1		07/13/2017	2018.03	07/13/2017 11:37:52 AM Eastern Daylight Time	08/03/2017 04:53:15 PM Eastern Daylight Time	08/03/2017 04:57:12 PM Eastern Daylight Time			08/07/2017 03:08:04 PM Eastern Daylight Time	OPTIMA HEALTH PLAN	Optima Medicare	www.optimahealth.com/medicare	Optima Medicare Prime (HMO)	01	01		1			H2563	005	1	2018	Hampton Roads	Southside	2	21323	2			2						www.optimahealth.com	www.optimahealth.com/medicare	http://optimahealth.prismisp.com/	(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		2					2					2	2			
H2563	005	2	1	01	01	H2563_005_2	6			1		07/13/2017	2018.03	07/13/2017 11:38:12 AM Eastern Daylight Time	08/03/2017 04:54:54 PM Eastern Daylight Time	08/03/2017 04:26:45 PM Eastern Daylight Time			08/07/2017 03:08:04 PM Eastern Daylight Time	OPTIMA HEALTH PLAN	Optima Medicare	www.optimahealth.com/medicare	Optima Medicare Prime (HMO)	01	01		1			H2563	005	2	2018	Hampton Roads	Peninsula	2	2587	2			2						www.optimahealth.com	www.optimahealth.com/medicare	http://optimahealth.prismisp.com/	(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)927-6048		(757)687-6160		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		(800)828-1140		(711)-		2					2					2	2			
H2591	801	0	1	04	01	H2591_801_0	2			1		06/13/2017	2018.03	06/13/2017 09:37:13 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	healthalliancemedicare.org	Medicare Employer PPO (PPO)	01	04		1			H2591	801	0	2018	Health Alliance Medicare		1	120	1	1		2						healthalliancemedicare.org	healthalliancemedicare.org	healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)933-8454		(877)933-8454										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H2591	802	0	1	04	01	H2591_802_0	2			1		06/13/2017	2018.03	06/13/2017 09:37:22 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	healthalliancemedicare.org	Health Alliance Medicare (PPO)	01	04		1			H2591	802	0	2018	Health Alliance Medicare		1	1200	1	1		2						healthalliancemedicare.org	healthalliancemedicare.org	healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)933-8454		(877)933-8454		(877)917-8550		(877)917-8550		(877)933-8454		(877)933-8454		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2591	803	0	1	04	01	H2591_803_0	1			1		04/26/2017	2018.03	04/26/2017 08:38:29 AM Central Daylight Time					06/03/2017 09:22:38 AM Central Daylight Time	HEALTH ALLIANCE - MIDWEST, INC.	Health Alliance Medicare	healthalliancemedicare.org	Health Alliance Medicare (non calendar) (PPO)	01	04		1			H2591	803	0	2018	Health Alliance Medicare  (non calendar)		1	0	1	1		2						healthalliancemedicare.org	healthalliancemedicare.org	healthalliancemedicare.org	(877)917-8550		(877)917-8550		(877)933-8454		(877)933-8454		(877)917-8550		(877)917-8550		(877)933-8454		(877)933-8454		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H2593	001	0	1	01	01	H2593_001_0	5			1		08/03/2017	2018.03	08/03/2017 01:32:19 PM Pacific Daylight Time	08/03/2017 03:18:14 PM Pacific Daylight Time	08/02/2017 12:29:58 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Classic (HMO)	01	01		1			H2593	001	0	2018	Pima County		2	54772	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	003	0	1	01	01	H2593_003_0	6		1	1		08/03/2017	2018.03	08/03/2017 02:58:09 PM Pacific Daylight Time	08/03/2017 03:19:47 PM Pacific Daylight Time	08/02/2017 12:30:22 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Care To You (HMO SNP)	01	01		1			H2593	003	0	2018	Pima County		2	11221	2			1	1	3				www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	005	0	1	01	01	H2593_005_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:05:53 PM Pacific Daylight Time	08/03/2017 03:21:29 PM Pacific Daylight Time	08/02/2017 12:30:47 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore COPD (HMO SNP)	01	01		1			H2593	005	0	2018	Pima County		2	10390	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	006	0	1	01	01	H2593_006_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:06:19 PM Pacific Daylight Time	08/03/2017 03:20:43 PM Pacific Daylight Time	08/02/2017 12:31:11 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H2593	006	0	2018	Pima County		2	37034	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	013	0	1	01	01	H2593_013_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:06:44 PM Pacific Daylight Time	08/03/2017 03:22:14 PM Pacific Daylight Time	08/02/2017 12:31:35 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Heart Care (HMO SNP)	01	01		1			H2593	013	0	2018	Pima County		2	11985	2			1	4			00000000000000010000		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	018	0	1	01	01	H2593_018_0	5			1		08/02/2017	2018.03	08/02/2017 05:07:11 PM Pacific Daylight Time	08/03/2017 03:19:01 PM Pacific Daylight Time	08/02/2017 12:31:59 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Smart Value (HMO)	01	01		1			H2593	018	0	2018	Pima County		2	21941	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	019	0	1	01	01	H2593_019_0	6		1	1		08/02/2017	2018.03	08/02/2017 05:08:10 PM Pacific Daylight Time	08/03/2017 03:26:09 PM Pacific Daylight Time	08/02/2017 12:32:27 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore Care To You (HMO SNP)	01	01		1			H2593	019	0	2018	Maricopa County (partial)		2	8911	2			1	1	3				www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	020	0	1	01	01	H2593_020_0	5			1		08/02/2017	2018.03	08/02/2017 05:07:51 PM Pacific Daylight Time	08/03/2017 03:07:15 PM Pacific Daylight Time	08/02/2017 12:32:54 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	www.caremore.com	CareMore Care Access (HMO)	01	01		1			H2593	020	0	2018	Pima County		2	4494	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	801	0	1	01	01	H2593_801_0	2			1		05/30/2017	2018.03	05/30/2017 10:26:25 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP (HMO)	01	01		1			H2593	801	0	2018	Arizona		1	125	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2593	802	0	1	01	01	H2593_802_0	2			1		05/30/2017	2018.03	05/30/2017 10:26:41 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H2593	802	0	2018	Arizona		1	125	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2593	804	0	1	01	01	H2593_804_0	2			1		05/30/2017	2018.03	05/30/2017 10:26:58 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H2593	804	0	2018	Arizona		1	38	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2610	005	0	1	01	01	H2610_005_0	8			1		08/03/2017	2018.03	08/03/2017 08:40:03 AM Central Daylight Time	08/03/2017 08:21:05 AM Central Daylight Time	08/03/2017 08:20:06 AM Central Daylight Time			08/03/2017 09:37:57 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H2610	005	0	2018	St. Louis Metropolitan Area		2	667989	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2610	006	0	1	01	01	H2610_006_0	8			1		08/03/2017	2018.03	08/03/2017 08:41:02 AM Central Daylight Time	08/03/2017 08:23:45 AM Central Daylight Time	08/03/2017 08:24:09 AM Central Daylight Time			08/03/2017 09:37:57 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Plus (HMO)	01	01		1			H2610	006	0	2018	St. Louis Metropolitan Area		2	23641	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2610	011	0	1	01	01	H2610_011_0	8			1		08/03/2017	2018.03	08/03/2017 08:45:57 AM Central Daylight Time	08/03/2017 08:26:36 AM Central Daylight Time	08/03/2017 08:27:02 AM Central Daylight Time			08/03/2017 09:37:57 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H2610	011	0	2018	Columbia Metropolitan Area		2	14084	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2610	015	0	1	01	01	H2610_015_0	8			1		08/03/2017	2018.03	08/03/2017 08:48:52 AM Central Daylight Time	08/03/2017 08:29:23 AM Central Daylight Time	08/03/2017 08:32:14 AM Central Daylight Time			08/03/2017 09:37:57 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	CoxHealth MedicarePlus (HMO)	01	01		1			H2610	015	0	2018	Southwest Missouri		2	132558	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2610	803	0	1	01	01	H2610_803_0	2			1		05/18/2017	2018.03	05/18/2017 09:55:25 AM Central Daylight Time					05/26/2017 07:49:07 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan calendar (HMO)	01	01		1			H2610	803	0	2018	MO and IL Service Area		1	600	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	1	3-1;3-2;3-3;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;16b;	1					1				
H2610	804	0	1	01	01	H2610_804_0	2			1		05/18/2017	2018.03	05/18/2017 09:55:39 AM Central Daylight Time					05/26/2017 07:49:07 AM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan non-calendar (HMO)	01	01		1			H2610	804	0	2018	MO and IL Service Area		1	600	2			2						https://www.everythingessence.com/public/find-a-pharmacy.aspx	https://www.everythingessence.com/public/drug-formulary.aspx	www.essencehealthcare.com	(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(866)597-9560		(314)209-2700		(866)509-5399		(314)209-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	1	3-1;3-2;3-3;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;16b;	1					1				
H2649	012	0	1	01	01	H2649_012_0	2			1		05/27/2017	2018.03	05/27/2017 12:42:37 PM Eastern Daylight Time	06/01/2017 07:29:01 PM Eastern Daylight Time				06/02/2017 09:37:49 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-012 (HMO)	01	01		1			H2649	012	0	2018	Kansas City Metro Area		2		2			2						1	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2649	021	0	1	01	01	H2649_021_0	3			1		08/02/2017	2018.03	08/02/2017 02:27:44 PM Eastern Daylight Time	08/04/2017 02:55:45 PM Eastern Daylight Time	08/04/2017 09:52:18 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-021 (HMO)	01	01		1			H2649	021	0	2018	Wichita area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	023	0	1	01	01	H2649_023_0	6			1		08/02/2017	2018.03	08/02/2017 02:28:24 PM Eastern Daylight Time	08/04/2017 02:54:37 PM Eastern Daylight Time	08/04/2017 09:52:19 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-023 (HMO)	01	01		1			H2649	023	0	2018	St. Louis Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	028	0	1	01	01	H2649_028_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 12:46:42 PM Eastern Daylight Time	08/04/2017 02:56:22 PM Eastern Daylight Time	08/04/2017 09:52:19 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H2649-028 (HMO SNP)	01	01		1			H2649	028	0	2018	Select counties in Missouri		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	029	0	1	01	01	H2649_029_0	4			1		08/02/2017	2018.03	08/02/2017 12:02:29 PM Eastern Daylight Time	08/04/2017 04:08:49 PM Eastern Daylight Time	08/04/2017 09:52:20 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-029 (HMO)	01	01		1			H2649	029	0	2018	Albuquerque Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;8a1;8a2;8b3;	
H2649	030	0	1	01	01	H2649_030_0	5			1		06/28/2017	2018.03	06/28/2017 10:31:21 AM Eastern Daylight Time	08/04/2017 01:22:17 PM Eastern Daylight Time	08/04/2017 09:52:20 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-030 (HMO)	01	01		1			H2649	030	0	2018	Maricopa and Pinal (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	031	0	1	01	01	H2649_031_0	4			1		08/02/2017	2018.03	08/02/2017 03:05:20 PM Eastern Daylight Time	08/04/2017 01:15:52 PM Eastern Daylight Time	08/04/2017 09:52:22 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-031 (HMO)	01	01		1			H2649	031	0	2018	Pima and Pinal (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	032	0	1	01	01	H2649_032_0	4			1		08/02/2017	2018.03	08/02/2017 03:07:26 PM Eastern Daylight Time	08/04/2017 01:19:06 PM Eastern Daylight Time	08/04/2017 09:52:23 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-032 (HMO)	01	01		1			H2649	032	0	2018	Maricopa and Pinal (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	033	0	1	01	01	H2649_033_0	4			1		06/28/2017	2018.03	06/28/2017 10:32:24 AM Eastern Daylight Time	08/04/2017 01:24:37 PM Eastern Daylight Time	08/04/2017 09:52:23 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-033 (HMO)	01	01		1			H2649	033	0	2018	La Paz and Mohave counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	034	0	1	01	01	H2649_034_0	4			1		06/28/2017	2018.03	06/28/2017 10:33:52 AM Eastern Daylight Time	08/04/2017 01:23:23 PM Eastern Daylight Time	08/04/2017 09:52:24 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-034 (HMO)	01	01		1			H2649	034	0	2018	Yavapai County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	039	0	1	01	01	H2649_039_0	4			1		08/02/2017	2018.03	08/02/2017 03:08:02 PM Eastern Daylight Time	08/04/2017 01:26:45 PM Eastern Daylight Time	08/04/2017 09:52:25 AM Eastern Daylight Time			08/06/2017 09:12:43 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-039 (HMO)	01	01		1			H2649	039	0	2018	La Paz and Mohave counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	043	0	1	01	01	H2649_043_0	4			1		08/02/2017	2018.03	08/02/2017 12:02:20 PM Eastern Daylight Time	08/04/2017 04:17:49 PM Eastern Daylight Time	08/04/2017 09:52:25 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-043 (HMO)	01	01		1			H2649	043	0	2018	Colorado's I-25 Corridor Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;8a1;8a2;8b3;	
H2649	045	0	1	01	01	H2649_045_0	3			1		08/02/2017	2018.03	08/02/2017 03:36:17 PM Eastern Daylight Time	08/04/2017 04:25:47 PM Eastern Daylight Time	08/04/2017 09:52:26 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-045 (HMO)	01	01		1			H2649	045	0	2018	Corpus Christi Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	046	0	1	01	01	H2649_046_0	5			1		08/02/2017	2018.03	08/02/2017 03:37:00 PM Eastern Daylight Time	08/04/2017 04:24:51 PM Eastern Daylight Time	08/04/2017 09:52:26 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-046 (HMO)	01	01		1			H2649	046	0	2018	San Antonio Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	048	0	1	01	01	H2649_048_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 03:37:44 PM Eastern Daylight Time	08/04/2017 04:24:00 PM Eastern Daylight Time	08/04/2017 09:52:27 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H2649-048 (HMO SNP)	01	01		1			H2649	048	0	2018	Select Counties in Texas		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	049	0	1	01	01	H2649_049_0	4			1		08/02/2017	2018.03	08/02/2017 03:38:31 PM Eastern Daylight Time	08/04/2017 04:23:05 PM Eastern Daylight Time	08/04/2017 09:52:27 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-049 (HMO)	01	01		1			H2649	049	0	2018	El Paso County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	050	0	1	01	01	H2649_050_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 03:39:22 PM Eastern Daylight Time	08/04/2017 04:22:27 PM Eastern Daylight Time	08/04/2017 09:52:28 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H2649-050 (HMO SNP)	01	01		1			H2649	050	0	2018	Corpus Christi/San Antonio area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	051	0	1	01	01	H2649_051_0	2			1		08/02/2017	2018.03	08/02/2017 03:40:08 PM Eastern Daylight Time	08/04/2017 04:21:44 PM Eastern Daylight Time	08/04/2017 09:52:28 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-051 (HMO)	01	01		1			H2649	051	0	2018	Hays, Travis and Williamson		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	052	0	1	01	01	H2649_052_0	2			1		08/02/2017	2018.03	08/02/2017 03:40:53 PM Eastern Daylight Time	08/04/2017 04:20:59 PM Eastern Daylight Time	08/04/2017 09:52:29 AM Eastern Daylight Time			08/06/2017 08:52:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-052 (HMO)	01	01		1			H2649	052	0	2018	Houston Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	053	0	1	01	01	H2649_053_0	2		1	1		08/02/2017	2018.03	08/02/2017 03:41:53 PM Eastern Daylight Time	08/04/2017 04:20:13 PM Eastern Daylight Time	08/04/2017 09:52:29 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H2649	053	0	2018	Corpus Christi Metro Area		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	054	0	1	01	01	H2649_054_0	2		1	1		08/02/2017	2018.03	08/02/2017 03:42:39 PM Eastern Daylight Time	08/04/2017 04:19:01 PM Eastern Daylight Time	08/04/2017 09:52:30 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H2649	054	0	2018	San Antonio Metro Area		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	055	0	1	01	01	H2649_055_0	2			1		05/27/2017	2018.03	05/27/2017 11:49:13 AM Eastern Daylight Time	08/04/2017 04:16:03 PM Eastern Daylight Time	08/04/2017 09:52:30 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-055 (HMO)	01	01		1			H2649	055	0	2018	Select Counties in Texas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	056	0	1	02	01	H2649_056_0	3		1	1		08/03/2017	2018.03	08/03/2017 10:10:59 AM Eastern Daylight Time		08/04/2017 09:52:31 AM Eastern Daylight Time		08/05/2017 11:24:39 AM Eastern Daylight Time	08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Kidney Care (HMO-POS SNP)	01	02		1			H2649	056	0	2018	Houston Metro Area		2		2			1	4			00000000100000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	059	1	1	01	01	H2649_059_1	4			1		06/28/2017	2018.03	06/28/2017 11:25:38 AM Eastern Daylight Time	08/04/2017 02:56:57 PM Eastern Daylight Time	08/04/2017 09:52:31 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-059 (HMO)	01	01		1			H2649	059	1	2018	Southwest Missouri	Southwest Missouri	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	059	2	1	01	01	H2649_059_2	3			1		06/28/2017	2018.03	06/28/2017 11:25:52 AM Eastern Daylight Time	08/04/2017 02:57:31 PM Eastern Daylight Time	08/04/2017 09:52:32 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-059 (HMO)	01	01		1			H2649	059	2	2018	Southwest Missouri	Southwest Missouri	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	060	0	1	02	01	H2649_060_0	4		1	1		06/02/2017	2018.03	06/02/2017 07:41:49 AM Eastern Daylight Time		08/04/2017 09:52:32 AM Eastern Daylight Time		08/06/2017 09:22:24 AM Eastern Daylight Time	08/06/2017 09:27:01 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Kidney Care (HMO-POS SNP)	01	02		1			H2649	060	0	2018	Denver/Colorado Springs Metro Area		2		2			1	4			00000000100000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	061	1	1	01	01	H2649_061_1	3			1		05/27/2017	2018.03	05/27/2017 12:30:20 PM Eastern Daylight Time	08/04/2017 04:20:56 PM Eastern Daylight Time	08/04/2017 09:52:33 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-061 (HMO)	01	01		1			H2649	061	1	2018	Denver Metro Area	Denver Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;8a1;8a2;8b3;	
H2649	061	2	1	01	01	H2649_061_2	3			1		05/27/2017	2018.03	05/27/2017 12:31:45 PM Eastern Daylight Time	08/04/2017 04:22:03 PM Eastern Daylight Time	08/04/2017 09:52:34 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-061 (HMO)	01	01		1			H2649	061	2	2018	Denver Metro Area	North & South Colorado area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;8a1;8a2;8b3;	
H2649	062	1	1	01	01	H2649_062_1	3			1		06/28/2017	2018.03	06/28/2017 11:26:09 AM Eastern Daylight Time	08/04/2017 02:58:05 PM Eastern Daylight Time	08/04/2017 09:52:35 AM Eastern Daylight Time			08/06/2017 09:31:02 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-062 (HMO)	01	01		1			H2649	062	1	2018	Kansas City Metro Area	Kansas City Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	062	2	1	01	01	H2649_062_2	3			1		06/28/2017	2018.03	06/28/2017 11:26:18 AM Eastern Daylight Time	08/04/2017 02:58:43 PM Eastern Daylight Time	08/04/2017 09:52:35 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H2649-062 (HMO)	01	01		1			H2649	062	2	2018	Kansas City Metro Area	Kansas City Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	063	0	1	01	01	H2649_063_0	3			1		08/03/2017	2018.03	08/03/2017 12:48:29 PM Eastern Daylight Time	08/04/2017 01:27:43 PM Eastern Daylight Time	08/04/2017 09:52:36 AM Eastern Daylight Time			08/06/2017 08:53:33 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-063 (HMO)	01	01		1			H2649	063	0	2018	Maricopa and Pinal (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;7a;7g;8a1;8b3;	
H2649	064	0	1	01	01	H2649_064_0	2			1		08/02/2017	2018.03	08/02/2017 03:43:25 PM Eastern Daylight Time	08/04/2017 04:13:54 PM Eastern Daylight Time	08/04/2017 09:52:36 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-064 (HMO)	01	01		1			H2649	064	0	2018	Houston area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	065	1	1	01	01	H2649_065_1	2			1		08/02/2017	2018.03	08/02/2017 03:44:09 PM Eastern Daylight Time	08/04/2017 04:15:20 PM Eastern Daylight Time	08/04/2017 09:52:37 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-065 (HMO)	01	01		1			H2649	065	1	2018	Dallas area	Dallas area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	065	2	1	01	01	H2649_065_2	2			1		05/27/2017	2018.03	05/27/2017 04:53:42 PM Eastern Daylight Time	08/04/2017 04:14:32 PM Eastern Daylight Time	08/04/2017 09:52:37 AM Eastern Daylight Time			08/06/2017 08:56:50 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-065 (HMO)	01	01		1			H2649	065	2	2018	Dallas area	Dallas area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	066	0	1	01	01	H2649_066_0	6			1		06/28/2017	2018.03	06/28/2017 11:17:20 AM Eastern Daylight Time	08/04/2017 04:23:41 PM Eastern Daylight Time	08/04/2017 09:52:38 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Value Plus H2649-066 (HMO)	01	01		1			H2649	066	0	2018	Denver Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	067	0	1	01	01	H2649_067_0	2			1		05/30/2017	2018.03	05/30/2017 09:05:19 AM Eastern Daylight Time	08/04/2017 03:52:54 PM Eastern Daylight Time	08/04/2017 09:52:38 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Value Plus H2649-067 (HMO)	01	01		1			H2649	067	0	2018	Select counties in Kansas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2649	801	0	1	01	01	H2649_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:21:42 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2649	801	0	2018	Select counties in Kansas City Metro area		1	38232	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2649	802	0	1	01	01	H2649_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:22:18 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2649	802	0	2018	Select counties in Kansas City Metro area		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2649	814	0	1	01	01	H2649_814_0	3			1		06/13/2017	2018.03	06/13/2017 10:22:39 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2649	814	0	2018	Multi-State		1	2676	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2649	815	0	1	01	01	H2649_815_0	3			1		06/13/2017	2018.03	06/13/2017 10:22:53 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H2649	815	0	2018	Multi-State		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2663	002	0	1	01	01	H2663_002_0	4			1		08/03/2017	2018.03	08/03/2017 11:34:21 AM Central Daylight Time	08/03/2017 08:28:12 AM Central Daylight Time	07/31/2017 04:29:03 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra Option 2 (HMO)	01	01		1			H2663	002	0	2018	St. Louis MO Metro Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	005	0	1	01	01	H2663_005_0	4			1		08/02/2017	2018.03	08/02/2017 03:39:08 PM Eastern Daylight Time	08/03/2017 08:31:52 AM Central Daylight Time	07/31/2017 04:29:28 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Gold Advantage (HMO)	01	01		1			H2663	005	0	2018	St. Louis MO Metro Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	006	0	1	02	01	H2663_006_0	3			1		06/27/2017	2018.03	06/27/2017 08:47:21 PM Eastern Daylight Time	08/03/2017 08:37:56 AM Central Daylight Time	07/31/2017 04:29:53 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra Option 1 (HMO-POS)	01	02		1			H2663	006	0	2018	St. Louis MO Metro Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	015	0	1	02	01	H2663_015_0	4			1		08/01/2017	2018.03	08/01/2017 08:57:22 PM Central Daylight Time	08/03/2017 08:43:22 AM Central Daylight Time	07/31/2017 04:30:19 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (HMO-POS)	01	02		1			H2663	015	0	2018	St. Louis MO Metro Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	016	0	1	01	01	H2663_016_0	4			1		08/02/2017	2018.03	08/02/2017 02:25:55 PM Eastern Daylight Time	08/03/2017 03:52:05 PM Eastern Daylight Time	07/31/2017 05:36:13 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (HMO)	01	01		1			H2663	016	0	2018	Boone, Winnebago IL		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	017	0	1	01	01	H2663_017_0	3			1		08/03/2017	2018.03	08/03/2017 03:20:00 PM Central Daylight Time	08/03/2017 08:50:36 AM Central Daylight Time	07/31/2017 04:30:44 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (HMO)	01	01		1			H2663	017	0	2018	Peoria, Tazewell Illinois		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	021	0	1	01	01	H2663_021_0	4			1		08/03/2017	2018.03	08/03/2017 11:34:53 AM Central Daylight Time	08/02/2017 07:05:57 AM Central Daylight Time	07/31/2017 04:31:10 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Advantage (HMO)	01	01		1			H2663	021	0	2018	Southwest Missouri		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	022	0	1	01	01	H2663_022_0	3			1		06/30/2017	2018.03	06/30/2017 11:05:25 AM Eastern Daylight Time	05/30/2017 11:19:11 AM Central Daylight Time				07/07/2017 08:31:10 AM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Advantage (no drug) (HMO)	01	01		1			H2663	022	0	2018	Southwest Missouri		2		2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2663	023	0	1	02	01	H2663_023_0	4			1		08/02/2017	2018.03	08/02/2017 10:58:14 AM Central Daylight Time	08/02/2017 07:07:17 AM Central Daylight Time	07/31/2017 04:31:36 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Advantage Plus (HMO-POS)	01	02		1			H2663	023	0	2018	Southwest Missouri		2		2			2						www.coventry-medicare.com/formulary	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	024	0	1	02	01	H2663_024_0	4			1		08/04/2017	2018.03	08/04/2017 09:10:20 AM Central Daylight Time	08/02/2017 07:13:01 AM Central Daylight Time	07/31/2017 04:32:01 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	https://www.coventry-medicare.com	Coventry Total Care (HMO-POS)	01	02		1			H2663	024	0	2018	Oklahoma City area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	025	0	1	01	01	H2663_025_0	3			1		06/30/2017	2018.03	06/30/2017 11:06:18 AM Eastern Daylight Time	05/30/2017 11:21:35 AM Central Daylight Time				07/07/2017 08:31:10 AM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Select (no drug) (HMO)	01	01		1			H2663	025	0	2018	Limited counties Oklahoma, Missouri and Kansas		2		2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	http://www.providerdirectory.coventry-medicare.com	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2663	026	0	1	01	01	H2663_026_0	6			1		08/03/2017	2018.03	08/03/2017 11:35:25 AM Central Daylight Time	08/02/2017 06:59:30 AM Central Daylight Time	07/31/2017 04:32:27 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra Advantage (HMO)	01	01		1			H2663	026	0	2018	Kansas City Metro Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	027	0	1	01	01	H2663_027_0	5			1		08/02/2017	2018.03	08/02/2017 10:58:59 AM Central Daylight Time	08/02/2017 07:00:12 AM Central Daylight Time	07/31/2017 04:32:53 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra Advantage (HMO)	01	01		1			H2663	027	0	2018	Wyandotte County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	028	0	1	01	01	H2663_028_0	4			1		08/03/2017	2018.03	08/03/2017 11:35:54 AM Central Daylight Time	08/02/2017 07:01:08 AM Central Daylight Time	07/31/2017 04:33:18 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Coventry Medicare Advantage Total Care (HMO)	01	01		1			H2663	028	0	2018	Wichita Kansas Area		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	029	0	1	01	01	H2663_029_0	4			1		08/02/2017	2018.03	08/02/2017 10:59:22 AM Central Daylight Time	08/02/2017 07:02:00 AM Central Daylight Time	07/31/2017 04:33:44 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra Total Care (HMO)	01	01		1			H2663	029	0	2018	NW Arkansas		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)727-9712		(800)727-9712		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	031	0	1	02	01	H2663_031_0	3			1		06/27/2017	2018.03	06/27/2017 08:49:29 PM Eastern Daylight Time	08/03/2017 08:54:08 AM Central Daylight Time	07/31/2017 04:34:10 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Advantra (HMO-POS)	01	02		1			H2663	031	0	2018	Hannibal MO		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	032	0	1	01	01	H2663_032_0	4			1		08/01/2017	2018.03	08/01/2017 09:00:44 PM Central Daylight Time	08/03/2017 08:57:58 AM Central Daylight Time	07/31/2017 04:34:35 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.coventry-medicare.com	Gold Advantage Value (HMO)	01	01		1			H2663	032	0	2018	St. Louis and surrounding counties IL-MO		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2663	802	0	1	01	01	H2663_802_0	1			1		05/31/2017	2018.03	05/31/2017 09:14:17 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.chcmissourimedicare.com	Employer Group Calendar Rx (HMO)	01	01		1			H2663	802	0	2018	St. Louis MO Metro Area - Employer Group		1	47870	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	https://coventry-medicare.com/findprovider	(800)533-0367		(800)533-0367		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2663	805	0	1	01	01	H2663_805_0	1			1		05/31/2017	2018.03	05/31/2017 09:13:23 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	www.chcmissourimedicare.com	Employer Group Calendar No Rx (HMO)	01	01		1			H2663	805	0	2018	St. Louis MO Metro Area - Employer Group		1	6260	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	https://coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(866)557-8753		(866)557-8753										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2663	810	0	1	01	01	H2663_810_0	1			1		05/31/2017	2018.03	05/31/2017 09:13:44 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	http://www.aetna-coventryretiree.com/	Employer Group SOI w/Rx (HMO)	01	01		1			H2663	810	0	2018	Illinois		1	70350	2			2						http://www.aetna-coventryretiree.com/	http://www.aetna-coventryretiree.com/	http://www.aetna-coventryretiree.com/	(855)223-4807		(855)223-4807		(855)233-4807		(855)233-4807		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2663	811	0	1	01	01	H2663_811_0	1			1		05/31/2017	2018.03	05/31/2017 09:13:53 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	coventry-medicare.coventryhealthcare.com	Heartland Advantra Empoyer Group w/RX (HMO)	01	01		1			H2663	811	0	2018	SW Missouri		1	14080	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(844)741-8423		(844)741-8423		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2663	812	0	1	01	01	H2663_812_0	1			1		05/31/2017	2018.03	05/31/2017 08:02:03 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	coventry-medicare.coventryhealthcare.com	Heartland Employer Group w/o RX (HMO)	01	01		1			H2663	812	0	2018	KS and MO		1	120	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2663	813	0	1	01	01	H2663_813_0	1			1		05/31/2017	2018.03	05/31/2017 08:01:39 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF MISSOURI, INC	Coventry Health Care	coventry-medicare.coventryhealthcare.com	Heartland Advantra Employer Group w/RX (HMO)	01	01		1			H2663	813	0	2018	SW Missouri		1	2400	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(844)741-8423		(844)741-8423		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H2758	002	0	1	01	01	H2758_002_0	7			1		08/10/2017	2018.03	08/10/2017 01:45:32 PM Eastern Daylight Time	08/07/2017 01:32:04 PM Eastern Daylight Time	08/07/2017 01:32:04 PM Eastern Daylight Time			08/10/2017 01:59:49 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	www.BlueMedicareFL.com	BlueMedicare Preferred (HMO)	01	01		1			H2758	002	0	2018	Manatee and Sarasota counties		2		2			2						www.BlueMedicareFL.com	www.BlueMedicareFL.com	www.BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2758	004	0	1	01	01	H2758_004_0	6			1		08/10/2017	2018.03	08/10/2017 10:24:39 AM Eastern Daylight Time	08/07/2017 01:32:05 PM Eastern Daylight Time	08/07/2017 01:32:05 PM Eastern Daylight Time			08/10/2017 01:59:49 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	www.BlueMedicareFL.com	BlueMedicare Preferred (HMO)	01	01		1			H2758	004	0	2018	Clay and Duval Counties		2		2			2						www.BlueMedicareFL.com	www.BlueMedicareFL.com	www.BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2758	005	0	1	01	01	H2758_005_0	7		1	1		08/10/2017	2018.03	08/10/2017 10:25:15 AM Eastern Daylight Time	08/07/2017 01:32:06 PM Eastern Daylight Time	08/07/2017 01:32:06 PM Eastern Daylight Time			08/10/2017 01:59:49 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	www.BlueMedicareFL.com	BlueMedicare Preferred HMO (HMO SNP)	01	01		1			H2758	005	0	2018	Manatee and Sarasota Counties		2		2			1	4			00000000000000000010		www.BlueMedicareFL.com	www.BlueMedicareFL.com	www.BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2758	006	0	1	01	01	H2758_006_0	5			1		08/10/2017	2018.03	08/10/2017 10:26:48 AM Eastern Daylight Time	08/07/2017 01:32:06 PM Eastern Daylight Time	08/07/2017 01:32:06 PM Eastern Daylight Time			08/10/2017 01:59:49 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	www.BlueMedicareFL.com	BlueMedicare Preferred (HMO)	01	01		1			H2758	006	0	2018	Pinellas		2		2			2						www.BlueMedicareFL.com	www.BlueMedicareFL.com	www.BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2758	007	0	1	01	01	H2758_007_0	7		1	1		08/10/2017	2018.03	08/10/2017 10:43:54 AM Eastern Daylight Time	08/07/2017 01:32:03 PM Eastern Daylight Time	08/07/2017 01:32:03 PM Eastern Daylight Time			08/10/2017 01:59:49 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	BlueMedicareFL.com	BlueMedicare Preferred HMO (HMO SNP)	01	01		1			H2758	007	0	2018	Clay and Duval		2		2			1	4			00000000000000000010		BlueMedicareFL.com	BlueMedicareFL.com	BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2758	008	0	1	02	01	H2758_008_0	5			1		08/03/2017	2018.03	08/03/2017 03:55:18 PM Eastern Daylight Time	08/07/2017 01:32:03 PM Eastern Daylight Time	08/07/2017 01:32:04 PM Eastern Daylight Time			08/07/2017 02:35:04 PM Eastern Daylight Time	BEHEALTHY FLORIDA, INC.	Florida Blue Preferred HMO	BlueMedicareFL.com	BlueMedicare Preferred POS (HMO-POS)	01	02		1			H2758	008	0	2018	Pinellas, Sarasota & Manatee		2		2			2						BlueMedicareFL.com	BlueMedicareFL.com	BlueMedicareFL.com	(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(844)783-5189		(844)783-5189		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2					2	2			
H2773	003	0	1	01	01	H2773_003_0	12		1	1		08/06/2017	2018.03	08/06/2017 11:29:12 PM Eastern Daylight Time	08/06/2017 10:39:09 PM Eastern Daylight Time	08/06/2017 11:26:55 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Health LI - SNP (HMO SNP)	01	01		1			H2773	003	0	2018	Nassau, and Suffolk Counties		2	16021	2			1	4			00000000000000000010		www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2773	017	0	1	01	01	H2773_017_0	10		1	1		08/06/2017	2018.03	08/06/2017 11:29:20 PM Eastern Daylight Time	08/06/2017 10:39:26 PM Eastern Daylight Time	08/06/2017 11:27:02 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Health NYC - SNP (HMO SNP)	01	01		1			H2773	017	0	2018	Queens County and Staten Island		2	2430	2			1	4			00000000000000000010		www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2773	018	0	1	01	01	H2773_018_0	8		1	1	2	08/06/2017	2018.03	08/06/2017 11:29:29 PM Eastern Daylight Time	08/06/2017 10:39:15 PM Eastern Daylight Time	08/06/2017 11:27:07 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Value One NY - Dual (HMO SNP)	01	01		1			H2773	018	0	2018	Nassau, Queens, Staten Island and Suffolk Counties		2	731	2			1	3		2		2	www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2773	019	0	1	01	01	H2773_019_0	9			1		08/06/2017	2018.03	08/06/2017 11:29:46 PM Eastern Daylight Time	08/06/2017 10:38:36 PM Eastern Daylight Time	08/06/2017 11:26:33 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Silver - NY (HMO)	01	01		1			H2773	019	0	2018	Nassau and Suffolk Counties		2	47519	2			2						www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2773	020	0	1	01	01	H2773_020_0	8			1		08/06/2017	2018.03	08/06/2017 11:29:57 PM Eastern Daylight Time	08/06/2017 10:38:28 PM Eastern Daylight Time	08/06/2017 11:26:37 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Silver - NY City (HMO)	01	01		1			H2773	020	0	2018	Queens and Staten Island		2	6087	2			2						www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2773	022	0	1	01	01	H2773_022_0	8			1		08/06/2017	2018.03	08/06/2017 11:30:09 PM Eastern Daylight Time	08/06/2017 10:38:45 PM Eastern Daylight Time	08/06/2017 11:26:44 PM Eastern Daylight Time			08/06/2017 11:30:57 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qhpny.com	Advantage Premium - LI (HMO)	01	01		1			H2773	022	0	2018	Nassau and Suffolk Counties		2	472	2			2						www.qhpny.com	www.qhpny.com	www.qhpny.com	(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(877)233-7058		(631)403-4265		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2775	082	0	1	04	01	H2775_082_0	8			1		06/01/2017	2018.03	06/01/2017 02:14:05 PM Central Daylight Time	08/02/2017 01:43:23 PM Central Daylight Time	07/31/2017 03:32:38 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	082	0	2018	Select Counties in NY, ME		2	80035	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	083	0	1	04	01	H2775_083_0	11			1		06/01/2017	2018.03	06/01/2017 02:10:15 PM Central Daylight Time	08/02/2017 01:45:28 PM Central Daylight Time	07/31/2017 03:32:16 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	083	0	2018	Select Counties in NY, ME		2	21972	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	088	0	1	04	01	H2775_088_0	8			1		06/01/2017	2018.03	06/01/2017 02:10:20 PM Central Daylight Time	08/02/2017 01:47:34 PM Central Daylight Time	07/31/2017 03:31:48 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 550B (PPO)	01	04		1			H2775	088	0	2018	Select Counties in NY, ME		2	107885	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	089	0	1	04	01	H2775_089_0	8			1		06/01/2017	2018.03	06/01/2017 02:10:28 PM Central Daylight Time	08/02/2017 01:49:39 PM Central Daylight Time	07/31/2017 03:31:22 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 550B (PPO)	01	04		1			H2775	089	0	2018	Select Counties in NY,ME		2	101301	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	095	0	1	04	01	H2775_095_0	7			1		06/01/2017	2018.03	06/01/2017 02:10:36 PM Central Daylight Time	06/01/2017 04:33:32 PM Central Daylight Time				06/01/2017 05:25:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage 300 (PPO)	01	04		1			H2775	095	0	2018	Select Counties in NY,ME		2	7254	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967										(711)-		(711)-		(711)-		(711)-										2					2						2			
H2775	099	0	1	04	01	H2775_099_0	8			1		06/01/2017	2018.03	06/01/2017 02:10:43 PM Central Daylight Time	08/04/2017 09:48:53 AM Central Daylight Time	07/31/2017 03:30:55 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450A (PPO)	01	04		1			H2775	099	0	2018	Select counties in New York		2	5373	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	100	0	1	04	01	H2775_100_0	8			1		06/01/2017	2018.03	06/01/2017 02:10:51 PM Central Daylight Time	08/04/2017 09:50:50 AM Central Daylight Time	07/31/2017 03:30:31 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 750B (PPO)	01	04		1			H2775	100	0	2018	Select counties in New York		2	25438	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2775	801	0	1	04	01	H2775_801_0	1			1		05/28/2017	2018.03	05/28/2017 12:18:53 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options PPO - MA Group Plan (PPO)	01	04		1			H2775	801	0	2018	National		1	300	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2775	802	0	1	04	01	H2775_802_0	1			1		05/28/2017	2018.03	05/28/2017 12:19:51 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan (PPO)	01	04		1			H2775	802	0	2018	National		1	300	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2775	803	0	1	04	01	H2775_803_0	1			1		05/28/2017	2018.03	05/28/2017 12:19:46 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan - NCY (PPO)	01	04		1			H2775	803	0	2018	National		1	300	2			2						http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H2802	001	0	1	01	01	H2802_001_0	4			1		08/02/2017	2018.03	08/02/2017 02:00:45 PM Central Daylight Time	08/03/2017 02:29:58 PM Central Daylight Time	08/01/2017 10:06:57 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	001	0	2018	Omaha Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	007	0	1	01	01	H2802_007_0	3			1		08/03/2017	2018.03	08/03/2017 08:57:18 AM Central Daylight Time	08/03/2017 02:30:32 PM Central Daylight Time	08/01/2017 10:07:25 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Profile (HMO)	01	01		1			H2802	007	0	2018	Fort Wayne area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	008	0	1	01	01	H2802_008_0	3			1		08/02/2017	2018.03	08/02/2017 01:44:26 PM Central Daylight Time	08/03/2017 02:31:06 PM Central Daylight Time	08/01/2017 10:07:53 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	008	0	2018	South Bend area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	010	0	1	01	01	H2802_010_0	3			1		08/02/2017	2018.03	08/02/2017 01:45:26 PM Central Daylight Time	08/03/2017 02:31:41 PM Central Daylight Time	08/01/2017 10:08:21 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	010	0	2018	Indianapolis and Central Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	012	0	1	01	01	H2802_012_0	3			1		08/02/2017	2018.03	08/02/2017 01:46:11 PM Central Daylight Time	08/03/2017 02:32:15 PM Central Daylight Time	08/01/2017 10:08:49 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	012	0	2018	Evansville area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	013	0	1	01	01	H2802_013_0	4			1		06/28/2017	2018.03	06/28/2017 09:43:55 AM Central Daylight Time	08/03/2017 02:32:48 PM Central Daylight Time	08/01/2017 10:09:16 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	013	0	2018	Evansville area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	014	0	1	01	01	H2802_014_0	4			1		06/28/2017	2018.03	06/28/2017 09:45:04 AM Central Daylight Time	08/03/2017 02:33:23 PM Central Daylight Time	08/01/2017 10:09:43 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	014	0	2018	Indianapolis and Central Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	015	0	1	01	01	H2802_015_0	4			1		06/28/2017	2018.03	06/28/2017 09:47:04 AM Central Daylight Time	08/03/2017 02:33:57 PM Central Daylight Time	08/01/2017 10:10:10 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	015	0	2018	Northeast Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	016	0	1	01	01	H2802_016_0	4			1		08/02/2017	2018.03	08/02/2017 01:46:56 PM Central Daylight Time	08/03/2017 02:34:33 PM Central Daylight Time	08/01/2017 10:10:37 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	016	0	2018	Southeast Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	017	0	1	01	01	H2802_017_0	4			1		06/28/2017	2018.03	06/28/2017 09:48:11 AM Central Daylight Time	08/03/2017 02:35:07 PM Central Daylight Time	08/01/2017 10:11:03 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	017	0	2018	Southeast Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	018	0	1	01	01	H2802_018_0	4			1		06/01/2017	2018.03	06/01/2017 09:04:22 AM Central Daylight Time	08/03/2017 02:35:41 PM Central Daylight Time	08/01/2017 10:11:30 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	018	0	2018	Northwest Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	019	0	1	01	01	H2802_019_0	4			1		06/28/2017	2018.03	06/28/2017 09:49:02 AM Central Daylight Time	08/03/2017 02:36:15 PM Central Daylight Time	08/01/2017 10:11:58 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	019	0	2018	Northwest Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	020	0	1	01	01	H2802_020_0	4			1		06/01/2017	2018.03	06/01/2017 09:05:45 AM Central Daylight Time	08/03/2017 02:36:49 PM Central Daylight Time	08/01/2017 10:12:26 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	020	0	2018	West Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	021	0	1	01	01	H2802_021_0	4			1		06/28/2017	2018.03	06/28/2017 09:49:42 AM Central Daylight Time	08/03/2017 02:37:23 PM Central Daylight Time	08/01/2017 10:12:53 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	021	0	2018	West Indiana		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	022	0	1	01	01	H2802_022_0	5			1		08/02/2017	2018.03	08/02/2017 02:01:24 PM Central Daylight Time	08/03/2017 02:37:58 PM Central Daylight Time	08/01/2017 10:13:21 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	022	0	2018	Lincoln Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	023	0	1	01	01	H2802_023_0	4			1		08/02/2017	2018.03	08/02/2017 02:02:05 PM Central Daylight Time	08/03/2017 02:38:31 PM Central Daylight Time	08/01/2017 10:13:49 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Access (HMO)	01	01		1			H2802	023	0	2018	McLean county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	024	0	1	01	01	H2802_024_0	4			1		08/02/2017	2018.03	08/02/2017 02:02:44 PM Central Daylight Time	08/03/2017 02:39:05 PM Central Daylight Time	08/01/2017 10:14:17 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Access (HMO)	01	01		1			H2802	024	0	2018	Chicago Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	025	0	1	01	01	H2802_025_0	4			1		05/25/2017	2018.03	05/25/2017 11:12:31 AM Central Daylight Time	08/03/2017 02:39:40 PM Central Daylight Time	08/01/2017 10:14:44 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	025	0	2018	Chicago Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	026	0	1	01	01	H2802_026_0	4			1		06/28/2017	2018.03	06/28/2017 10:02:32 AM Central Daylight Time	08/03/2017 02:40:15 PM Central Daylight Time	08/01/2017 10:15:11 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	026	0	2018	Chicago Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	027	0	1	02	01	H2802_027_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:23:41 PM Central Daylight Time	08/03/2017 02:40:50 PM Central Daylight Time	08/01/2017 10:15:40 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H2802	027	0	2018	Chicago Metro area		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	028	0	1	01	01	H2802_028_0	4			1		08/02/2017	2018.03	08/02/2017 02:03:41 PM Central Daylight Time	08/03/2017 02:41:25 PM Central Daylight Time	08/01/2017 10:16:07 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	028	0	2018	St. Louis Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	029	0	1	01	01	H2802_029_0	4			1		08/02/2017	2018.03	08/02/2017 02:04:26 PM Central Daylight Time	08/03/2017 02:41:59 PM Central Daylight Time	08/01/2017 10:16:35 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	029	0	2018	Jefferson City and Columbia Metro Areas		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	030	0	1	01	01	H2802_030_0	5			1		08/02/2017	2018.03	08/02/2017 02:05:06 PM Central Daylight Time	08/03/2017 02:42:34 PM Central Daylight Time	08/01/2017 10:17:03 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	030	0	2018	Springfield Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	031	0	1	01	01	H2802_031_0	5			1		08/02/2017	2018.03	08/02/2017 02:09:07 PM Central Daylight Time	08/03/2017 02:43:09 PM Central Daylight Time	08/01/2017 10:17:31 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	031	0	2018	Springfield Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	032	0	1	01	01	H2802_032_0	4			1		08/02/2017	2018.03	08/02/2017 02:09:45 PM Central Daylight Time	08/03/2017 02:43:44 PM Central Daylight Time	08/01/2017 10:17:59 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	032	0	2018	Kansas City Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	033	0	1	01	01	H2802_033_0	4			1		05/25/2017	2018.03	05/25/2017 11:17:39 AM Central Daylight Time	08/03/2017 02:44:18 PM Central Daylight Time	08/01/2017 10:18:26 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	033	0	2018	Kansas City Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	034	0	1	01	01	H2802_034_0	5			1		08/02/2017	2018.03	08/02/2017 02:10:26 PM Central Daylight Time	08/03/2017 02:44:53 PM Central Daylight Time	08/01/2017 10:18:52 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	034	0	2018	Butler, Harvey, and Sedgwick Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	035	0	1	01	01	H2802_035_0	5			1		06/01/2017	2018.03	06/01/2017 09:28:57 AM Central Daylight Time	08/03/2017 02:45:28 PM Central Daylight Time	08/01/2017 10:19:18 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	035	0	2018	Butler, Harvey, and Sedgwick Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	036	0	1	01	01	H2802_036_0	5			1		06/28/2017	2018.03	06/28/2017 10:05:30 AM Central Daylight Time	08/03/2017 02:46:02 PM Central Daylight Time	08/01/2017 10:19:45 AM Central Daylight Time			08/04/2017 02:27:25 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H2802	036	0	2018	Butler, Harvey, and Sedgwick Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	037	0	1	01	01	H2802_037_0	6			1		08/02/2017	2018.03	08/02/2017 02:02:44 PM Central Daylight Time	08/03/2017 02:46:38 PM Central Daylight Time	08/01/2017 10:20:11 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	037	0	2018	Fayetteville Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	038	0	1	01	01	H2802_038_0	6			1		06/28/2017	2018.03	06/28/2017 09:42:05 AM Central Daylight Time	08/03/2017 02:10:42 PM Central Daylight Time	08/01/2017 10:20:37 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	038	0	2018	Fayetteville Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	039	0	1	01	01	H2802_039_0	6			1		08/02/2017	2018.03	08/02/2017 02:03:01 PM Central Daylight Time	08/03/2017 01:05:30 PM Central Daylight Time	08/01/2017 10:21:03 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	039	0	2018	Little Rock Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	040	0	1	01	01	H2802_040_0	6			1		08/02/2017	2018.03	08/02/2017 02:00:43 PM Central Daylight Time	08/03/2017 01:05:58 PM Central Daylight Time	08/01/2017 10:21:30 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	040	0	2018	Little Rock Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	041	0	1	01	01	H2802_041_0	4			1		08/03/2017	2018.03	08/03/2017 10:54:56 AM Central Daylight Time	08/03/2017 01:06:25 PM Central Daylight Time	08/01/2017 10:21:56 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H2802	041	0	2018	Select Counties in Alabama		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	042	0	1	01	01	H2802_042_0	4			1		07/20/2017	2018.03	07/20/2017 01:21:29 PM Central Daylight Time	08/03/2017 01:06:53 PM Central Daylight Time	08/01/2017 10:22:22 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H2802	042	0	2018	Select Counties in Alabama		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	044	0	1	01	01	H2802_044_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:44:15 AM Central Daylight Time	08/03/2017 01:07:20 PM Central Daylight Time	08/01/2017 10:22:50 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H2802	044	0	2018	Select counties in Alabama		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	045	0	1	01	01	H2802_045_0	4			1		06/01/2017	2018.03	06/01/2017 09:31:29 AM Central Daylight Time	08/03/2017 01:07:47 PM Central Daylight Time	08/01/2017 10:23:17 AM Central Daylight Time			08/04/2017 01:04:12 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	045	0	2018	Boone and Winnebago counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	046	0	1	01	01	H2802_046_0	4			1		06/28/2017	2018.03	06/28/2017 09:50:51 AM Central Daylight Time	08/03/2017 01:08:15 PM Central Daylight Time	08/01/2017 10:23:44 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H2802	046	0	2018	Lake County		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2802	801	0	1	01	01	H2802_801_0	3			1		06/08/2017	2018.03	06/08/2017 11:29:36 AM Central Daylight Time					06/13/2017 04:51:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	801	0	2018	Select Counties in Alabama		1	204	2			2						www.UHCRetiree.com	www.UHCRetiree.com	www.UHCRetiree.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H2802	802	0	1	01	01	H2802_802_0	2			1		05/25/2017	2018.03	05/25/2017 12:19:28 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	802	0	2018	Select Counties in Alabama		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H2802	803	0	1	01	01	H2802_803_0	2			1		05/25/2017	2018.03	05/25/2017 12:19:45 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	803	0	2018	Select Counties in Alabama		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H2802	804	0	1	01	01	H2802_804_0	3			1		06/08/2017	2018.03	06/08/2017 11:29:57 AM Central Daylight Time					06/13/2017 04:51:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	804	0	2018	St Louis Area		1	37656	2			2						www.UHCRetiree.com	www.UHCRetiree.com	www.UHCRetiree.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2802	805	0	1	01	01	H2802_805_0	3			1		06/08/2017	2018.03	06/08/2017 11:30:15 AM Central Daylight Time					06/13/2017 04:51:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	805	0	2018	St Louis Area		1	204	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2802	806	0	1	01	01	H2802_806_0	2			1		05/25/2017	2018.03	05/25/2017 12:21:50 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	806	0	2018	St Louis Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2802	807	0	1	01	01	H2802_807_0	2			1		05/25/2017	2018.03	05/25/2017 12:25:08 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	807	0	2018	Springfield Area		1	0	2			2						www.UHCRetiree.com	www.UHCRetiree.com	www.UHCRetiree.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H2802	808	0	1	01	01	H2802_808_0	2			1		05/25/2017	2018.03	05/25/2017 12:24:39 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	808	0	2018	Springfield Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H2802	809	0	1	01	01	H2802_809_0	2			1		05/25/2017	2018.03	05/25/2017 12:24:45 PM Pacific Daylight Time					06/01/2017 04:44:21 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2802	809	0	2018	Springfield Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H2815	001	0	1	20	08	H2815_001_0	2			1		05/24/2017	2018.03	05/24/2017 09:19:42 AM Mountain Daylight Time		07/06/2017 10:41:32 AM Mountain Daylight Time			07/06/2017 10:44:58 AM Mountain Daylight Time	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	Senior CommUnity Care of Colorado	www.seniorcommunitycare.org	Senior CommUnity Care of Colorado (PACE)	08	20		1			H2815	001	0	2018	Senior CommUnity Care of Colorado		2		2			2						www.voa.org	www.voa.org										(866)961-1451		(970)252-0522		(866)961-1451		(970)252-0522										(970)835-2900		(970)252-0522		(970)835-2900		(970)252-0522																
H2815	002	0	1	20	08	H2815_002_0	2			1		05/24/2017	2018.03	05/24/2017 09:19:50 AM Mountain Daylight Time		07/06/2017 10:42:37 AM Mountain Daylight Time			07/06/2017 10:44:58 AM Mountain Daylight Time	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	Senior CommUnity Care of Colorado	www.seniorcommunitycare.org	Senior CommUnity Care of Colorado (PACE)	08	20		1			H2815	002	0	2018	Senior CommUnity Care of Colorado		2		2			2						www.voa.org	www.voa.org										(866)961-1451		(970)252-0522		(866)961-1451		(970)252-0522										(970)835-2900		(970)252-0522		(970)835-2900		(970)252-0522																
H2816	001	0	1	09	04	H2816_001_0	7			1		06/01/2017	2018.03	06/01/2017 02:11:01 PM Central Daylight Time	06/01/2017 04:24:18 PM Central Daylight Time				06/01/2017 05:25:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H2816	001	0	2018	Select counties in NY and ME		2	21524	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2816	002	0	1	09	04	H2816_002_0	7			1		06/01/2017	2018.03	06/01/2017 02:11:14 PM Central Daylight Time	06/01/2017 04:26:18 PM Central Daylight Time				06/01/2017 05:25:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H2816	002	0	2018	Select counties in NY and ME		2	36040	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2816	007	0	1	09	04	H2816_007_0	7			1		06/01/2017	2018.03	06/01/2017 02:11:22 PM Central Daylight Time	06/01/2017 04:28:18 PM Central Daylight Time				06/01/2017 05:25:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier 300 (PFFS)	04	09	1	1			H2816	007	0	2018	Select counties in NY and ME		2	91792	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2816	008	0	1	09	04	H2816_008_0	7			1		06/01/2017	2018.03	06/01/2017 02:11:29 PM Central Daylight Time	06/01/2017 04:30:19 PM Central Daylight Time				06/01/2017 05:25:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier 300 (PFFS)	04	09	1	1			H2816	008	0	2018	Select counties in NY and ME		2	43267	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2816	013	0	1	09	04	H2816_013_0	11			1		06/01/2017	2018.03	06/01/2017 02:11:36 PM Central Daylight Time	08/02/2017 11:12:29 AM Central Daylight Time	07/31/2017 03:30:09 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H2816	013	0	2018	Select counties in NY and ME		2	19878	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2816	019	0	1	09	04	H2816_019_0	8			1		06/01/2017	2018.03	06/01/2017 02:11:44 PM Central Daylight Time	08/02/2017 11:14:35 AM Central Daylight Time	07/31/2017 03:29:41 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options Premier Plus 650B (PFFS)	04	09	1	1			H2816	019	0	2018	Select counties in NY and ME		2	31464	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2816	801	0	1	09	04	H2816_801_0	1			1		05/28/2017	2018.03	05/28/2017 12:18:34 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options PFFS - MA Group Plan (PFFS)	04	09	1	1			H2816	801	0	2018	National		1	300	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923										(711)-		(711)-		(711)-		(711)-										1					1					1				
H2816	802	0	1	09	04	H2816_802_0	1			1		05/28/2017	2018.03	05/28/2017 12:18:38 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan (PFFS)	04	09	1	1			H2816	802	0	2018	National		1	300	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1					1					1				
H2816	803	0	1	09	04	H2816_803_0	1			1		05/28/2017	2018.03	05/28/2017 12:18:42 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Universal American Corp.	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan - NCY (PFFS)	04	09	1	1			H2816	803	0	2018	National		1	300	2			2						www.TodaysOptions.com	www.TodaysOptions.com		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(866)568-8921		(866)568-8921		(866)418-1923		(866)418-1923		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1					1					1				
H2829	001	0	1	01	01	H2829_001_0	5			1		08/01/2017	2018.03	08/01/2017 12:04:29 PM Eastern Daylight Time	08/04/2017 08:19:03 PM Eastern Daylight Time	07/31/2017 06:25:25 PM Eastern Daylight Time			08/04/2017 08:50:13 PM Eastern Daylight Time	INNOVATION HEALTH PLAN, INC.	Innovation Health	www.aetnamedicare.com	Innovation Health Medicare Connection Plan (HMO)	01	01		1			H2829	001	0	2018	Fairfax County and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;7a;7d;7g;	
H2835	001	0	1	20	08	H2835_001_0	1			1		05/31/2017	2018.03	05/31/2017 11:25:42 AM Eastern Daylight Time		05/31/2017 11:19:04 AM Eastern Daylight Time			05/31/2017 11:31:18 AM Eastern Daylight Time	THE CASCADE PACE, INC.	Thome PACE	www.thomepace.org	Thome PACE (PACE)	08	20		1			H2835	001	0	2018	Jackson, Lenawee, and Hillsdale Counties		2		2			2						www.genoa-qol.com	www.thomepace.org	www.thomepace.org									(844)855-7223		(517)768-9791		(844)855-7223		(517)768-9791										(800)649-3777		(800)649-3777		(800)649-3777		(800)649-3777																
H2835	002	0	1	20	08	H2835_002_0	1			1		05/31/2017	2018.03	05/31/2017 11:26:32 AM Eastern Daylight Time		05/31/2017 11:18:38 AM Eastern Daylight Time			05/31/2017 11:31:18 AM Eastern Daylight Time	THE CASCADE PACE, INC.	Thome PACE	www.thomepace.org	Thome PACE Medicare Only (PACE)	08	20		1			H2835	002	0	2018	Jackson, Lenawee, and Hillsdale County		2		2			2						www.genoa-qol.com	www.thomepace.org	www.thomepace.org									(844)855-7223		(517)768-9791		(844)855-7223		(517)768-9791										(800)649-3777		(800)649-3777		(800)649-3777		(800)649-3777																
H2836	801	0	1	04	01	H2836_801_0	1			1		06/02/2017	2018.03	06/03/2017 11:19:57 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	801	0	2018	Connecticut		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(855)397-9261		(855)397-9261		(800)409-7056		(800)409-7056		(855)397-9261		(855)397-9261		(800)409-7056		(800)409-7056		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H2836	802	0	1	04	01	H2836_802_0	1			1		06/03/2017	2018.03	06/03/2017 11:31:38 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	802	0	2018	Connecticut		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(855)397-9261		(855)397-9261		(800)409-7056		(800)409-7056										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H2836	803	0	1	04	01	H2836_803_0	1			1		06/02/2017	2018.03	06/03/2017 11:20:34 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	803	0	2018	Connecticut		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(855)397-9261		(855)397-9261		(800)409-7056		(800)409-7056		(855)397-9261		(855)397-9261		(800)409-7056		(800)409-7056		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H2879	001	0	1	01	01	H2879_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:50:26 AM Pacific Daylight Time	08/03/2017 03:36:14 PM Pacific Daylight Time	08/01/2017 09:00:32 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WISCONSIN	Molina Healthcare of Wisconsin	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H2879	001	0	2018	Milwaukee		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(855)315-5663		(855)315-5663		(866)403-8293		(866)403-8293		(855)315-5663		(855)315-5663		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2906	005	0	1	04	01	H2906_005_0	12			1		08/09/2017	2018.03	08/09/2017 03:48:08 PM Pacific Daylight Time	08/05/2017 09:16:33 AM Pacific Daylight Time	08/05/2017 09:15:29 AM Pacific Daylight Time			08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Select Plan (PPO)	01	04		1			H2906	005	0	2018	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	1752	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	4b;7a;	
H2906	006	0	1	04	01	H2906_006_0	10			1		08/09/2017	2018.03	08/09/2017 03:45:45 PM Pacific Daylight Time	08/05/2017 09:16:33 AM Pacific Daylight Time	08/05/2017 09:15:29 AM Pacific Daylight Time			08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Enhanced Plan (PPO)	01	04		1			H2906	006	0	2018	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	9600	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	7a;	
H2906	007	0	1	04	01	H2906_007_0	10			1		08/09/2017	2018.03	08/09/2017 10:39:28 AM Pacific Daylight Time	08/05/2017 09:16:33 AM Pacific Daylight Time	08/05/2017 09:15:30 AM Pacific Daylight Time			08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Plan (PPO)	01	04		1			H2906	007	0	2018	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	28584	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	7a;	
H2906	008	0	1	04	01	H2906_008_0	9			1		08/09/2017	2018.03	08/09/2017 10:40:20 AM Pacific Daylight Time	07/26/2017 01:08:44 PM Pacific Daylight Time				08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Basic Plan (PPO)	01	04		1			H2906	008	0	2018	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	2472	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112										(711)-		(711)-		(711)-		(711)-										2					2						1	01	7a;	
H2906	801	0	1	04	01	H2906_801_0	4			1		08/09/2017	2018.03	08/09/2017 10:42:51 AM Pacific Daylight Time					08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Group (PPO)	01	04		1			H2906	801	0	2018	State of Nevada		1	624	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2915	001	0	1	01	01	H2915_001_0	2		1	1	2	08/04/2017	2018.03	08/04/2017 03:59:53 PM Eastern Daylight Time	08/04/2017 04:49:50 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/04/2017 07:48:53 PM Pacific Daylight Time	PENNSYLVANIA HEALTH AND WELLNESS, INC.	Allwell	www.allwell.pahealthwellness.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H2915	001	0	2018	Southwestern Zone		2		2			1	3		1		1	www.centene.com	www.centene.com	www.allwell.pahealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H2915	002	0	1	01	01	H2915_002_0	2		1	1	2	08/02/2017	2018.03	08/02/2017 02:06:56 PM Eastern Daylight Time	08/04/2017 04:49:50 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/04/2017 07:48:53 PM Pacific Daylight Time	PENNSYLVANIA HEALTH AND WELLNESS, INC.	Allwell	www.allwell.pahealthwellness.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H2915	002	0	2018	Southeastern Zone		2		2			1	3		1		1	www.centene.com	www.centene.com	www.allwell.pahealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H2915	003	0	1	01	01	H2915_003_0	2			1		08/02/2017	2018.03	08/02/2017 01:37:15 PM Pacific Daylight Time	08/04/2017 04:49:50 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/04/2017 07:48:53 PM Pacific Daylight Time	PENNSYLVANIA HEALTH AND WELLNESS, INC.	Allwell	www.allwell.pahealthwellness.com	Allwell Medicare (HMO)	01	01		1			H2915	003	0	2018	Southwestern Zone		2		2			2						www.centene.com	www.centene.com	www.allwell.pahealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H2926	001	0	1	01	01	H2926_001_0	3		1	1	2	05/29/2017	2018.03	05/29/2017 01:20:27 PM Central Daylight Time	08/07/2017 09:57:24 AM Central Daylight Time	08/07/2017 09:54:24 AM Central Daylight Time			08/07/2017 10:06:30 AM Central Daylight Time	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	PrimeWest Health	www.primewest.org/phc	Prime Health Complete (HMO SNP)	01	01		1			H2926	001	0	2018	Northern, west central, and southwestern Minnesota		2	2268	2			1	3		1		1	https://primewest.org/drug-search	https://primewest.org/pharmacy-search	https://www.primewest.org/find-a-health-care-provider	(877)600-4913		(320)335-5243		(877)600-4913		(320)335-5243		(877)600-4913		(320)335-5243		(877)600-4913		(320)335-5243		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		(800)627-3529		1	1	8a;8b1;8b2;9a;9b;9c;11a;11b;	2		1					1				
H2931	002	0	1	01	01	H2931_002_0	3			1		08/03/2017	2018.03	08/03/2017 01:00:53 PM Central Daylight Time	08/04/2017 08:30:46 AM Central Daylight Time	08/01/2017 10:24:12 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	Senior Dimensions Southern Nevada (HMO)	01	01		1			H2931	002	0	2018	Clark and Nye counties		2		2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(800)555-5757		(800)555-5757		(800)650-6232		(800)650-6232		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2931	004	0	1	01	01	H2931_004_0	3			1		05/25/2017	2018.03	05/25/2017 11:22:01 AM Central Daylight Time	08/03/2017 12:51:54 PM Central Daylight Time	08/01/2017 10:24:39 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	Senior Dimensions Greater Nevada (HMO)	01	01		1			H2931	004	0	2018	Lyon, Mineral and portions of Washoe		2		2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(800)555-5757		(800)555-5757		(800)650-6232		(800)650-6232		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2931	801	0	1	01	01	H2931_801_0	3			1		06/02/2017	2018.03	06/02/2017 01:30:12 PM Central Daylight Time					06/02/2017 01:46:20 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	Basic Group (with Drug) Coverage (HMO)	01	01		1			H2931	801	0	2018	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	0	2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(877)271-8591		(877)271-8591		(800)650-6232		(800)650-6232		(877)271-8591		(877)271-8591		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2931	803	0	1	01	01	H2931_803_0	1			1		05/25/2017	2018.03	05/25/2017 12:27:33 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	Basic Group MA Only Coverage (HMO)	01	01		1			H2931	803	0	2018	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	0	2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(877)271-8591		(877)271-8591										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2931	804	0	1	01	01	H2931_804_0	1			1		05/25/2017	2018.03	05/25/2017 12:27:48 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	(NCY) Basic Group (With Drug) Coverage (HMO)	01	01		1			H2931	804	0	2018	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	0	2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(877)271-8591		(877)271-8591		(800)650-6232		(800)650-6232		(877)271-8591		(877)271-8591		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2931	806	0	1	01	01	H2931_806_0	2			1		06/02/2017	2018.03	06/02/2017 01:30:49 PM Central Daylight Time					06/02/2017 01:46:20 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	UnitedHealthcare	www.SeniorDimensions.com	Basic Group (with drug) Coverage (HMO)	01	01		1			H2931	806	0	2018	Counties:  Clk, Ny, Lyn, Mnrl, parts of Wsh		1	0	2			2						www.SeniorDimensions.com	www.SeniorDimensions.com	www.SeniorDimensions.com	(800)650-6232		(800)650-6232		(877)271-9591		(877)271-9591		(800)650-6232		(800)650-6232		(877)271-9591		(877)271-9591		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H2936	001	0	1	20	08	H2936_001_0	1			1		05/23/2017	2018.03	05/23/2017 10:41:14 AM Eastern Daylight Time		05/23/2017 10:36:27 AM Eastern Daylight Time			05/23/2017 10:44:19 AM Eastern Daylight Time	LIFECIRCLES	LIFECIRCLES	http:www.lifecircles-pace.org	LifeCircles (PACE)	08	20		1			H2936	001	0	2018	Muskegon, Ottawa, Allegan		2		2			2						www.lifecircles-pace.org	www.lifecircles-pace.org										(888)204-8626		(231)733-8686		(888)204-8626		(231)733-8686										(888)204-8626		(231)733-8686		(888)204-8626		(231)733-8686																
H2936	002	0	1	20	08	H2936_002_0	1			1		05/23/2017	2018.03	05/23/2017 10:41:39 AM Eastern Daylight Time		05/23/2017 10:37:13 AM Eastern Daylight Time			05/23/2017 10:44:19 AM Eastern Daylight Time	LIFECIRCLES	LIFECIRCLES	http:www.lifecircles-pace.org	002 - Medicare Only (PACE)	08	20		1			H2936	002	0	2018	002 - Medicare Only		2		2			2						www.lifecircles-pace.org	www.lifecircles-pace.org										(888)204-8626		(231)733-8686		(888)204-8626		(231)733-8686										(888)204-8626		(231)733-8686		(888)204-8626		(231)733-8686																
H2937	001	0	1	20	08	H2937_001_0	2			1		05/25/2017	2018.03	05/25/2017 11:54:53 AM Eastern Daylight Time		07/21/2017 10:50:54 AM Eastern Daylight Time			07/21/2017 11:03:04 AM Eastern Daylight Time	SENIOR LIFE GREENSBURG, INC.	Westmoreland county PACE	www.seniorlifepa.com	Senior LIFE Greensburg Dual Eligible (PACE)	08	20		1			H2937	001	0	2018	Senior LIFE Westmoreland		2	2240	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H2937	002	0	1	20	08	H2937_002_0	2			1		05/25/2017	2018.03	05/25/2017 11:54:58 AM Eastern Daylight Time		07/21/2017 10:50:51 AM Eastern Daylight Time			07/21/2017 11:03:04 AM Eastern Daylight Time	SENIOR LIFE GREENSBURG, INC.	Westmoreland county PACE	www.Seniorlifegreensburg.com	Senior LIFE Greensburg MC Only (PACE)	08	20		1			H2937	002	0	2018	Senior LIFE Westmoreland MC Only		2	12	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H2941	001	0	1	20	08	H2941_001_0	1			1		05/31/2017	2018.03	05/31/2017 11:59:27 AM Eastern Daylight Time		05/31/2017 11:42:59 AM Eastern Daylight Time			05/31/2017 12:02:38 PM Eastern Daylight Time	SENTARA LIFE CARE CORPORATION, INC	Sentara PACE	www.sentara.com	Sentara Senior Community Care Dual (PACE)	08	20		1			H2941	001	0	2018	Chesapeake, Norfolk, Portsmouth, Suffolk, VA Beach		2		2			2						www.sentara.com	www.sentara.com										(800)736-4677		(757)892-5400		(800)736-4677		(757)892-5400										(800)225-7784		(757)552-7120		(800)225-7784		(757)552-7120																
H2941	002	0	1	20	08	H2941_002_0	1			1		05/31/2017	2018.03	05/31/2017 11:59:17 AM Eastern Daylight Time		05/31/2017 11:43:19 AM Eastern Daylight Time			05/31/2017 12:02:38 PM Eastern Daylight Time	SENTARA LIFE CARE CORPORATION, INC	Sentara PACE	www.sentara.com	Sentara Senior Community Care Private (PACE)	08	20		1			H2941	002	0	2018	Chesapeake, Norfolk, Portsmouth, Suffolk, VA Beach		2		2			2						www.sentara.com	www.sentara.com										(800)736-8272		(757)892-5400		(800)736-8272		(757)892-5400										(800)225-7784		(757)552-7120		(800)225-7784		(757)552-7120																
H2944	004	0	1	09	04	H2944_004_0	3			1		05/31/2017	2018.03	05/31/2017 01:45:10 PM Eastern Daylight Time	08/04/2017 04:30:35 PM Eastern Daylight Time	08/04/2017 09:52:39 AM Eastern Daylight Time			08/06/2017 09:18:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-004 (PFFS)	04	09	3	1			H2944	004	0	2018	Select Counties in Nebraska		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2944	013	0	1	09	04	H2944_013_0	3			1		05/27/2017	2018.03	05/27/2017 12:53:42 PM Eastern Daylight Time	08/04/2017 02:55:12 PM Eastern Daylight Time	08/04/2017 09:52:40 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-013 (PFFS)	04	09	3	1			H2944	013	0	2018	Select Counties in KS, MO and OK		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2944	114	0	1	09	04	H2944_114_0	3			1		05/27/2017	2018.03	05/27/2017 02:07:58 PM Eastern Daylight Time	08/04/2017 03:00:21 PM Eastern Daylight Time	08/04/2017 09:52:40 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-114 (PFFS)	04	09	3	1			H2944	114	0	2018	Select Counties in Georgia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2944	124	0	1	09	04	H2944_124_0	5			1		06/28/2017	2018.03	06/28/2017 12:19:14 PM Eastern Daylight Time	08/04/2017 01:46:56 PM Eastern Daylight Time	08/04/2017 09:52:41 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-124 (PFFS)	04	09	3	1			H2944	124	0	2018	Select Counties in Indiana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2944	127	0	1	09	04	H2944_127_0	3			1		05/27/2017	2018.03	05/27/2017 11:56:40 AM Eastern Daylight Time	08/04/2017 05:28:50 PM Eastern Daylight Time	08/04/2017 09:52:41 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-127 (PFFS)	04	09	3	1			H2944	127	0	2018	Select Counties in Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2944	197	0	1	09	04	H2944_197_0	2			1		05/27/2017	2018.03	05/27/2017 12:54:33 PM Eastern Daylight Time	06/01/2017 05:40:31 PM Eastern Daylight Time				06/02/2017 09:37:49 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H2944-197 (PFFS)	04	09	3	1			H2944	197	0	2018	Select Counties in KS, MO and OK		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H2960	004	0	1	01	01	H2960_004_0	10			1		08/05/2017	2018.03	08/05/2017 09:21:44 AM Pacific Daylight Time	08/09/2017 07:53:37 AM Pacific Daylight Time	08/05/2017 09:15:30 AM Pacific Daylight Time			08/09/2017 10:08:15 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Enhanced Plan (HMO)	01	01		1			H2960	004	0	2018	Washoe County, NV		2	61308	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H2960	009	0	1	01	01	H2960_009_0	8			1		07/10/2017	2018.03	07/10/2017 03:53:56 PM Pacific Daylight Time	07/26/2017 01:08:44 PM Pacific Daylight Time				07/26/2017 01:18:00 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Basic Plan (HMO)	01	01		1			H2960	009	0	2018	Washoe County, NV		2	5724	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112										(711)-		(711)-		(711)-		(711)-										2					2					2	1	01	7a;	
H2960	012	0	1	01	01	H2960_012_0	8			1		08/05/2017	2018.03	08/05/2017 09:21:57 AM Pacific Daylight Time	08/05/2017 09:16:33 AM Pacific Daylight Time	08/05/2017 09:15:30 AM Pacific Daylight Time			08/05/2017 09:24:59 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Plan (HMO)	01	01		1			H2960	012	0	2018	Washoe County, NV		2	92268	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H2960	018	0	1	01	01	H2960_018_0	11			1		08/09/2017	2018.03	08/09/2017 03:48:36 PM Pacific Daylight Time	08/05/2017 09:16:33 AM Pacific Daylight Time	08/05/2017 09:15:30 AM Pacific Daylight Time			08/09/2017 03:54:45 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Select (HMO)	01	01		1			H2960	018	0	2018	Washoe County, NV		2	10392	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;7a;	
H2960	803	0	1	01	01	H2960_803_0	1			1		05/16/2017	2018.03	05/16/2017 01:15:28 PM Pacific Daylight Time					06/04/2017 03:39:15 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN, INC.	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Group Plan (HMO)	01	01		1			H2960	803	0	2018	State of Nevada		1	2280	2			2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com	(888)775-7003		(775)982-3112		(888)775-7003		(775)982-3112		(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2962	001	0	1	01	01	H2962_001_0	8			1		06/27/2017	2018.03	06/27/2017 12:35:00 PM Eastern Daylight Time	08/04/2017 10:14:38 AM Eastern Daylight Time	08/03/2017 11:46:05 AM Eastern Daylight Time			08/04/2017 03:42:47 PM Eastern Daylight Time	ULTIMATE HEALTH PLANS, INC.	Ultimate Health Plans	www.chooseultimate.com	Ultimate Premier (HMO)	01	01		1			H2962	001	0	2018	Hernando County		2	46519	2			2						www.chooseultimate.com	www.chooseultimate.com	www.chooseultimate.com	(888)657-4170		(352)835-7151		(855)858-7526		(352)835-7163		(800)311-7157		(352)835-7151		(855)858-7526		(352)835-7163		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2962	002	0	1	01	01	H2962_002_0	8			1		06/27/2017	2018.03	06/27/2017 12:39:22 PM Eastern Daylight Time	08/04/2017 10:16:07 AM Eastern Daylight Time	08/03/2017 11:47:43 AM Eastern Daylight Time			08/04/2017 03:42:47 PM Eastern Daylight Time	ULTIMATE HEALTH PLANS, INC.	Ultimate Health Plans	www.chooseultimate.com	Ultimate Premier Plus (HMO)	01	01		1			H2962	002	0	2018	Citrus, Hernando and Pasco Counties		2	12286	2			2						www.chooseultimate.com	www.chooseultimate.com	www.chooseultimate.com	(888)657-4170		(352)835-7151		(855)858-7526		(352)835-7163		(800)311-7157		(352)835-7151		(855)858-7526		(352)835-7163		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2962	003	0	1	01	01	H2962_003_0	8			1		06/27/2017	2018.03	06/27/2017 12:32:55 PM Eastern Daylight Time	08/04/2017 10:17:33 AM Eastern Daylight Time	08/03/2017 11:49:10 AM Eastern Daylight Time			08/04/2017 03:42:47 PM Eastern Daylight Time	ULTIMATE HEALTH PLANS, INC.	Ultimate Health Plans	www.chooseultimate.com	Ultimate Elite (HMO)	01	01		1			H2962	003	0	2018	Pasco and Citrus Counties		2	46519	2			2						www.chooseultimate.com	www.chooseultimate.com	www.chooseultimate.com	(888)657-4170		(352)835-7151		(855)858-7526		(352)835-7163		(800)311-7157		(352)835-7151		(855)858-7526		(352)835-7163		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2968	001	0	1	04	01	H2968_001_0	6			1		08/07/2017	2018.03	08/07/2017 11:03:33 AM Central Daylight Time	08/03/2017 08:53:52 AM Central Daylight Time	08/03/2017 08:59:43 AM Central Daylight Time			08/07/2017 05:40:39 PM Central Daylight Time	MEMORIAL HERMANN HEALTH INSURANCE COMPANY	Memorial Hermann Health Plan	healthplan.memorialhermann.org/medicare	Memorial Hermann Advantage (PPO)	01	04		1			H2968	001	0	2018	Texas Counties - Harris, Montgomery, Fort Bend		2	2125	2			2						healthplan.memorialhermann.org/medicare	healthplan.memorialhermann.org/medicare	healthplan.memorialhermann.org/medicare	(855)645-8448		(855)645-8448		(888)801-5431		(888)801-5431		(855)645-8448		(855)645-8448		(888)801-5431		(888)801-5431		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H2986	001	0	1	01	01	H2986_001_0	6			1		08/06/2017	2018.03	08/06/2017 11:26:08 AM Pacific Daylight Time	08/04/2017 10:19:44 AM Pacific Daylight Time	07/31/2017 03:44:44 PM Pacific Daylight Time			08/06/2017 12:16:04 PM Pacific Daylight Time	STANFORD HEALTHCARE ADVANTAGE	Stanford Health Care Advantage	www.StanfordHealthCareAdvantage.org	Stanford Health Care Advantage - Platinum (HMO)	01	01		1			H2986	001	0	2018	Santa Clara County		2	38826	2			2						www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	(855)996-8422		(855)996-8422		(844)205-8422		(844)205-8422		(800)243-2051		(800)243-2051		(844)205-8422		(844)205-8422		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2986	002	0	1	01	01	H2986_002_0	6			1		08/06/2017	2018.03	08/06/2017 11:27:59 AM Pacific Daylight Time	08/04/2017 10:20:24 AM Pacific Daylight Time	07/31/2017 03:49:20 PM Pacific Daylight Time			08/06/2017 12:16:04 PM Pacific Daylight Time	STANFORD HEALTHCARE ADVANTAGE	Stanford Health Care Advantage	www.StanfordHealthCareAdvantage.org	Stanford Health Care Advantage - Gold (HMO)	01	01		1			H2986	002	0	2018	Santa Clara County		2	4314	2			2						www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	(855)996-8422		(855)996-8422		(844)205-8422		(844)205-8422		(800)243-2051		(800)243-2051		(844)205-8422		(844)205-8422		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2986	004	0	1	01	01	H2986_004_0	6			1		08/06/2017	2018.03	08/06/2017 11:26:55 AM Pacific Daylight Time	08/04/2017 10:21:12 AM Pacific Daylight Time	07/31/2017 03:50:08 PM Pacific Daylight Time			08/06/2017 12:16:04 PM Pacific Daylight Time	STANFORD HEALTHCARE ADVANTAGE	Stanford Health Care Advantage	www.StanfordHealthCareAdvantage.org	Stanford Health Care Advantage - Platinum (HMO)	01	01		1			H2986	004	0	2018	Alameda County		2	21222	2			2						www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	(855)996-8422		(855)996-8422		(844)205-8422		(844)205-8422		(800)243-2051		(800)243-2051		(844)205-8422		(844)205-8422		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2986	005	0	1	01	01	H2986_005_0	6			1		08/06/2017	2018.03	08/06/2017 11:28:31 AM Pacific Daylight Time	08/04/2017 10:21:56 AM Pacific Daylight Time	07/31/2017 03:50:26 PM Pacific Daylight Time			08/06/2017 12:16:04 PM Pacific Daylight Time	STANFORD HEALTHCARE ADVANTAGE	Stanford Health Care Advantage	www.StanfordHealthCareAdvantage.org	Stanford Health Care Advantage - Gold (HMO)	01	01		1			H2986	005	0	2018	Alameda County		2	2358	2			2						www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	(855)996-8422		(855)996-8422		(844)205-8422		(844)205-8422		(800)243-2051		(800)243-2051		(844)205-8422		(844)205-8422		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H2986	801	0	1	01	01	H2986_801_0	4			1		06/02/2017	2018.03	06/02/2017 04:04:48 PM Pacific Daylight Time					06/05/2017 12:50:22 PM Pacific Daylight Time	STANFORD HEALTHCARE ADVANTAGE	Stanford Health Care Advantage	www.StanfordHealthCareAdvantage.org	Stanford Health Care Advantage (HMO)	01	01		1			H2986	801	0	2018	Alameda and Santa Clara counties		1	300	2			2						www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	www.StanfordHealthCareAdvantage.org	(855)996-8422		(855)996-8422		(844)205-8422		(844)205-8422		(800)243-2051		(800)243-2051		(844)205-8422		(844)205-8422		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					2				
H2992	001	0	1	20	08	H2992_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:05 AM Eastern Daylight Time		05/24/2017 08:18:26 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifepa.com	Senior LIFE Washington Dual Eligible (PACE)	08	20		1			H2992	001	0	2018	Senior LIFE Washington Fayete Greene County		2	3150	2			2						http://granerx.com/	None										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H2992	002	0	1	20	08	H2992_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:08 AM Eastern Daylight Time		05/24/2017 08:18:19 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifewashington.com	Senior LIFE Washington Medicare Only (PACE)	08	20		1			H2992	002	0	2018	Senior LIFE Washington Greene County Medicare Only		2	12	2			2						http://granerx.com/	None										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H2992	003	0	1	20	08	H2992_003_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:12 AM Eastern Daylight Time		05/24/2017 08:18:12 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifeuniontown.com	Senior LIFE Uniontown Dual Eligible (PACE)	08	20		1			H2992	003	0	2018	Senior LIFE Uniontown Fayette County Dual Eligible		2	2950	2			2						http://granerx.com/	None										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H2992	004	0	1	20	08	H2992_004_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:19 AM Eastern Daylight Time		05/24/2017 08:18:03 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifeuniontown.com	Senior LIFE Uniontown Medicare Only (PACE)	08	20		1			H2992	004	0	2018	Senior LIFE Fayette County Medicare Only		2	12	2			2						http://granerx.com/	None										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H3018	001	0	1	48	05	H3018_001_0	5			1		07/06/2017	2018.03	07/06/2017 11:40:28 AM Eastern Daylight Time					07/06/2017 11:50:34 AM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for FIDA Care Complete	www.centersplan.com/fida	Centers Plan for FIDA Care Complete (Medicare-Medicaid Plan)	05	48		1			H3018	001	0	2018	Ki, Qu, Brx, NY, Ri Counties		2		2			2						www.centersplan.com	www.centersplan.com	www.centersplan.com	(800)466-2745		(800)466-2745		(800)466-2745		(800)466-2745		(888)266-7460		(888)266-7460		(800)466-2745		(800)466-2745		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-																
H3054	001	0	1	01	01	H3054_001_0	7		1	1	1	07/17/2017	2018.03	07/17/2017 12:05:38 PM SA Western Standard Time	08/04/2017 08:21:04 AM SA Western Standard Time	08/03/2017 05:30:19 PM SA Western Standard Time			08/07/2017 07:02:05 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Genesis - Constellation Health (HMO SNP)	01	01		1			H3054	001	0	2018	Puerto Rico		2	147238	2		1	1	3		2		1	www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H3054	003	0	1	01	01	H3054_003_0	7		1	1	1	07/17/2017	2018.03	07/17/2017 12:13:19 PM SA Western Standard Time	08/04/2017 08:22:44 AM SA Western Standard Time	08/03/2017 05:32:43 PM SA Western Standard Time			08/07/2017 07:02:05 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Genesis Prime - Constellation Health (HMO SNP)	01	01		1			H3054	003	0	2018	Puerto Rico		2	222469	2		1	1	3		2		1	www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H3054	004	0	1	01	01	H3054_004_0	8		1	1	1	08/07/2017	2018.03	08/07/2017 05:24:50 PM SA Western Standard Time	08/04/2017 08:24:38 AM SA Western Standard Time	08/03/2017 05:34:13 PM SA Western Standard Time			08/07/2017 07:02:05 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Genesis @ Home- Constellation Health (HMO SNP)	01	01		1			H3054	004	0	2018	Puerto Rico		2	10571	2		1	1	3		2		1	www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H3060	001	0	1	20	08	H3060_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:04:57 PM Eastern Daylight Time		05/24/2017 04:23:33 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE BUTLER, LLC	LIFE Butler County	www.lutheranseniorlife.org	VieCare Butler, LLC dba LIFE Butler County (PACE)	08	20		1			H3060	001	0	2018	Butler County		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)287-5433		(724)742-2226		(724)287-5433		(724)742-2226										(711)-		(711)-		(724)287-5433		(724)742-2226																
H3060	002	0	1	20	08	H3060_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:06:33 PM Eastern Daylight Time		05/24/2017 04:23:34 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE BUTLER, LLC	LIFE Butler County	www.lutheranseniorlife.org	VieCare Butler, LLC dba LIFE Butler County (PACE)	08	20		1			H3060	002	0	2018	Butler County		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)287-5433		(724)742-2226		(724)287-5433		(724)742-2226										(711)-		(711)-		(724)287-5433		(724)742-2226																
H3071	002	0	1	01	01	H3071_002_0	5			1		08/04/2017	2018.03	08/04/2017 10:57:52 AM Central Daylight Time	08/07/2017 01:11:53 PM Central Daylight Time	08/07/2017 01:11:53 PM Central Daylight Time			08/07/2017 02:20:31 PM Central Daylight Time	COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP	Community Care Alliance of Illinois, NFP	www.ccaillinois.com/medicare	Community Advantage (HMO)	01	01		1			H3071	002	0	2018	Rockford Area, Chicago Area		2	102988	2			2						www.ccaillinois.com/medicare	www.ccaillinois.com/medicare	www.ccaillinois.com/medicare	(855)275-2781		(855)275-2781		(855)275-2781		(855)275-2781		(888)232-8479		(888)232-8479		(855)275-2781		(855)275-2781		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3071	003	0	1	02	01	H3071_003_0	7			1		07/07/2017	2018.03	07/07/2017 10:17:10 AM Central Daylight Time	08/07/2017 01:09:02 PM Central Daylight Time	08/07/2017 01:09:02 PM Central Daylight Time			08/07/2017 02:20:31 PM Central Daylight Time	COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP	Community Care Alliance of Illinois, NFP	www.ccaillinois.com/medicare	Community Flex-Plan (HMO-POS)	01	02		1			H3071	003	0	2018	Rockford Area, Chicago Area		2	1400	2			2						www.ccaillinois.com/medicare	www.ccaillinois.com/medicare	www.ccaillinois.com/medicare	(855)275-2781		(855)275-2781		(855)275-2781		(855)275-2781		(888)232-8479		(888)232-8479		(855)275-2781		(855)275-2781		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	001	0	1	01	01	H3113_001_0	4		1	1		07/07/2017	2018.03	07/07/2017 11:37:41 AM Central Daylight Time	08/03/2017 01:09:56 PM Central Daylight Time	08/01/2017 10:25:07 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3113	001	0	2018	Northern and Central New Jersey		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	005	0	1	01	01	H3113_005_0	3		1	1	2	05/30/2017	2018.03	05/30/2017 12:50:34 PM Central Daylight Time	08/03/2017 01:10:22 PM Central Daylight Time	08/01/2017 10:25:35 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete ONE (HMO SNP)	01	01		1			H3113	005	0	2018	Select counties in New Jersey		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)514-4911		(800)514-4911		(888)834-3721		(888)834-3721		(800)514-4911		(800)514-4911		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	008	0	1	01	01	H3113_008_0	3		1	1		06/28/2017	2018.03	06/28/2017 10:04:50 AM Central Daylight Time	08/03/2017 01:10:50 PM Central Daylight Time	08/01/2017 10:26:01 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (HMO SNP)	01	01		1			H3113	008	0	2018	Lane County		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	009	0	1	01	01	H3113_009_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:30:06 AM Central Daylight Time	08/03/2017 01:11:17 PM Central Daylight Time	08/01/2017 10:26:28 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHC.com/PADual	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3113	009	0	2018	Select counties in Pennsylvania		2		2			1	3		1		1	www.UHC.com/PADual	www.UHC.com/PADual	www.UHC.com/PADual	(800)290-4009		(800)290-4009		(888)834-3721		(888)834-3721		(800)290-4009		(800)290-4009		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	010	0	1	01	01	H3113_010_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:31:55 AM Central Daylight Time	08/03/2017 01:11:44 PM Central Daylight Time	08/01/2017 10:26:55 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3113	010	0	2018	Select counties in Rhode Island		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)275-6093		(866)275-6093		(888)834-3721		(888)834-3721		(866)275-6093		(866)275-6093		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	011	0	1	01	01	H3113_011_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:35:19 AM Central Daylight Time	08/03/2017 01:12:11 PM Central Daylight Time	08/01/2017 10:27:22 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3113	011	0	2018	New Castle County		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)262-9919		(866)262-9919		(888)834-3721		(888)834-3721		(866)262-9919		(866)262-9919		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3113	012	0	1	01	01	H3113_012_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:35:58 AM Central Daylight Time	08/03/2017 01:12:38 PM Central Daylight Time	08/01/2017 10:27:49 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	UnitedHealthcare	www.UHC.com/PADualOne	UnitedHealthcare Dual Complete ONE (HMO SNP)	01	01		1			H3113	012	0	2018	Select Counties in Pennsylvania		2		2			1	3		1		1	www.UHC.com/PADualOne	www.UHC.com/PADualOne	www.UHC.com/PADualOne	(800)290-4009		(800)290-4009		(888)834-3721		(888)834-3721		(800)290-4009		(800)290-4009		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3132	001	0	1	01	01	H3132_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 11:11:22 AM Pacific Daylight Time	08/04/2017 11:07:35 AM Pacific Daylight Time	08/04/2017 11:07:35 AM Pacific Daylight Time			08/04/2017 12:53:19 PM Pacific Daylight Time	AHF MCO OF FLORIDA, INC.	AHF	www.php-fl.org	PHP (HMO SNP)	01	01		1			H3132	001	0	2018	Broward, Miami-Dade and Duval Counties, Florida		2	22464	2			1	4			00000000001000000000		www.php-fl.org/provider-find	www.php-fl.org/for-members/drug-benefit/formulary	www.php-fl.org/provider-find	(888)456-4715		(888)456-4715		(888)456-4715		(888)456-4715		(866)763-9096		(866)763-9096		(888)456-4715		(888)456-4715		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	022	0	1	01	01	H3152_022_0	4			1		08/03/2017	2018.03	08/03/2017 11:36:27 AM Central Daylight Time	08/02/2017 03:39:30 PM Central Daylight Time	07/31/2017 04:35:01 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3152	022	0	2018	Counties: ATL, BUR, CAM, CPM, CUM, GLO, SLM		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	045	0	1	01	01	H3152_045_0	2			1		06/27/2017	2018.03	06/27/2017 08:50:34 PM Eastern Daylight Time	05/30/2017 07:49:56 AM Central Daylight Time				07/07/2017 08:37:52 AM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3152	045	0	2018	New Jersey		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3152	048	0	1	01	01	H3152_048_0	4			1		07/13/2017	2018.03	07/13/2017 04:36:21 PM Central Daylight Time	08/02/2017 03:41:16 PM Central Daylight Time	07/31/2017 04:35:27 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3152	048	0	2018	Northern New Jersey		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	080	0	1	01	01	H3152_080_0	3			1		08/02/2017	2018.03	08/02/2017 11:18:46 AM Eastern Daylight Time	08/02/2017 03:42:10 PM Central Daylight Time	07/31/2017 04:35:52 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare NNJ Prime Plan (HMO)	01	01		1			H3152	080	0	2018	Counties: MRS, PAS, SOM, SSX, UNN, WRN		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	082	0	1	01	01	H3152_082_0	3			1		08/03/2017	2018.03	08/03/2017 10:28:59 AM Central Daylight Time	08/03/2017 02:05:34 PM Central Daylight Time	07/31/2017 04:36:17 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (HMO)	01	01		1			H3152	082	0	2018	Middlesex, Monmouth and Ocean counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	084	0	1	01	01	H3152_084_0	3			1		08/03/2017	2018.03	08/03/2017 10:35:39 AM Central Daylight Time	08/03/2017 02:07:20 PM Central Daylight Time	07/31/2017 04:36:42 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan 1 (HMO)	01	01		1			H3152	084	0	2018	Bergen, Essex and Hudson counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	085	0	1	01	01	H3152_085_0	3			1		08/01/2017	2018.03	08/01/2017 07:47:28 PM Eastern Daylight Time	08/02/2017 03:45:06 PM Central Daylight Time	07/31/2017 04:37:07 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare SNJ Prime Value Plan (HMO)	01	01		1			H3152	085	0	2018	Burlington, Camden and Gloucester counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	086	0	1	01	01	H3152_086_0	3			1		08/02/2017	2018.03	08/02/2017 11:05:21 AM Eastern Daylight Time	08/02/2017 03:46:06 PM Central Daylight Time	07/31/2017 04:37:33 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare NNJ Prime Plan 1 (HMO)	01	01		1			H3152	086	0	2018	Hunterdon county		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3152	801	0	1	01	01	H3152_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:28:49 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3152	801	0	2018	New Jersey		1	177900	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3152	804	0	1	01	01	H3152_804_0	2			1		05/30/2017	2018.03	05/30/2017 11:29:10 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (NJ)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3152	804	0	2018	New Jersey		1	17940	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3154	004	0	1	01	01	H3154_004_0	6			1		07/06/2017	2018.03	07/06/2017 10:04:09 AM Eastern Daylight Time	08/03/2017 11:16:14 AM Eastern Daylight Time	08/03/2017 11:11:17 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon Medicare Blue Value w/ Rx (HMO)	01	01		1			H3154	004	0	2018	Counties:  CPM, HUD, SLM, UNN, WRN		2	38808	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	013	0	1	01	01	H3154_013_0	5			1		07/06/2017	2018.03	07/06/2017 10:07:07 AM Eastern Daylight Time	07/18/2017 12:51:10 PM Eastern Daylight Time				07/18/2017 01:25:11 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon Medicare Blue Value (HMO)	01	01		1			H3154	013	0	2018	Counties:  CPM, HUD,  SLM, UNN, WRN		2	3180	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3154	022	0	1	01	01	H3154_022_0	6			1		07/06/2017	2018.03	07/06/2017 10:08:58 AM Eastern Daylight Time	08/03/2017 11:19:51 AM Eastern Daylight Time	08/03/2017 11:18:43 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon Medicare Blue Choice w/Rx (HMO)	01	01		1			H3154	022	0	2018	11 Counties Throughout New Jersey		2	59532	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	029	0	1	01	01	H3154_029_0	5			1		07/07/2017	2018.03	07/07/2017 07:56:05 AM Eastern Daylight Time	08/03/2017 11:21:35 AM Eastern Daylight Time	08/03/2017 11:20:39 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon OMNIA Medicare Blue (HMO)	01	01		1			H3154	029	0	2018	Ocean and Monmouth		2	38465	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	030	0	1	01	01	H3154_030_0	5			1		07/07/2017	2018.03	07/07/2017 07:56:20 AM Eastern Daylight Time	08/03/2017 11:23:44 AM Eastern Daylight Time	08/03/2017 11:22:22 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon OMNIA Medicare Blue (HMO)	01	01		1			H3154	030	0	2018	Bergen, Essex, Hudson, Middlesex, Union, Mercer		2	85423	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	031	0	1	01	01	H3154_031_0	6			1		07/07/2017	2018.03	07/07/2017 07:56:46 AM Eastern Daylight Time	08/03/2017 11:26:54 AM Eastern Daylight Time	08/03/2017 11:24:31 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon OMNIA Medicare Blue (HMO)	01	01		1			H3154	031	0	2018	Somerset, Sussex, Warren, Hunterdon		2	9394	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	032	0	1	01	01	H3154_032_0	5			1		07/07/2017	2018.03	07/07/2017 07:57:00 AM Eastern Daylight Time	08/03/2017 11:32:55 AM Eastern Daylight Time	08/03/2017 11:29:55 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/medicare	Horizon OMNIA Medicare Blue (HMO)	01	01		1			H3154	032	0	2018	Morris, Atlantic, Cumberland		2	13794	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3154	801	0	1	02	01	H3154_801_0	1			1		05/30/2017	2018.03	05/30/2017 10:19:16 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Blue Access Group (HMO-POS)	01	02		1			H3154	801	0	2018	New Jersey		1	22591	2			2						https://medicare.horizonblue.com/medicare-advantage-health-insurance-plans-new-jersey-introduction	medicare.horizonblue.com/medicare-advantage-health-insurance-new-jersey-formulary-drug-search	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1				
H3154	802	0	1	02	01	H3154_802_0	1			1		05/30/2017	2018.03	05/30/2017 10:19:49 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Blue Access Grp w/ Rx (HMO-POS)	01	02		1			H3154	802	0	2018	New Jersey		1	8814	2			2						https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJHMOG/en.html	https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJHMOG/en/find-medicine.html	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1				
H3154	811	0	1	01	01	H3154_811_0	1			1		05/30/2017	2018.03	05/30/2017 10:20:16 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Advantage HMO10 (HMO)	01	01		1			H3154	811	0	2018	New Jersey		1	120	2			2						https://medicare.horizonblue.com/medicare-advantage-health-insurance-plans-new-jersey-introduction	medicare.horizonblue.com/medicare-advantage-health-insurance-new-jersey-formulary-drug-search	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1					1				
H3170	001	0	1	01	01	H3170_001_0	9			1		08/03/2017	2018.03	08/03/2017 04:13:14 PM Eastern Daylight Time	08/08/2017 12:51:52 PM Eastern Daylight Time	08/04/2017 02:45:42 PM Eastern Daylight Time			08/11/2017 09:53:46 AM Eastern Daylight Time	SAPPHIRE EDGE, INC.	Blue Cross and Blue Shield of Nebraska	http://medicare.nebraskablue.com	Blue Cross Blue Shield Nebraska MA Core (HMO)	01	01		1			H3170	001	0	2018	Omaha Lincoln Metro Area		2	10768	2			2						https://www.myprime.com/en/find-pharmacy.html	http://medicare.nebraskablue.com	https://medicare.nebraskablue.com/MedicareAdvantage/FindADoc	(888)488-9850		(888)488-9850		(844)899-6060		(844)899-6060		(855)457-1349		(855)457-1349		(844)899-6060		(844)899-6060		(711)-		(711)-	1	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3170	002	0	1	02	01	H3170_002_0	8			1		07/19/2017	2018.03	07/19/2017 02:38:50 PM Eastern Daylight Time	08/04/2017 02:46:37 PM Eastern Daylight Time	08/04/2017 02:46:00 PM Eastern Daylight Time			08/04/2017 03:22:57 PM Eastern Daylight Time	SAPPHIRE EDGE, INC.	Blue Cross and Blue Shield of Nebraska	http://medicare.nebraskablue.com	Blue Cross Blue Shield Nebraska MA Choice (HMO-POS)	01	02		1			H3170	002	0	2018	Omaha Lincoln Metro Area		2	9940	2			2						https://www.myprime.com/en/find-pharmacy.html	http://medicare.nebraskablue.com	https://medicare.nebraskablue.com/MedicareAdvantage/FindADoc	(888)488-9850		(888)488-9850		(844)899-6060		(844)899-6060		(855)457-1349		(855)457-1349		(844)899-6060		(844)899-6060		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3204	001	0	1	01	01	H3204_001_0	5			1		07/06/2017	2018.03	07/06/2017 04:11:32 PM Mountain Daylight Time	08/01/2017 03:55:13 PM Mountain Daylight Time	07/31/2017 02:32:14 PM Mountain Daylight Time			08/03/2017 12:25:44 PM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Plan 2 with Rx (HMO)	01	01		1			H3204	001	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		2	235099	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		2					2					2	2			
H3204	007	0	1	01	01	H3204_007_0	6			1		08/03/2017	2018.03	08/03/2017 12:09:15 PM Mountain Daylight Time	08/01/2017 03:56:22 PM Mountain Daylight Time	07/31/2017 02:32:57 PM Mountain Daylight Time			08/03/2017 12:25:44 PM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Plan 3 with Rx (HMO)	01	01		1			H3204	007	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		2	45529	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		2					2					2	2			
H3204	008	0	1	01	01	H3204_008_0	3			1		07/06/2017	2018.03	07/06/2017 04:22:47 PM Mountain Daylight Time	06/02/2017 05:06:45 PM Mountain Daylight Time				07/06/2017 04:50:32 PM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Plan 1 (HMO)	01	01		1			H3204	008	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		2	22112	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458										(800)659-8331		(711)-		(800)659-8331		(711)-										2					2					2	2			
H3204	012	0	1	01	01	H3204_012_0	5		1	1	2	08/01/2017	2018.03	08/01/2017 03:30:11 PM Mountain Daylight Time	08/01/2017 03:51:21 PM Mountain Daylight Time	07/31/2017 02:33:20 PM Mountain Daylight Time			08/03/2017 12:25:44 PM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Dual Plus (HMO SNP)	01	01		1			H3204	012	0	2018	Bernalilo, Sandoval, Torrance, Valencia		2	7073	2			1	3		1		2	www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(855)465-7737		(505)923-7675		(800)347-4766		(505)923-8458		(855)465-7737		(505)923-7675		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		2					1					2	2			
H3204	801	0	1	01	01	H3204_801_0	1			1		05/31/2017	2018.03	05/31/2017 11:03:04 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Pres Senior Care Emp Group Plan 2 with Rx (HMO)	01	01		1			H3204	801	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		1	1981	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1					1				
H3204	802	0	1	01	01	H3204_802_0	1			1		05/31/2017	2018.03	05/31/2017 11:06:14 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Pres Senior Care Emp Group Plan 1 (HMO)	01	01		1			H3204	802	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458										(800)659-8331		(711)-		(800)659-8331		(711)-										1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1					1				
H3204	803	0	1	01	01	H3204_803_0	1			1		05/31/2017	2018.03	05/31/2017 11:06:28 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Pres Senior Care Emp Group Plan 2 w/ Rx NC (HMO)	01	01		1			H3204	803	0	2018	Greater Albuquerque Area, Rio Arriba and Santa Fe		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1					1				
H3204	808	0	1	02	01	H3204_808_0	1			1		05/31/2017	2018.03	05/31/2017 11:03:47 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Emp Group Plan 5 (HMO-POS)	01	02		1			H3204	808	0	2018	State of New Mexico		1	134395	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1	2		2		1				
H3204	809	0	1	02	01	H3204_809_0	1			1		05/31/2017	2018.03	05/31/2017 11:06:46 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Emp Group Plan 6 (HMO-POS)	01	02		1			H3204	809	0	2018	State of New Mexico		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458										(800)659-8331		(711)-		(800)659-8331		(711)-										1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1	2		2		1				
H3204	810	0	1	02	01	H3204_810_0	1			1		05/31/2017	2018.03	05/31/2017 11:06:58 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Health Plan	http://www.phs.org/Medicare	Presbyterian Senior Care Emp Group Plan 5 NC (HMO-POS)	01	02		1			H3204	810	0	2018	State of New Mexico		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1	2		2		1				
H3206	001	0	1	04	01	H3206_001_0	7			1		07/06/2017	2018.03	07/06/2017 04:27:01 PM Mountain Daylight Time	08/01/2017 03:57:20 PM Mountain Daylight Time	07/31/2017 02:33:58 PM Mountain Daylight Time			08/03/2017 12:25:44 PM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian Insurance Company, Inc.	http://www.phs.org/Medicare	Presbyterian MediCare PPO Plan 2 with Rx (PPO)	01	04		1			H3206	001	0	2018	State of New Mexico		2	38021	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		2					2						2			
H3206	003	0	1	04	01	H3206_003_0	4			1		07/06/2017	2018.03	07/06/2017 04:29:50 PM Mountain Daylight Time	06/02/2017 05:10:11 PM Mountain Daylight Time				07/06/2017 04:50:32 PM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian Insurance Company, Inc.	http://www.phs.org/Medicare	Presbyterian MediCare PPO Plan 1 (PPO)	01	04		1			H3206	003	0	2018	State of New Mexico		2	2853	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458										(800)659-8331		(711)-		(800)659-8331		(711)-										2					2						2			
H3206	801	0	1	04	01	H3206_801_0	1			1		05/31/2017	2018.03	05/31/2017 11:05:10 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian Insurance Company, Inc.	http://www.phs.org/Medicare	Pres MediCare PPO Emp Group Plan 2 with Rx (PPO)	01	04		1			H3206	801	0	2018	State of New Mexico		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1									
H3206	802	0	1	04	01	H3206_802_0	1			1		05/31/2017	2018.03	05/31/2017 11:05:29 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian Insurance Company, Inc.	http://www.phs.org/Medicare	Pres Medicare PPO Employer Group Plan 1 (PPO)	01	04		1			H3206	802	0	2018	State of New Mexico		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458										(800)659-8331		(711)-		(800)659-8331		(711)-										1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1									
H3206	803	0	1	04	01	H3206_803_0	1			1		05/31/2017	2018.03	05/31/2017 11:05:46 AM Mountain Daylight Time					06/01/2017 08:06:39 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian Insurance Company, Inc.	http://www.phs.org/Medicare	Pres MediCare PPO Empl Group Plan 2 +Rx NC (PPO)	01	04		1			H3206	803	0	2018	State of New Mexico		1	12	2			2						www.phs.org/Medicare	http://www.phs.org/Medicare	https://www.phs.org/doctors-services/Pages/find-a-doctor.aspx	(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)797-5343		(505)923-6060		(800)347-4766		(505)923-8458		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		(800)659-8331		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;11a;11b;	2		1									
H3227	001	0	1	01	01	H3227_001_0	15		1	1	2	06/05/2017	2018.03	06/05/2017 11:08:21 AM Eastern Daylight Time	08/03/2017 04:30:58 PM Eastern Daylight Time	08/02/2017 04:49:56 PM Eastern Daylight Time			08/04/2017 11:36:16 AM Eastern Daylight Time	ERIENIAGARA MLTC	Kalos Health Plan	Kaloshealth.org	Kalos Health Gold Plus (HMO SNP)	01	01		1			H3227	001	0	2018	Western New York		2	8190	2			1	3		1		1	Kaloshealth.org	Kaloshealth.org	Kaloshealth.org	(800)894-2464		(716)304-1213		(800)894-2464		(716)304-1213		(800)894-2464		(716)304-1213		(800)894-2464		(716)304-1213		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		2					2					1	2			
H3233	001	0	1	01	01	H3233_001_0	6			1		08/07/2017	2018.03	08/07/2017 02:32:29 PM Eastern Daylight Time	08/04/2017 11:53:06 AM Eastern Daylight Time	08/04/2017 11:56:14 AM Eastern Daylight Time			08/07/2017 03:57:41 PM Eastern Daylight Time	PREMIER HEALTH INSURING CORPORATION	Premier Health Plan	www.premierhealthplan.org/medicare	Premier Health Advantage (HMO)	01	01		1			H3233	001	0	2018	Dayton Metro		2		2			2						www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H3233	002	0	1	01	01	H3233_002_0	3		1	1	2	08/07/2017	2018.03	08/07/2017 01:24:56 PM Eastern Daylight Time	08/04/2017 11:54:20 AM Eastern Daylight Time	08/04/2017 11:57:02 AM Eastern Daylight Time			08/07/2017 03:57:41 PM Eastern Daylight Time	PREMIER HEALTH INSURING CORPORATION	Premier Health Plan	www.premierhealthplan.org/medicare	Premier Health Advantage VIP (HMO SNP)	01	01		1			H3233	002	0	2018	Dayton Metro		2		2			1	3		2		2	www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H3233	003	0	1	02	01	H3233_003_0	5			1		08/07/2017	2018.03	08/07/2017 12:51:54 PM Eastern Daylight Time	08/07/2017 03:54:01 PM Eastern Daylight Time	08/07/2017 03:54:01 PM Eastern Daylight Time			08/07/2017 03:57:41 PM Eastern Daylight Time	PREMIER HEALTH INSURING CORPORATION	Premier Health Plan	www.premierhealthplan.org/medicare	Premier Health Advantage Choice (HMO-POS)	01	02		1			H3233	003	0	2018	Dayton Metro		2		2			2						www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	www.premierhealthplan.org/medicare	(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)572-2161		(855)572-2161		(855)572-2157		(855)572-2157		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H3237	001	0	1	48	05	H3237_001_0	5			1		09/18/2017	2018.03	09/18/2017 12:15:55 PM Pacific Daylight Time					09/18/2017 03:27:45 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS, INC.	Health Net Cal MediConnect Medicare Medicaid Plan	www.healthnet.com/calmediconnect	Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H3237	001	0	2018	Los Angeles County		2	131149	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/calmediconnect	(855)464-3571		(855)464-3571		(888)788-5395		(888)788-5395		(855)464-3571		(855)464-3571		(888)788-5395		(888)788-5395		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H3237	002	0	1	48	05	H3237_002_0	5			1		09/18/2017	2018.03	09/18/2017 09:49:35 AM Pacific Daylight Time					09/18/2017 03:27:45 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS, INC.	Health Net Cal MediConnect Medicare Medicaid Plan	www.healthnet.com/calmediconnect	Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H3237	002	0	2018	San Diego County		2	22662	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/calmediconnect	(855)464-3572		(855)464-3572		(888)788-5805		(888)788-5805		(855)464-3572		(855)464-3572		(888)788-5805		(888)788-5805		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H3240	013	0	1	01	01	H3240_013_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 09:07:48 AM Eastern Daylight Time	08/07/2017 08:51:45 AM Eastern Daylight Time	08/06/2017 03:05:35 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H3240	013	0	2018	Eastern and Central New Jersey		2	123996	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5160		(844)765-5160		(844)316-0355		(844)316-0355		(844)765-5160		(844)765-5160		(844)288-7623		(844)288-7623		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3240	016	0	1	01	01	H3240_016_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 09:08:04 AM Eastern Daylight Time	08/07/2017 08:51:45 AM Eastern Daylight Time	08/06/2017 03:05:36 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H3240	016	0	2018	Select Counties in New Jersey		2	8403	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5160		(844)765-5160		(844)316-0355		(844)316-0355		(844)765-5160		(844)765-5160		(844)288-7623		(844)288-7623		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3240	017	0	1	02	01	H3240_017_0	8		1	1		08/04/2017	2018.03	08/04/2017 11:05:50 AM Eastern Daylight Time		08/06/2017 03:05:36 PM Eastern Daylight Time		08/07/2017 08:51:45 AM Eastern Daylight Time	08/07/2017 02:33:32 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage ESRD (HMO-POS SNP)	01	02		1			H3240	017	0	2018	Select Counties in New Jersey		2	2514	2			1	4			00000000100000000000		www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)887-6350		(844)887-6350		(844)316-0355		(844)316-0355		(844)887-6350		(844)887-6350		(844)288-7623		(844)288-7623		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3240	021	0	1	01	01	H3240_021_0	9			1		06/30/2017	2018.03	06/30/2017 08:42:53 AM Eastern Daylight Time	08/07/2017 08:51:46 AM Eastern Daylight Time	08/06/2017 03:05:36 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Balance (HMO)	01	01		1			H3240	021	0	2018	Select Counties in New Jersey		2	1376	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5160		(844)765-5160		(844)316-0355		(844)316-0355		(844)765-5160		(844)765-5160		(844)288-7623		(844)288-7623		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3251	002	0	1	01	01	H3251_002_0	8			1		08/08/2017	2018.03	08/08/2017 01:38:52 PM Central Daylight Time	08/04/2017 03:43:32 PM Central Daylight Time	08/01/2017 03:49:24 PM Central Daylight Time			08/08/2017 01:41:04 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of New Mexico	www.getbluenm.com/mapd	Blue Cross Medicare Advantage Select (HMO)	01	01		1			H3251	002	0	2018	Greater New Mexico Area		2	119647	2			2						www.getbluenm.com/mapd/pharmacies	www.getbluenm.com/mapd/druglist	www.getbluenm.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3251	021	0	1	02	01	H3251_021_0	10			1		08/04/2017	2018.03	08/04/2017 12:55:02 PM Central Daylight Time	08/04/2017 03:45:53 PM Central Daylight Time	08/01/2017 03:49:55 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of New Mexico	www.getbluenm.com/mapd	Blue Cross Medicare Advantage Flex (HMO-POS)	01	02		1			H3251	021	0	2018	Greater New Mexico Area		2	9053	2			2						www.getbluenm.com/mapd/pharmacies	www.getbluenm.com/mapd/druglist	www.getbluenm.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3251	804	0	1	01	01	H3251_804_0	1			1		05/26/2017	2018.03	05/26/2017 10:42:50 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of New Mexico	www.getbluenm.com/mapd	Blue Cross Medicare Advantage (HMO)	01	01		1			H3251	804	0	2018	New Mexico Statewide		1	6826	2			2						www.myprime.com	www.myprime.com	www.getbluenm.com/mapd/providers	(877)895-6448		(877)895-6448		(877)583-8129		(877)583-8129		(877)895-6448		(877)895-6448		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3259	001	0	1	01	01	H3259_001_0	8		1	1	2	08/10/2017	2018.03	08/10/2017 01:49:13 PM Eastern Daylight Time	08/09/2017 04:06:11 PM Eastern Daylight Time	08/03/2017 01:12:36 PM Eastern Daylight Time			08/10/2017 01:50:45 PM Eastern Daylight Time	VOLUNTEER STATE HEALTH PLAN	BlueCare Plus Tennessee	bluecareplus.bcbst.com	BlueCare Plus (HMO SNP)	01	01		1			H3259	001	0	2018	Tennessee		2	209625	2			1	3		2		2	bluecareplus.bcbst.com	bluecareplus.bcbst.com	bluecareplus.bcbst.com	(800)332-5762		(800)332-5762		(888)413-9637		(888)413-9637		(800)332-5762		(800)332-5762		(888)413-9637		(888)413-9637		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3262	001	0	1	01	01	H3262_001_0	5		1	1		08/01/2017	2018.03	08/01/2017 03:48:40 PM Central Daylight Time		08/03/2017 04:28:19 PM Central Daylight Time		08/03/2017 04:28:16 PM Central Daylight Time	08/03/2017 04:34:28 PM Central Daylight Time	FRESENIUS HEALTH PLANS OF NEW YORK, INC.	Fresenius Health Plans	www.esrdplans.com	Fresenius Total Health (HMO SNP)	01	01		1			H3262	001	0	2018	Bronx, Kings, New York, and Queens Counties		2	2032	2			1	4			00000000100000000000		www.esrdplans.com	www.esrdplans.com	www.esrdplans.com	(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		2					2					2	2			
H3291	001	0	1	01	01	H3291_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:05:06 AM Central Daylight Time	08/07/2017 10:57:45 AM Central Daylight Time	08/07/2017 10:57:59 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	PRUITTHEALTH PREMIER, INC.	PruittHealth Premier (HMO SNP)	www.pruitthealthpremier.com	PruittHealth Premier (HMO SNP)	01	01		1			H3291	001	0	2018	Georgia (partial)		2	14220	2			1	1	1				www.pruitthealthpremier.com	www.pruitthealthpremier.com	www.pruitthealthpremier.com	(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3291	002	0	1	01	01	H3291_002_0	3		1	1	2	08/07/2017	2018.03	08/07/2017 11:05:12 AM Central Daylight Time	08/07/2017 10:57:45 AM Central Daylight Time	08/07/2017 10:58:00 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	PRUITTHEALTH PREMIER, INC.	PruittHealth Premier (HMO SNP)	www.pruitthealthpremier.com	PruittHealth Premier D-SNP (HMO SNP)	01	01		1			H3291	002	0	2018	GA (Clarke County)		2	1200	2			1	3		2		1	www.pruitthealthpremier.com	www.pruitthealthpremier.com	www.pruitthealthpremier.com	(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(844)224-3659		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3305	007	0	1	02	01	H3305_007_0	5			1		07/06/2017	2018.03	07/06/2017 01:09:17 PM Eastern Daylight Time	07/27/2017 10:59:11 AM Eastern Daylight Time				07/27/2017 11:13:59 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold without Part D (HMO-POS)	01	02		1			H3305	007	0	2018	Western NY (Rochester/Buffalo)		2	21072	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220										2					2					2	2			
H3305	015	0	1	02	01	H3305_015_0	8			1		07/28/2017	2018.03	07/28/2017 09:51:37 AM Eastern Daylight Time	08/07/2017 05:16:37 PM Eastern Daylight Time	08/07/2017 05:10:35 PM Eastern Daylight Time			08/07/2017 05:27:30 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold with Part D (HMO-POS)	01	02		1			H3305	015	0	2018	Western NY (Rochester/Buffalo)		2	186684	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H3305	020	0	1	02	01	H3305_020_0	4			1		07/06/2017	2018.03	07/06/2017 01:09:59 PM Eastern Daylight Time	07/27/2017 10:58:56 AM Eastern Daylight Time				07/27/2017 11:13:59 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinmvpmedicare.com	Preferred Gold without Part D (HMO-POS)	01	02		1			H3305	020	0	2018	S. Tier NY, Capital District NY, Hudson Valley, NY		2	4872	2			2						www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220										2					2					2	2			
H3305	021	0	1	02	01	H3305_021_0	8			1		07/18/2017	2018.03	07/18/2017 11:45:50 AM Eastern Daylight Time	08/07/2017 05:16:24 PM Eastern Daylight Time	08/07/2017 05:10:24 PM Eastern Daylight Time			08/07/2017 05:27:30 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinmvpmedicare.com	Preferred Gold with Part D (HMO-POS)	01	02		1			H3305	021	0	2018	S. Tier NY, Capital District NY, Hudson Valley, NY		2	47364	2			2						www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H3305	022	0	1	02	01	H3305_022_0	7			1		07/18/2017	2018.03	07/18/2017 11:46:09 AM Eastern Daylight Time	08/07/2017 05:16:15 PM Eastern Daylight Time	08/07/2017 05:10:15 PM Eastern Daylight Time			08/07/2017 05:27:30 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinmvpmedicare.com	GoldValue with Part D (HMO-POS)	01	02		1			H3305	022	0	2018	Cent. NY, Eastern NY, Hudson Valley, NY,Western VT		2	56604	2			2						www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H3305	030	0	1	02	01	H3305_030_0	7			1		08/11/2017	2018.03	08/11/2017 12:00:49 PM Eastern Daylight Time	08/07/2017 05:16:00 PM Eastern Daylight Time	08/07/2017 05:10:04 PM Eastern Daylight Time			08/11/2017 02:55:33 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinmvpmedicare.com	GoldSecure with Part D (HMO-POS)	01	02		1			H3305	030	0	2018	Western NY (Rochester/Buffalo)		2	12000	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H3305	801	0	1	02	01	H3305_801_0	1			1		06/04/2017	2018.03	06/04/2017 07:24:28 PM Eastern Daylight Time					06/04/2017 07:48:17 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold - Employer Group (HMO-POS)	01	02		1			H3305	801	0	2018	Employer Group West Region		1	12600	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		2				
H3305	803	0	1	02	01	H3305_803_0	1			1		06/04/2017	2018.03	06/04/2017 07:46:35 PM Eastern Daylight Time					06/04/2017 07:48:17 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold Rx - Employer Group (HMO-POS)	01	02		1			H3305	803	0	2018	Employer Group West Region		1	86940	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1				
H3305	804	0	1	02	01	H3305_804_0	1			1		06/04/2017	2018.03	06/04/2017 07:58:20 PM Eastern Daylight Time					06/04/2017 07:59:09 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold Rx - Employer Group (HMO-POS)	01	02		1			H3305	804	0	2018	Eastern NY, Hudson Valley NY, Vermont		1	48888	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1				
H3307	002	0	1	01	01	H3307_002_0	3			1		06/01/2017	2018.03	06/01/2017 09:15:02 AM Central Daylight Time	08/03/2017 01:14:42 PM Central Daylight Time	08/01/2017 10:28:16 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3307	002	0	2018	New York City		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	012	0	1	01	01	H3307_012_0	3			1		08/02/2017	2018.03	08/02/2017 02:35:12 PM Central Daylight Time	08/03/2017 01:15:08 PM Central Daylight Time	08/01/2017 10:28:42 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3307	012	0	2018	Rockland, Orange, and Westchester counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	015	0	1	01	01	H3307_015_0	3			1		08/02/2017	2018.03	08/02/2017 02:35:30 PM Central Daylight Time	08/03/2017 01:15:35 PM Central Daylight Time	08/01/2017 10:29:08 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Mosaic (HMO)	01	01		1			H3307	015	0	2018	New York City		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)870-9604		(866)870-9604		(800)555-5757		(800)555-5757		(866)870-9604		(866)870-9604		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	018	0	1	01	01	H3307_018_0	2			1		05/24/2017	2018.03	05/24/2017 11:08:46 AM Central Daylight Time	06/01/2017 12:23:16 PM Central Daylight Time				07/06/2017 03:47:50 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H3307	018	0	2018	NYC and Rockland, Orange, and Westchester Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3307	023	0	1	01	01	H3307_023_0	3			1		06/01/2017	2018.03	06/01/2017 09:16:42 AM Central Daylight Time	08/03/2017 01:16:01 PM Central Daylight Time	08/01/2017 10:29:35 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3307	023	0	2018	Rockland, Orange, and Westchester counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	024	0	1	01	01	H3307_024_0	3			1		06/01/2017	2018.03	06/01/2017 09:16:56 AM Central Daylight Time	08/03/2017 01:16:30 PM Central Daylight Time	08/01/2017 10:30:02 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H3307	024	0	2018	New York City		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	025	0	1	01	01	H3307_025_0	3			1		08/02/2017	2018.03	08/02/2017 02:36:04 PM Central Daylight Time	08/03/2017 01:16:57 PM Central Daylight Time	08/01/2017 10:30:29 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3307	025	0	2018	Dutchess, Putnam, Sullivan and Ulster counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3307	802	0	1	01	01	H3307_802_0	2			1		06/08/2017	2018.03	06/08/2017 11:30:38 AM Central Daylight Time					06/13/2017 04:53:23 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	802	0	2018	New York Metropolitan Area		1	11724	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3307	804	0	1	01	01	H3307_804_0	1			1		05/25/2017	2018.03	05/25/2017 12:31:22 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	804	0	2018	New York Metropolitan Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3307	805	0	1	01	01	H3307_805_0	1			1		05/25/2017	2018.03	05/25/2017 12:31:28 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	805	0	2018	Select counties in New York		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3312	002	0	1	01	01	H3312_002_0	4			1		08/02/2017	2018.03	08/02/2017 12:47:52 PM Eastern Daylight Time	08/02/2017 02:50:00 PM Central Daylight Time	07/31/2017 04:37:58 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3312	002	0	2018	Metro (Bronx, Kings, Staten Island)		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3312	018	0	1	01	01	H3312_018_0	3			1		08/02/2017	2018.03	08/02/2017 12:48:55 PM Eastern Daylight Time	08/02/2017 02:51:20 PM Central Daylight Time	07/31/2017 04:38:28 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	018	0	2018	Westchester/Rockland		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3312	048	0	1	01	01	H3312_048_0	3			1		08/02/2017	2018.03	08/02/2017 02:28:53 PM Eastern Daylight Time	08/02/2017 06:37:54 PM Central Daylight Time	07/31/2017 04:38:54 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	048	0	2018	Central Upstate		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3312	062	0	1	01	01	H3312_062_0	3			1		06/27/2017	2018.03	06/27/2017 08:52:45 PM Eastern Daylight Time	08/02/2017 07:26:22 PM Central Daylight Time	07/31/2017 04:39:19 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	062	0	2018	Capital District		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3312	063	0	1	01	01	H3312_063_0	4			1		08/02/2017	2018.03	08/02/2017 03:48:42 PM Eastern Daylight Time	08/02/2017 07:27:04 PM Central Daylight Time	07/31/2017 04:39:44 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3312	063	0	2018	New York and Queens counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3312	801	0	1	01	01	H3312_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:29:39 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3312	801	0	2018	New York		1	940	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3312	804	0	1	01	01	H3312_804_0	2			1		05/30/2017	2018.03	05/30/2017 11:29:50 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (NY)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3312	804	0	2018	New York		1	5100	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3321	001	0	1	20	08	H3321_001_0	1			1		05/24/2017	2018.03	05/24/2017 10:48:02 AM Eastern Daylight Time		05/24/2017 10:34:00 AM Eastern Daylight Time			05/26/2017 10:38:22 AM Eastern Daylight Time	LORETTO INDEPENDENT LIVING SERVICES, INC.	Independent Living Srvcs Of Central Ny	www.pacecny.org	PACE CNY (PACE)	08	20		1			H3321	001	0	2018	Onondaga County		2		2			2						www.loretto-cny.org	Independent Living Services of Central New York, Inc										(888)728-7223		(315)452-5800		(888)728-7223		(315)452-5800										(800)662-1220		(315)452-5800		(800)662-1220		(315)452-5800																
H3321	003	0	1	20	08	H3321_003_0	1			1		05/24/2017	2018.03	05/24/2017 10:48:28 AM Eastern Daylight Time		05/24/2017 10:34:31 AM Eastern Daylight Time			05/26/2017 10:38:22 AM Eastern Daylight Time	LORETTO INDEPENDENT LIVING SERVICES, INC.	Independent Living Srvcs Of Central Ny	www.pacecny.org	PACE CNY (PACE)	08	20		1			H3321	003	0	2018	Onondaga County		2		2			2						www.loretto-cny.org	Independent Living Services of Central New York, Inc										(888)728-7223		(315)452-5800		(888)728-7223		(315)452-5800										(800)662-1220		(315)452-5800		(800)662-1220		(315)452-5800																
H3322	001	0	1	20	08	H3322_001_0	1			1		06/02/2017	2018.03	06/02/2017 11:04:26 AM Eastern Daylight Time		06/02/2017 08:21:22 AM Eastern Daylight Time			06/02/2017 11:07:53 AM Eastern Daylight Time	SENIOR CARE CONNECTION, INC.	Eddy SeniorCare	www.nehealth.com/Senior_Services/Senior_Care_PACE/	Senior Care Connection dba Eddy SeniorCare (PACE)	08	20		1			H3322	001	0	2018	Schenectady County, Albany County, NY		2		2			2						www.northeasthealth.com	www.northeasthealth.com										(518)382-4567		(518)382-4567		(518)382-3290	6361	(518)382-3290	6361									(518)382-4567		(518)382-4567		(518)382-3290	6361	(518)382-3290	6361															
H3322	002	0	1	20	08	H3322_002_0	1			1		06/02/2017	2018.03	06/02/2017 11:05:16 AM Eastern Daylight Time		06/02/2017 08:21:43 AM Eastern Daylight Time			06/02/2017 11:07:53 AM Eastern Daylight Time	SENIOR CARE CONNECTION, INC.	Eddy SeniorCare	www.nehealth.com/Senior_Services/Senior_Care_PACE/	Senior Care Connection dba:  Eddy SeniorCare (PACE)	08	20		1			H3322	002	0	2018	Schenectady County, Albany County		2		2			2						www.northeasthealth.com	www.northeasthealth.com										(518)382-4567		(518)382-4567		(518)382-3290	6361	(518)382-3290	6361									(518)382-4567		(518)382-4567		(518)382-3290	6361	(518)382-3290	6361															
H3328	001	0	1	02	01	H3328_001_0	5			1		06/05/2017	2018.03	06/05/2017 09:43:59 AM Eastern Daylight Time	06/05/2017 02:55:08 PM Eastern Daylight Time				06/05/2017 02:56:39 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage without Rx (HMO-POS)	01	02		1			H3328	001	0	2018	NY Counties		2	214	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447										(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544										2					2					2	2			
H3328	002	0	1	01	01	H3328_002_0	7		1	1	2	08/02/2017	2018.03	08/02/2017 09:05:54 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Dual Advantage (HMO SNP)	01	01		1			H3328	002	0	2018	NY Counties		2	1563	2			1	3		1		1	www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	003	0	1	02	01	H3328_003_0	6			1		08/03/2017	2018.03	08/03/2017 10:43:48 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Flex (HMO-POS)	01	02		1			H3328	003	0	2018	NY Counties		2	21002	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	016	0	1	01	01	H3328_016_0	7		1	1	2	06/05/2017	2018.03	06/05/2017 09:38:23 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicaid Advantage Plus (HMO SNP)	01	01		1			H3328	016	0	2018	NY Counties		2	146	2			1	3		1		1	www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	017	0	1	01	01	H3328_017_0	6		1	1	2	08/03/2017	2018.03	08/03/2017 10:44:45 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Dual Advantage Flex (HMO SNP)	01	01		1			H3328	017	0	2018	NY Counties		2	32832	2			1	3		2		2	www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	020	1	1	01	01	H3328_020_1	7			1		08/03/2017	2018.03	08/03/2017 11:33:35 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare $0 Premium (HMO)	01	01		1			H3328	020	1	2018	NY Counties	Non-Mid Hudson Region	2	8730	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	020	2	1	01	01	H3328_020_2	6			1		08/03/2017	2018.03	08/03/2017 11:34:45 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time	08/04/2017 11:52:44 AM Eastern Daylight Time			08/04/2017 12:16:57 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare $0 Premium (HMO)	01	01		1			H3328	020	2	2018	NY Counties	Mid Hudson Region	2	2984	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	801	0	1	02	01	H3328_801_0	6			1		06/05/2017	2018.03	06/05/2017 12:05:22 PM Eastern Daylight Time					06/05/2017 02:56:39 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer without RX (HMO-POS)	01	02		1			H3328	801	0	2018	New York Counties		1	500	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447										(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544										2					2					2	2			
H3328	802	0	1	02	01	H3328_802_0	6			1		06/05/2017	2018.03	06/05/2017 12:05:02 PM Eastern Daylight Time					06/05/2017 02:56:39 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer (HMO-POS)	01	02		1			H3328	802	0	2018	New York Counties		1	500	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3328	803	0	1	02	01	H3328_803_0	6			1		06/05/2017	2018.03	06/05/2017 12:05:45 PM Eastern Daylight Time					06/05/2017 02:56:39 PM Eastern Daylight Time	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer Non-calendar (HMO-POS)	01	02		1			H3328	803	0	2018	New York Counties		1	500	2			2						www.fideliscare.org	www.fideliscare.org	www.fideliscare.org	(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)247-1447		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		(800)695-8544		2					2					2	2			
H3329	001	0	1	20	08	H3329_001_0	1			1		06/05/2017	2018.03	06/05/2017 06:30:20 PM Eastern Daylight Time		06/05/2017 06:24:44 PM Eastern Daylight Time			06/05/2017 06:32:13 PM Eastern Daylight Time	CENTERLIGHT HEALTHCARE, INC.	CenterLight TeamCare	http://www.centerlighthealthcare.org/	CenterLight Healthcare PACE Dual Eligible (PACE)	08	20		1			H3329	001	0	2018	NYC  and Westchester Counties		2		2			2						N/A	N/A										(877)226-8500		(347)640-6280		(877)226-8500		(347)640-6280										(711)-		(711)-		(711)-		(711)-																
H3329	002	0	1	20	08	H3329_002_0	1			1		06/05/2017	2018.03	06/05/2017 06:30:44 PM Eastern Daylight Time		06/05/2017 06:24:32 PM Eastern Daylight Time			06/05/2017 06:32:13 PM Eastern Daylight Time	CENTERLIGHT HEALTHCARE, INC.	CenterLight TeamCare	http://www.centerlighthealthcare.org/	CenterLight Healthcare - PACE - Medicare only (PACE)	08	20		1			H3329	002	0	2018	NYC and Westchester Counties		2		2			2						N/A	N/A										(877)226-8500		(347)640-6280		(877)226-8500		(347)640-6280										(711)-		(711)-		(711)-		(711)-																
H3330	021	1	1	01	01	H3330_021_1	7			1		08/04/2017	2018.03	08/04/2017 01:15:34 PM Eastern Daylight Time	08/04/2017 01:51:26 PM Eastern Daylight Time	08/04/2017 01:51:26 PM Eastern Daylight Time			08/04/2017 01:56:50 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Gold (HMO)	01	01		1			H3330	021	1	2018	NYC, Westchester, Long Island, Orange, Rockland	Brx,Kings, New York, Queens Counties	2	81513	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	021	2	1	01	01	H3330_021_2	7			1		08/04/2017	2018.03	08/04/2017 01:15:48 PM Eastern Daylight Time	08/04/2017 01:51:26 PM Eastern Daylight Time	08/04/2017 01:51:26 PM Eastern Daylight Time			08/04/2017 01:56:50 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Gold (HMO)	01	01		1			H3330	021	2	2018	NYC, Westchester, Long Island, Orange, Rockland	Nassau and Richmond Counties	2	69927	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	021	3	1	01	01	H3330_021_3	8			1		08/10/2017	2018.03	08/10/2017 01:35:34 PM Eastern Daylight Time	08/10/2017 02:12:48 PM Eastern Daylight Time	08/04/2017 01:51:27 PM Eastern Daylight Time			08/10/2017 03:33:04 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Gold (HMO)	01	01		1			H3330	021	3	2018	NYC, Westchester, Long Island, Orange, Rockland	Suffolk County	2	11285	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	021	4	1	01	01	H3330_021_4	8			1		08/10/2017	2018.03	08/10/2017 01:35:53 PM Eastern Daylight Time	08/10/2017 02:12:48 PM Eastern Daylight Time	08/04/2017 01:51:27 PM Eastern Daylight Time			08/10/2017 03:33:04 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Gold (HMO)	01	01		1			H3330	021	4	2018	NYC, Westchester, Long Island, Orange, Rockland	Westchester, Orange, Rockland Counties	2	6949	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	032	1	1	01	01	H3330_032_1	6			1		08/04/2017	2018.03	08/04/2017 01:16:40 PM Eastern Daylight Time	08/04/2017 01:51:27 PM Eastern Daylight Time	08/04/2017 01:51:27 PM Eastern Daylight Time			08/04/2017 01:59:39 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Essential (HMO)	01	01		1			H3330	032	1	2018	NYC, Westchester, Long Island, Orange, Rockland	Brx,Kings, New York and Queens Counties	2	196309	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	032	2	1	01	01	H3330_032_2	7			1		08/04/2017	2018.03	08/04/2017 01:16:57 PM Eastern Daylight Time	08/04/2017 01:51:27 PM Eastern Daylight Time	08/04/2017 01:51:26 PM Eastern Daylight Time			08/04/2017 01:59:39 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Essential (HMO)	01	01		1			H3330	032	2	2018	NYC, Westchester, Long Island, Orange, Rockland	Nassau and Richmond Counties	2	55486	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	032	3	1	01	01	H3330_032_3	8			1		08/10/2017	2018.03	08/10/2017 01:36:12 PM Eastern Daylight Time	08/10/2017 02:12:48 PM Eastern Daylight Time	08/04/2017 01:51:57 PM Eastern Daylight Time			08/10/2017 03:35:31 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Essential (HMO)	01	01		1			H3330	032	3	2018	NYC, Westchester, Long Island, Orange, Rockland	Suffolk County	2	11297	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	032	4	1	01	01	H3330_032_4	6			1		08/04/2017	2018.03	08/04/2017 01:17:42 PM Eastern Daylight Time	08/04/2017 01:51:57 PM Eastern Daylight Time	08/04/2017 01:51:57 PM Eastern Daylight Time			08/04/2017 01:59:39 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Essential (HMO)	01	01		1			H3330	032	4	2018	NYC, Westchester, Long Island, Orange, Rockland	Westchester, Orange and Rockland Counties	2	9608	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	036	0	1	01	01	H3330_036_0	7			1		08/04/2017	2018.03	08/04/2017 01:12:04 PM Eastern Daylight Time	08/04/2017 01:51:57 PM Eastern Daylight Time	08/04/2017 01:51:57 PM Eastern Daylight Time			08/04/2017 02:02:42 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Value (HMO)	01	01		1			H3330	036	0	2018	NYC, Westchester,  Long Island, Orange, Rockland		2	7218	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	037	0	1	01	01	H3330_037_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 01:06:43 PM Eastern Daylight Time	08/04/2017 01:51:58 PM Eastern Daylight Time	08/04/2017 01:51:58 PM Eastern Daylight Time			08/04/2017 02:04:57 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Dual (HMO SNP)	01	01		1			H3330	037	0	2018	NYC, Westchester, Long Island, Orange, Rockland		2	110022	2			1	3		1		1	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	038	0	1	01	01	H3330_038_0	6			1		05/30/2017	2018.03	05/30/2017 06:22:52 PM Eastern Daylight Time	08/04/2017 01:51:58 PM Eastern Daylight Time	08/04/2017 01:51:58 PM Eastern Daylight Time			08/04/2017 01:52:43 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Gold Plus (HMO)	01	01		1			H3330	038	0	2018	NYC, Westchester, Long Island, Orange and Rockland		2	23320	2			2						www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	814	0	1	01	01	H3330_814_0	1			1		05/26/2017	2018.03	05/26/2017 03:31:58 PM Eastern Daylight Time					06/01/2017 01:56:01 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Premier (HMO)	01	01		1			H3330	814	0	2018	NYC, Long Island, Westchester, Orange and Rockland		1	590400	2			2						emblemhealth.com	emblemhealth.com	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	815	0	1	01	01	H3330_815_0	1			1		05/26/2017	2018.03	05/26/2017 03:32:17 PM Eastern Daylight Time					06/01/2017 01:38:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Rx Carveout (HMO)	01	01		1			H3330	815	0	2018	NYC, Long Island, Westchester, Orange and Rockland		1	186960	2			2						emblemhealth.com	emblemhealth.com	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3330	818	0	1	01	01	H3330_818_0	1		1	1	2	05/26/2017	2018.03	05/26/2017 03:32:33 PM Eastern Daylight Time					06/01/2017 11:34:18 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Dual Group (HMO SNP)	01	01		1			H3330	818	0	2018	NYC, Westchester, Long Island, Orange and Rockland		1	1860	2			1	3		1		1	emblemhealth.com	emblemhealth.com	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	819	0	1	01	01	H3330_819_0	1			1		05/30/2017	2018.03	05/30/2017 12:04:16 PM Eastern Daylight Time					06/01/2017 01:42:17 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Premier (HMO)	01	01		1			H3330	819	0	2018	NYC, Westchester, Long Island, Orange and Rockland		1	6000	2			2						emblemhealth.com	emblemhealth.com	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3330	820	0	1	02	01	H3330_820_0	1			1		06/02/2017	2018.03	06/02/2017 09:18:29 AM Eastern Daylight Time					06/02/2017 09:39:58 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com/our-plans/medicare	EmblemHealth VIP Choice (HMO-POS)	01	02		1			H3330	820	0	2018	NYC, Westchester, Long Island, Orange and Rockland		1	6000	2			2						emblemhealth.com	emblemhealth.com	www.emblemhealth.com/our-plans/medicare	(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(877)344-7364		(877)344-7364		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3331	001	0	1	20	08	H3331_001_0	1			1		05/25/2017	2018.03	05/25/2017 03:31:25 PM Eastern Daylight Time		05/25/2017 09:27:52 AM Eastern Daylight Time			05/25/2017 03:35:20 PM Eastern Daylight Time	INDEPENDENT LIVING FOR SENIORS, INC.	ElderONE an Affiliate of Rochester Regional Health	www.ElderONE.org	ElderONE an Affiliate of Rochester Regional Health (PACE)	08	20		1			H3331	001	0	2018	Monroe County		2		2			2						www.rochestergeneral.org/hillhaven	www.rochestergeneral.org										(855)457-4636		(585)922-2831		(855)457-4636		(585)922-2831										(800)662-1220		(585)922-2831		(800)662-1220		(585)922-2831																
H3331	002	0	1	20	08	H3331_002_0	1			1		05/25/2017	2018.03	05/25/2017 03:33:22 PM Eastern Daylight Time		05/25/2017 09:27:38 AM Eastern Daylight Time			05/25/2017 03:35:20 PM Eastern Daylight Time	INDEPENDENT LIVING FOR SENIORS, INC.	ElderONE an Affiliate of Rochester Regional Health	www.ElderONE.org	ElderONE an Affiliate of Rochester Regional Health (PACE)	08	20		1			H3331	002	0	2018	Monroe County		2		2			2						www.rochestergeneral.org/hillhaven	www.rochestergeneral.org										(855)457-4636		(585)922-2831		(855)457-4636		(585)922-2831										(800)662-1220		(585)922-2831		(800)662-1220		(585)922-2831																
H3335	005	0	1	04	01	H3335_005_0	5			1		08/07/2017	2018.03	08/07/2017 09:09:42 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueSecure (PPO)	01	04		1			H3335	005	0	2018	Utica-Rome Metro		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	006	0	1	04	01	H3335_006_0	5			1		06/29/2017	2018.03	06/29/2017 03:08:49 PM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueEnhanced (PPO)	01	04		1			H3335	006	0	2018	Utica-Rome Metro		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	014	0	1	04	01	H3335_014_0	5			1		08/07/2017	2018.03	08/07/2017 09:09:53 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueSecure (PPO)	01	04		1			H3335	014	0	2018	Central New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	015	0	1	04	01	H3335_015_0	5			1		06/29/2017	2018.03	06/29/2017 03:10:57 PM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueEnhanced (PPO)	01	04		1			H3335	015	0	2018	Central New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	018	0	1	04	01	H3335_018_0	5			1		06/29/2017	2018.03	06/29/2017 03:13:41 PM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BluePlus (PPO)	01	04		1			H3335	018	0	2018	East New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	038	0	1	04	01	H3335_038_0	5			1		08/07/2017	2018.03	08/07/2017 09:02:47 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueClassic (PPO)	01	04		1			H3335	038	0	2018	Central New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	041	0	1	04	01	H3335_041_0	4			1		06/29/2017	2018.03	06/29/2017 03:16:08 PM Eastern Daylight Time	06/05/2017 03:00:59 PM Eastern Daylight Time				06/30/2017 01:32:20 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueBasic (PPO)	01	04		1			H3335	041	0	2018	Utica-Rome Metro		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2						2			
H3335	043	0	1	04	01	H3335_043_0	4			1		06/29/2017	2018.03	06/29/2017 03:17:12 PM Eastern Daylight Time	06/05/2017 03:00:59 PM Eastern Daylight Time				06/30/2017 01:32:20 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueBasic (PPO)	01	04		1			H3335	043	0	2018	Central New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2						2			
H3335	044	0	1	04	01	H3335_044_0	4			1		06/30/2017	2018.03	06/30/2017 12:58:16 PM Eastern Daylight Time	06/05/2017 03:00:59 PM Eastern Daylight Time				06/30/2017 01:32:20 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueBasic (PPO)	01	04		1			H3335	044	0	2018	East New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2						2			
H3335	051	0	1	04	01	H3335_051_0	5			1		08/07/2017	2018.03	08/07/2017 08:59:31 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueClassic (PPO)	01	04		1			H3335	051	0	2018	Utica-Rome Metro		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	053	0	1	04	01	H3335_053_0	5			1		08/07/2017	2018.03	08/07/2017 09:26:17 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueEssential (PPO)	01	04		1			H3335	053	0	2018	Central New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	054	0	1	04	01	H3335_054_0	5			1		08/07/2017	2018.03	08/07/2017 09:26:48 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:28:35 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare BlueEssential (PPO)	01	04		1			H3335	054	0	2018	Utica-Rome Metro		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	801	0	1	04	01	H3335_801_0	1			1		05/31/2017	2018.03	05/31/2017 03:32:20 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera Medicare PPO Group (PPO)	01	04		1			H3335	801	0	2018	Western New York		1	2469	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	811	0	1	04	01	H3335_811_0	1			1		05/26/2017	2018.03	05/26/2017 03:23:19 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue PPO Group (PPO)	01	04		1			H3335	811	0	2018	National and Puerto Rico		1	126181	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	813	0	1	04	01	H3335_813_0	1			1		05/26/2017	2018.03	05/26/2017 03:23:46 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera Medicare PPO Group (PPO)	01	04		1			H3335	813	0	2018	Western New York		1	0	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2						2			
H3335	819	0	1	04	01	H3335_819_0	1			1		05/26/2017	2018.03	05/26/2017 03:24:50 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue PPO Group (PPO)	01	04		1			H3335	819	0	2018	National and Puerto Rico		1	0	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2						2			
H3335	820	0	1	04	01	H3335_820_0	1			1		05/26/2017	2018.03	05/26/2017 03:25:05 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue PPO Group Non-Calendar (PPO)	01	04		1			H3335	820	0	2018	National and Puerto Rico		1	0	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3335	822	0	1	04	01	H3335_822_0	1			1		05/26/2017	2018.03	05/26/2017 03:25:32 PM Eastern Daylight Time					05/31/2017 03:36:45 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera Medicare PPO Group Non-Calendar (PPO)	01	04		1			H3335	822	0	2018	Western New York		1	0	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2						2			
H3342	019	0	1	04	01	H3342_019_0	5			1		06/04/2017	2018.03	06/04/2017 02:51:59 PM Eastern Daylight Time	08/07/2017 08:51:46 AM Eastern Daylight Time	08/06/2017 03:05:36 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Access (PPO)	01	04		1			H3342	019	0	2018	Albany, Rensselaer, Saratoga, Schoharie		2	6606	2			2						www.empireblue.com/medicare	www.empireblue.com/medicare	www.empireblue.com/medicare	(866)395-5175		(866)395-5175		(800)797-6308		(800)797-6308		(866)395-5175		(866)395-5175		(844)364-2114		(844)364-2114		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3342	808	0	1	04	01	H3342_808_0	1			1		06/03/2017	2018.03	06/03/2017 11:29:50 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Freedom (PPO)	01	04		1			H3342	808	0	2018	New York		1	26988	2			2						www.empireblue.com/medicare	www.empireblue.com/medicare	www.empireblue.com/medicare	(866)222-0444		(866)222-0444		(866)205-6551		(866)205-6551		(866)222-0444		(866)222-0444		(866)205-6551		(866)205-6551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H3342	809	0	1	04	01	H3342_809_0	1			1		06/03/2017	2018.03	06/03/2017 11:31:19 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Freedom (PPO)	01	04		1			H3342	809	0	2018	New York		1	6891	2			2						www.empireblue.com/medicare	www.empireblue.com/medicare	www.empireblue.com/medicare	(866)222-0444		(866)222-0444		(866)205-6551		(866)205-6551										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H3342	810	0	1	04	01	H3342_810_0	2			1		06/03/2017	2018.03	06/03/2017 11:31:50 AM Pacific Daylight Time					06/04/2017 11:06:28 AM Pacific Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Freedom (PPO)	01	04		1			H3342	810	0	2018	New York		1	600	2			2						www.empireblue.com/medicare	www.empireblue.com/medicare	www.empireblue.com/medicare	(866)222-0444		(866)222-0444		(866)205-6551		(866)205-6551		(866)222-0444		(866)222-0444		(866)205-6551		(866)205-6551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H3344	005	0	1	04	01	H3344_005_0	9			1		08/01/2017	2018.03	08/01/2017 02:00:21 PM Eastern Daylight Time	08/01/2017 02:50:50 PM Eastern Daylight Time	08/01/2017 02:12:12 PM Eastern Daylight Time			08/07/2017 10:39:25 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	independenthealth.com/medicare	Independent Health Medicare Passport Advantage (PPO)	01	04		1			H3344	005	0	2018	Western New York		2	53294	2			2						www.independentheatlh.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		2					2						2			
H3344	801	0	1	04	01	H3344_801_0	2			1		06/02/2017	2018.03	06/02/2017 03:42:52 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	independenthealth.com/medicare	Independent Health Medicare PPO Base (PPO)	01	04		1			H3344	801	0	2018	IH Network and Medicare Deemed Network		1	23715	2			2						www.independentheatlh.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		1	1	1a;1b;2;5;6;7c;7d;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1									
H3344	804	0	1	04	01	H3344_804_0	2			1		06/02/2017	2018.03	06/02/2017 03:44:01 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	independenthealth.com/medicare	Independent Health Medicare PPO Base (PPO)	01	04		1			H3344	804	0	2018	IH Network and Medicare Deemed Network		1	17873	2			2						www.independentheatlh.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840										1	1	1a;1b;2;5;6;7c;7d;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1									
H3347	002	0	1	01	01	H3347_002_0	8		1	1	2	08/03/2017	2018.03	08/03/2017 05:15:28 PM Eastern Daylight Time	08/03/2017 06:18:28 PM Eastern Daylight Time	08/03/2017 04:18:28 PM Eastern Daylight Time			08/04/2017 03:10:34 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.elderplan.org	Elderplan For Medicaid Beneficiaries (HMO SNP)	01	01		1			H3347	002	0	2018	Brx, Ki, Na, NY, Qu, Wes		2	54120	2			1	3		2		2	www.caremark.com	www.elderplan.org	www.elderplan.org	(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3347	003	0	1	01	01	H3347_003_0	8		1	1		08/04/2017	2018.03	08/04/2017 04:04:51 PM Eastern Daylight Time	08/03/2017 06:19:58 PM Eastern Daylight Time	08/03/2017 04:19:56 PM Eastern Daylight Time			08/04/2017 04:06:46 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.elderplan.org	Elderplan Advantage For Nursing Home Residents (HMO SNP)	01	01		1			H3347	003	0	2018	Brx, Ki, Monr, Na, NY, Qu, Ri, Suf, Wes		2	22050	2			1	1	1				www.caremark.com	www.elderplan.org	www.elderplan.org	(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3347	007	0	1	01	01	H3347_007_0	9		1	1	2	08/03/2017	2018.03	08/03/2017 05:26:58 PM Eastern Daylight Time	08/03/2017 06:21:16 PM Eastern Daylight Time	08/03/2017 04:20:54 PM Eastern Daylight Time			08/04/2017 03:10:34 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.elderplan.org	Elderplan Plus Long Term Care (HMO SNP)	01	01		1			H3347	007	0	2018	Brx, Ki, Na, NY, Qu, Ri, Wes		2	16590	2			1	3		2		1	www.caremark.com	www.elderplan.org	www.elderplan.org	(877)891-6447		(718)921-7979		(866)695-8101		(866)695-8101		(877)891-6447		(718)921-7979		(866)695-8101		(866)695-8101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3347	009	0	1	01	01	H3347_009_0	7			1		08/03/2017	2018.03	08/03/2017 05:30:42 PM Eastern Daylight Time	08/03/2017 06:22:56 PM Eastern Daylight Time	08/03/2017 04:21:48 PM Eastern Daylight Time			08/04/2017 01:27:09 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.elderplan.org	Elderplan Extra Help (HMO)	01	01		1			H3347	009	0	2018	Brx, Ki, NY, Qu, Wes		2	38420	2			2						www.caremark.com	www.elderplan.org	www.elderplan.org	(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(800)353-3765		(718)921-7979		(866)695-8101		(866)695-8101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3351	001	0	1	02	01	H3351_001_0	4			1		06/28/2017	2018.03	06/28/2017 03:59:06 PM Eastern Daylight Time	06/05/2017 03:00:59 PM Eastern Daylight Time				06/30/2017 01:46:57 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Select (HMO-POS)	01	02		1			H3351	001	0	2018	Western New York		2		2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2					2	2			
H3351	002	0	1	02	01	H3351_002_0	5			1		08/07/2017	2018.03	08/07/2017 08:38:18 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Secure (HMO-POS)	01	02		1			H3351	002	0	2018	Western New York		2		2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	006	0	1	02	01	H3351_006_0	5			1		06/28/2017	2018.03	06/28/2017 03:58:49 PM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:22:20 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Optimum (HMO-POS)	01	02		1			H3351	006	0	2018	Metro Rochester		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	007	0	1	02	01	H3351_007_0	4			1		06/29/2017	2018.03	06/29/2017 04:28:35 PM Eastern Daylight Time	06/05/2017 03:00:59 PM Eastern Daylight Time				06/30/2017 01:46:57 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Platinum (HMO-POS)	01	02		1			H3351	007	0	2018	Metro Rochester		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2					2	2			
H3351	010	0	1	01	01	H3351_010_0	5			1		08/07/2017	2018.03	08/07/2017 08:37:31 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Value (HMO)	01	01		1			H3351	010	0	2018	Western New York		2		2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	011	0	1	01	01	H3351_011_0	5			1		08/07/2017	2018.03	08/07/2017 08:50:08 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Value (HMO)	01	01		1			H3351	011	0	2018	Metro Rochester		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	012	0	1	02	01	H3351_012_0	5			1		08/07/2017	2018.03	08/07/2017 08:37:47 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Value Plus (HMO-POS)	01	02		1			H3351	012	0	2018	Western New York		2		2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	013	0	1	01	01	H3351_013_0	5			1		08/07/2017	2018.03	08/07/2017 08:51:04 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Value Plus (HMO)	01	01		1			H3351	013	0	2018	Metro Rochester		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	015	0	1	02	01	H3351_015_0	5			1		06/28/2017	2018.03	06/28/2017 03:57:52 PM Eastern Daylight Time	08/07/2017 08:28:22 AM Eastern Daylight Time	08/07/2017 08:28:20 AM Eastern Daylight Time			08/07/2017 09:22:20 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Bassett (HMO-POS)	01	02		1			H3351	015	0	2018	East New York		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(844)854-4063		(844)854-4063		(800)659-1986		(800)659-1986		(844)854-4063		(844)854-4063		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	016	0	1	02	01	H3351_016_0	5			1		08/07/2017	2018.03	08/07/2017 08:46:12 AM Eastern Daylight Time	08/07/2017 08:28:20 AM Eastern Daylight Time	08/07/2017 08:28:20 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Select (HMO-POS)	01	02		1			H3351	016	0	2018	Metro Rochester		2		2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	017	0	1	01	01	H3351_017_0	5			1		08/07/2017	2018.03	08/07/2017 08:37:16 AM Eastern Daylight Time	08/07/2017 08:28:20 AM Eastern Daylight Time	08/07/2017 08:28:21 AM Eastern Daylight Time			08/07/2017 09:15:41 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Basic (HMO)	01	01		1			H3351	017	0	2018	Western New York		2		2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(877)883-9577		(877)883-9577		(800)659-1986		(800)659-1986		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	801	0	1	02	01	H3351_801_0	1			1		05/31/2017	2018.03	05/31/2017 03:31:58 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice - Group (HMO-POS)	01	02		1			H3351	801	0	2018	Western New York		1	3336	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	802	0	1	02	01	H3351_802_0	1			1		05/26/2017	2018.03	05/26/2017 03:42:23 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice - Group (HMO-POS)	01	02		1			H3351	802	0	2018	Metro Rochester and Central New York		1	207404	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	803	0	1	02	01	H3351_803_0	1			1		05/26/2017	2018.03	05/26/2017 03:43:08 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice - Group (HMO-POS)	01	02		1			H3351	803	0	2018	Western New York		1	60	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2					2	2			
H3351	804	0	1	02	01	H3351_804_0	1			1		05/26/2017	2018.03	05/26/2017 03:44:17 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice - Group (HMO-POS)	01	02		1			H3351	804	0	2018	Metro Rochester and Central New York		1	1854	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220										2					2					2	2			
H3351	805	0	1	02	01	H3351_805_0	1			1		05/26/2017	2018.03	05/26/2017 03:45:58 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.UniveraMedicare.com	Univera SeniorChoice Group Non-Calendar (HMO-POS)	01	02		1			H3351	805	0	2018	Western New York		1	0	2			2						www.UniveraMedicare.com	www.UniveraMedicare.com	www.UniveraMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3351	806	0	1	02	01	H3351_806_0	1			1		05/26/2017	2018.03	05/26/2017 03:46:13 PM Eastern Daylight Time					05/31/2017 05:10:53 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.ExcellusMedicare.com	Medicare Blue Choice Group Non-Calendar (HMO-POS)	01	02		1			H3351	806	0	2018	Metro Rochester and Central New York		1	0	2			2						www.ExcellusMedicare.com	www.ExcellusMedicare.com	www.ExcellusMedicare.com	(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220		2					2					2	2			
H3359	001	0	1	01	01	H3359_001_0	5			1		08/07/2017	2018.03	08/07/2017 02:15:07 PM Eastern Daylight Time	08/07/2017 02:49:18 PM Eastern Daylight Time	08/07/2017 03:12:29 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst 65 Plus Plan (HMO)	01	01		1			H3359	001	0	2018	New York City and Nassau County		2		2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	019	0	1	01	01	H3359_019_0	5			1		07/06/2017	2018.03	07/06/2017 02:09:43 PM Eastern Daylight Time	08/07/2017 02:52:08 PM Eastern Daylight Time	08/07/2017 03:13:16 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Increased Benefits Plan (HMO)	01	01		1			H3359	019	0	2018	New York City and Nassau County		2		2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	021	0	1	01	01	H3359_021_0	4		1	1	2	06/02/2017	2018.03	06/02/2017 01:45:47 PM Eastern Daylight Time	08/07/2017 02:54:17 PM Eastern Daylight Time	08/07/2017 03:13:47 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Life Improvement Plan (HMO SNP)	01	01		1			H3359	021	0	2018	New York City, Nassau and Westchester Counties		2		2			1	3		2		2	www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	027	0	1	01	01	H3359_027_0	4			1		07/06/2017	2018.03	07/06/2017 02:10:13 PM Eastern Daylight Time	06/05/2017 05:42:59 PM Eastern Daylight Time				07/06/2017 03:01:58 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Coordinated Benefits Plan (HMO)	01	01		1			H3359	027	0	2018	New York City and Nassau County		2		2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303										(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821										2					2					2	2			
H3359	034	0	1	01	01	H3359_034_0	4		1	1	2	06/01/2017	2018.03	06/01/2017 05:03:09 PM Eastern Daylight Time	08/07/2017 02:58:12 PM Eastern Daylight Time	08/07/2017 03:14:19 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst CompleteCare (HMO SNP)	01	01		1			H3359	034	0	2018	New York City, Nassau, and Westchester Counties		2		2			1	3		1		1	www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	035	0	1	01	01	H3359_035_0	5		1	1		07/06/2017	2018.03	07/06/2017 02:10:34 PM Eastern Daylight Time	08/07/2017 03:00:34 PM Eastern Daylight Time	08/07/2017 03:14:49 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst AssuredCare (HMO SNP)	01	01		1			H3359	035	0	2018	New York City and Nassau County		2		2			1	1	1				www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	036	0	1	01	01	H3359_036_0	7			1		07/06/2017	2018.03	07/06/2017 02:10:54 PM Eastern Daylight Time	08/07/2017 03:02:46 PM Eastern Daylight Time	08/07/2017 03:15:23 PM Eastern Daylight Time			08/07/2017 03:20:53 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Mount Sinai Select (HMO)	01	01		1			H3359	036	0	2018	Manhattan		2		2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	1	11	7a;7d;7f;7g;	7f;
H3359	808	0	1	01	01	H3359_808_0	5			1		07/20/2017	2018.03	07/20/2017 10:09:04 AM Eastern Daylight Time					07/20/2017 10:25:41 AM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Employer Group 1 (HMO)	01	01		1			H3359	808	0	2018	United States		1	120	2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare			(888)260-1010				(877)237-1303		(888)260-1010		(888)260-1010		(877)237-1303		(877)237-1303		(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821		(711)-		(711)-		(888)542-3821		(888)542-3821		2					2					2	2			
H3359	809	0	1	01	01	H3359_809_0	5			1		07/20/2017	2018.03	07/20/2017 10:09:49 AM Eastern Daylight Time					07/20/2017 10:25:41 AM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst Employer Group 2 (HMO)	01	01		1			H3359	809	0	2018	United States		1	120	2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare			(888)260-1010				(877)237-1303										(888)542-3821		(888)542-3821		(888)542-3821		(888)542-3821										2					2					2	2			
H3361	043	0	1	01	01	H3361_043_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 02:58:42 PM Eastern Daylight Time	08/04/2017 03:03:11 PM Eastern Daylight Time	07/31/2017 07:10:26 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H3361	043	0	2018	Select Counties in NY		2	28703	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)491-5746		(866)491-5746		(866)527-0056		(866)527-0056		(866)491-5746		(866)491-5746		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	059	0	1	01	01	H3361_059_0	1			1		05/05/2017	2018.03	05/05/2017 07:41:38 AM Eastern Daylight Time	06/02/2017 11:38:48 AM Eastern Daylight Time				06/02/2017 01:18:33 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Advance (HMO)	01	01		1			H3361	059	0	2018	Select Counties in NY		2	3403	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056										(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272										2					2					2	2			
H3361	065	0	1	01	01	H3361_065_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 08:41:22 AM Eastern Daylight Time	08/04/2017 03:04:21 PM Eastern Daylight Time	07/31/2017 07:10:49 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H3361	065	0	2018	Select Counties in NY		2	18715	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)482-3363		(866)482-3363		(866)527-0056		(866)527-0056		(866)482-3363		(866)482-3363		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	109	0	1	01	01	H3361_109_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 08:43:54 AM Eastern Daylight Time	08/04/2017 03:05:31 PM Eastern Daylight Time	07/31/2017 07:11:11 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Access (HMO SNP)	01	01		1			H3361	109	0	2018	Select Counties in NY		2	204489	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(866)482-3363		(866)482-3363		(866)527-0056		(866)527-0056		(866)482-3363		(866)482-3363		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	130	0	1	01	01	H3361_130_0	3			1		06/28/2017	2018.03	06/28/2017 09:49:01 AM Eastern Daylight Time	08/04/2017 03:06:39 PM Eastern Daylight Time	07/31/2017 07:11:33 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Rx (HMO)	01	01		1			H3361	130	0	2018	Bronx, Kings, New York, Queens, Richmond Counties		2	80283	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	132	0	1	01	01	H3361_132_0	3			1		08/03/2017	2018.03	08/03/2017 10:23:51 AM Eastern Daylight Time	08/04/2017 03:07:46 PM Eastern Daylight Time	07/31/2017 07:11:55 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO)	01	01		1			H3361	132	0	2018	Nassau County		2	2751	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	133	0	1	01	01	H3361_133_0	2			1		08/03/2017	2018.03	08/03/2017 10:22:21 AM Eastern Daylight Time	08/04/2017 03:08:52 PM Eastern Daylight Time	07/31/2017 07:12:18 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO)	01	01		1			H3361	133	0	2018	Ulster County		2	9118	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	134	0	1	01	01	H3361_134_0	2			1		08/03/2017	2018.03	08/03/2017 10:24:37 AM Eastern Daylight Time	08/04/2017 03:09:59 PM Eastern Daylight Time	07/31/2017 07:12:40 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO)	01	01		1			H3361	134	0	2018	Erie, Niagra, Oneida, Schenectady Counties		2	12660	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	135	0	1	02	01	H3361_135_0	2			1		08/03/2017	2018.03	08/03/2017 10:26:04 AM Eastern Daylight Time	08/04/2017 03:11:08 PM Eastern Daylight Time	07/31/2017 07:13:02 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Preferred (HMO-POS)	01	02		1			H3361	135	0	2018	Select Counties in NY		2	2905	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	136	1	1	01	01	H3361_136_1	2			1		08/03/2017	2018.03	08/03/2017 01:36:50 PM Eastern Daylight Time	08/04/2017 03:12:15 PM Eastern Daylight Time	07/31/2017 07:13:25 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H3361	136	1	2018	Select Counties in New York	Select Counties in New York	2	22576	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	136	2	1	01	01	H3361_136_2	2			1		08/03/2017	2018.03	08/03/2017 01:37:34 PM Eastern Daylight Time	08/04/2017 03:13:22 PM Eastern Daylight Time	07/31/2017 07:13:47 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H3361	136	2	2018	Select Counties in New York	Select Counties in New York	2	50174	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	137	1	1	02	01	H3361_137_1	2			1		08/03/2017	2018.03	08/03/2017 01:38:13 PM Eastern Daylight Time	08/04/2017 03:14:29 PM Eastern Daylight Time	07/31/2017 07:14:09 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO-POS)	01	02		1			H3361	137	1	2018	Select Counties in New York	Select Counties in New York	2	21290	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	137	2	1	02	01	H3361_137_2	3			1		08/03/2017	2018.03	08/03/2017 01:38:55 PM Eastern Daylight Time	08/04/2017 03:15:37 PM Eastern Daylight Time	07/31/2017 07:14:31 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Choice (HMO-POS)	01	02		1			H3361	137	2	2018	Select Counties in New York	Select Counties in New York	2	69405	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3361	138	0	1	01	01	H3361_138_0	2			1		08/03/2017	2018.03	08/03/2017 10:31:33 AM Eastern Daylight Time	08/03/2017 04:41:53 PM Eastern Daylight Time	07/31/2017 07:14:53 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	WELLCARE OF NEW YORK, INC.	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H3361	138	0	2018	Selected New York Counties		2	200	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(800)278-5155		(800)278-5155		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H3362	016	0	1	01	01	H3362_016_0	5			1		07/07/2017	2018.03	07/07/2017 10:49:07 AM Eastern Daylight Time	07/06/2017 04:20:07 PM Eastern Daylight Time				07/07/2017 11:56:51 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Encompass 65 (HMO)	01	01		1			H3362	016	0	2018	Western New York		2	46696	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840										2					2					2	2			
H3362	017	0	1	01	01	H3362_017_0	12			1		08/01/2017	2018.03	08/01/2017 02:06:02 PM Eastern Daylight Time	08/01/2017 02:18:10 PM Eastern Daylight Time	08/01/2017 02:12:58 PM Eastern Daylight Time			08/07/2017 10:39:25 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Encompass 65 Basic (HMO)	01	01		1			H3362	017	0	2018	Western New York		2	293454	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		2					2					2	2			
H3362	020	0	1	01	01	H3362_020_0	9		1	1		08/01/2017	2018.03	08/01/2017 02:07:21 PM Eastern Daylight Time	08/01/2017 02:20:24 PM Eastern Daylight Time	08/01/2017 02:13:40 PM Eastern Daylight Time			08/07/2017 10:39:25 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Medicare Family Choice (HMO SNP)	01	01		1			H3362	020	0	2018	Western New York		2	15475	2			1	1	3				www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		2					2					2	2			
H3362	033	0	1	01	01	H3362_033_0	9			1		08/01/2017	2018.03	08/01/2017 02:29:41 PM Eastern Daylight Time	08/04/2017 10:17:20 AM Eastern Daylight Time	08/01/2017 02:14:20 PM Eastern Daylight Time			08/07/2017 10:39:25 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health's Encompass 65 Core (HMO)	01	01		1			H3362	033	0	2018	Western New York		2	302580	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)250-4401		(800)665-1502		(716)250-4401		(800)958-4405		(716)250-4401		(800)432-1110		(716)631-3108		(888)357-9167		(716)631-3108		(800)432-1110		(716)631-3108		(888)357-9167		(716)631-3108		2					2					2	2			
H3362	801	0	1	01	01	H3362_801_0	2			1		05/26/2017	2018.03	05/26/2017 03:11:18 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Medicare Encompass (HMO)	01	01		1			H3362	801	0	2018	New York State		1	50123	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1					1				
H3362	807	0	1	02	01	H3362_807_0	2			1		05/26/2017	2018.03	05/26/2017 03:11:48 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Medicare Encompass (HMO-POS)	01	02		1			H3362	807	0	2018	IH Network and Medicare Deemed Network		1	37958	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840		1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1				
H3362	819	0	1	02	01	H3362_819_0	2			1		05/26/2017	2018.03	05/26/2017 03:12:12 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Medicare Encompass (HMO-POS)	01	02		1			H3362	819	0	2018	IH Network and Medicare Deemed Network		1	3570	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840										1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1				
H3362	820	0	1	01	01	H3362_820_0	2			1		05/26/2017	2018.03	05/26/2017 03:12:36 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	independenthealth.com/medicare	Independent Health Medicare Encompass (HMO)	01	01		1			H3362	820	0	2018	New York State		1	43820	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840										1	1	1a;1b;2;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;11c;15;16b;	2		1					1				
H3379	001	0	1	01	01	H3379_001_0	3			1		06/01/2017	2018.03	06/01/2017 09:20:08 AM Central Daylight Time	08/03/2017 01:18:42 PM Central Daylight Time	08/01/2017 10:30:56 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3379	001	0	2018	New York City		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	002	0	1	01	01	H3379_002_0	4		1	1		07/07/2017	2018.03	07/07/2017 11:37:57 AM Central Daylight Time	08/03/2017 01:19:10 PM Central Daylight Time	08/01/2017 10:31:24 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3379	002	0	2018	New York Metropolitan area		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	022	0	1	01	01	H3379_022_0	4		1	1		07/07/2017	2018.03	07/07/2017 11:38:08 AM Central Daylight Time	08/03/2017 01:19:37 PM Central Daylight Time	08/01/2017 10:31:51 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3379	022	0	2018	Upstate New York		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	039	0	1	01	01	H3379_039_0	6			1		08/02/2017	2018.03	08/02/2017 02:36:27 PM Central Daylight Time	08/03/2017 01:20:04 PM Central Daylight Time	08/01/2017 10:32:18 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3379	039	0	2018	Syracuse		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	040	0	1	01	01	H3379_040_0	6			1		08/02/2017	2018.03	08/02/2017 02:36:56 PM Central Daylight Time	08/03/2017 01:20:32 PM Central Daylight Time	08/01/2017 10:32:45 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete (HMO)	01	01		1			H3379	040	0	2018	Buffalo Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	041	0	1	01	01	H3379_041_0	6			1		08/02/2017	2018.03	08/02/2017 02:37:23 PM Central Daylight Time	08/03/2017 01:20:59 PM Central Daylight Time	08/01/2017 10:33:12 AM Central Daylight Time			08/04/2017 12:40:43 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete (HMO)	01	01		1			H3379	041	0	2018	Rochester Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3379	042	0	1	01	01	H3379_042_0	5		1	1		07/07/2017	2018.03	07/07/2017 11:38:18 AM Central Daylight Time	08/03/2017 01:21:26 PM Central Daylight Time	08/01/2017 10:33:39 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3379	042	0	2018	Jefferson County		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	013	0	1	01	01	H3384_013_0	4			1		08/07/2017	2018.03	08/07/2017 09:32:04 AM Eastern Daylight Time	08/07/2017 05:05:51 PM Eastern Daylight Time	08/07/2017 05:06:15 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com/medicare	BlueShield Senior Blue 652 (HMO)	01	01		1			H3384	013	0	2018	Northeastern New York		2	38544	2			2						www.bsneny.com/medicare	www.bsneny.com/medicare	www.bsneny.com/medicare	(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	019	0	1	01	01	H3384_019_0	3			1		06/02/2017	2018.03	06/02/2017 09:58:20 AM Eastern Daylight Time	08/07/2017 05:05:52 PM Eastern Daylight Time	08/07/2017 05:06:17 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Senior Blue 651 (HMO)	01	01		1			H3384	019	0	2018	Western New York		2	78396	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	022	0	1	01	01	H3384_022_0	2			1		06/02/2017	2018.03	06/02/2017 02:40:29 PM Eastern Daylight Time	06/05/2017 10:32:46 AM Eastern Daylight Time				06/05/2017 10:37:50 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Senior Blue 601 (HMO)	01	01		1			H3384	022	0	2018	Western New York		2	17556	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3384	058	0	1	01	01	H3384_058_0	4			1		06/21/2017	2018.03	06/21/2017 09:51:45 PM Eastern Daylight Time	08/07/2017 05:05:53 PM Eastern Daylight Time	08/07/2017 05:06:17 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Senior Blue Select (HMO)	01	01		1			H3384	058	0	2018	Western New York		2	80052	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	059	0	1	02	01	H3384_059_0	3			1		06/02/2017	2018.03	06/02/2017 12:25:16 PM Eastern Daylight Time	08/07/2017 05:05:54 PM Eastern Daylight Time	08/07/2017 05:06:18 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com/medicare	BlueShield Senior Blue 650 (HMO-POS)	01	02		1			H3384	059	0	2018	Northeastern New York		2	20340	2			2						www.bsneny.com/medicare	www.bsneny.com/medicare	www.bsneny.com/medicare	(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	062	0	1	01	01	H3384_062_0	3			1		08/07/2017	2018.03	08/07/2017 10:04:07 AM Eastern Daylight Time	08/07/2017 05:05:55 PM Eastern Daylight Time	08/07/2017 05:06:19 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield BlueSaver (HMO)	01	01		1			H3384	062	0	2018	Western New York		2	48768	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	063	0	1	01	01	H3384_063_0	3			1		06/02/2017	2018.03	06/02/2017 10:03:45 AM Eastern Daylight Time	08/07/2017 05:05:56 PM Eastern Daylight Time	08/07/2017 05:06:19 PM Eastern Daylight Time			08/07/2017 05:30:58 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com/medicare	BlueShield BlueSaver (HMO)	01	01		1			H3384	063	0	2018	Northeastern New York		2	16800	2			2						www.bsneny.com/medicare	www.bsneny.com/medicare	www.bsneny.com/medicare	(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3384	805	0	1	01	01	H3384_805_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:06 AM Eastern Daylight Time					06/13/2017 11:09:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	HMO Group MA Only Plan (HMO)	01	01		1			H3384	805	0	2018	Western and Northeastern New York		1	132	2			2						www.bcbswny.com	http://www.bcbswny.com/pharmacy	www.nymedicare.com	(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;9a;9b;9c;11a;11b;11c;15;	2		1					1				
H3384	806	0	1	01	01	H3384_806_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:25 AM Eastern Daylight Time					06/13/2017 11:09:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	HMO Group (MA-PD) Calendar Year (HMO)	01	01		1			H3384	806	0	2018	Western and Northeastern New York		1	49728	2			2						www.bcbswny.com	http://www.bcbswny.com/pharmacy	www.nymedicare.com	(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237		(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;9a;9b;9c;11a;11b;11c;15;	2		1					1				
H3387	010	0	1	01	01	H3387_010_0	3		1	1	2	07/06/2017	2018.03	07/06/2017 03:28:08 PM Central Daylight Time	08/03/2017 01:23:29 PM Central Daylight Time	08/01/2017 10:34:06 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3387	010	0	2018	Select counties in New York		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)514-4912		(800)514-4912		(888)834-3721		(888)834-3721		(800)514-4912		(800)514-4912		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3388	001	0	1	01	01	H3388_001_0	8			1		08/03/2017	2018.03	08/03/2017 09:25:11 AM Eastern Daylight Time	08/05/2017 12:09:04 AM Eastern Daylight Time				08/08/2017 09:28:04 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices		CDPHP Choice (HMO)	01	01		1			H3388	001	0	2018	Greater Capital Region of New York State		2	10513	2			2									(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400										(711)-		(711)-		(711)-		(711)-										2					2					2	1	01	7a;	
H3388	002	0	1	01	01	H3388_002_0	9			1		08/07/2017	2018.03	08/07/2017 10:03:57 AM Eastern Daylight Time	08/05/2017 12:26:28 AM Eastern Daylight Time	08/02/2017 12:35:28 PM Eastern Daylight Time			08/08/2017 09:28:04 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Choice Rx (HMO)	01	01		1			H3388	002	0	2018	Greater Capital Region of New York State		2	167506	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H3388	004	0	1	01	01	H3388_004_0	9			1		08/04/2017	2018.03	08/04/2017 08:39:28 AM Eastern Daylight Time	08/05/2017 12:27:46 AM Eastern Daylight Time	08/02/2017 12:37:42 PM Eastern Daylight Time			08/08/2017 09:28:04 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Value Rx (HMO)	01	01		1			H3388	004	0	2018	Greater Capital Region of New York State		2	118768	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H3388	013	0	1	01	01	H3388_013_0	9			1		08/04/2017	2018.03	08/04/2017 09:19:32 AM Eastern Daylight Time	08/05/2017 12:40:36 AM Eastern Daylight Time	08/02/2017 12:39:14 PM Eastern Daylight Time			08/08/2017 09:28:04 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Basic RX (HMO)	01	01		1			H3388	013	0	2018	Greater Capital Region of New York State		2	26333	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H3388	014	0	1	01	01	H3388_014_0	13			1		08/07/2017	2018.03	08/07/2017 02:47:11 PM Eastern Daylight Time	08/08/2017 11:19:57 AM Eastern Daylight Time	08/02/2017 12:40:50 PM Eastern Daylight Time			08/08/2017 11:51:32 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP $0 Medicare Rx (HMO)	01	01		1			H3388	014	0	2018	Greater Capital Region of New York State		2	9607	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3388	801	0	1	01	01	H3388_801_0	4			1		06/08/2017	2018.03	06/08/2017 01:39:11 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Group Medicare Rx (HMO)	01	01		1			H3388	801	0	2018	Greater Capital Region of New York State		1	36	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;14d;	1					1				
H3388	803	0	1	01	01	H3388_803_0	4			1		06/08/2017	2018.03	06/08/2017 01:44:18 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Group Medicare Rx (HMO)	01	01		1			H3388	803	0	2018	Greater Capital Region of New York State		1	110926	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(866)289-2319		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;	1					1				
H3388	804	0	1	01	01	H3388_804_0	4			1		06/08/2017	2018.03	06/08/2017 01:44:57 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	http://www.CDPHP.com/medicare	CDPHP Group Medicare (HMO)	01	01		1			H3388	804	0	2018	Greater Capital Region of New York State		1	3497	2			2						http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	http://www.CDPHP.com/medicare	(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;	1					1				
H3404	003	1	1	04	01	H3404_003_1	7			1		08/07/2017	2018.03	08/07/2017 09:30:17 AM Eastern Daylight Time	08/07/2017 09:14:27 AM Eastern Daylight Time	08/07/2017 09:15:50 AM Eastern Daylight Time			08/07/2017 09:56:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO Enhanced (PPO)	01	04		1			H3404	003	1	2018	Select North Carolina Counties	PPO Region 1	2	213461	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		2					2						2			
H3404	003	2	1	04	01	H3404_003_2	8			1		06/01/2017	2018.03	06/01/2017 03:21:11 PM Eastern Daylight Time	08/11/2017 01:49:46 PM Eastern Daylight Time	08/07/2017 09:15:56 AM Eastern Daylight Time			08/11/2017 01:52:25 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO Enhanced (PPO)	01	04		1			H3404	003	2	2018	Select North Carolina Counties	PPO Region 2	2	136805	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		2					2						2			
H3404	801	0	1	04	01	H3404_801_0	5			1		06/13/2017	2018.03	06/13/2017 11:47:36 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO EGWP Medical Only (PPO)	01	04		1			H3404	801	0	2018	North Carolina Employer Groups		1	50	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037										(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140										1	1	1a;1b;2;3-1;5;6;7e;7f;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;15;16b;	2		1									
H3404	803	0	1	04	01	H3404_803_0	5			1		06/13/2017	2018.03	06/13/2017 11:48:01 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO EGWP (PPO)	01	04		1			H3404	803	0	2018	North Carolina Employer Groups		1	1494	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		1	1	1a;1b;2;3-1;5;6;7e;7f;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1									
H3404	809	0	1	04	01	H3404_809_0	4			1		06/13/2017	2018.03	06/13/2017 11:48:50 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO EGWP Value (PPO)	01	04		1			H3404	809	0	2018	NC Employer Groups		1	498	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(877)494-7647		(877)494-7647		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		1	1	1a;1b;2;3-1;5;6;7e;7f;7h;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1									
H3416	001	4	1	04	01	H3416_001_4	7			1		08/04/2017	2018.03	08/04/2017 08:45:44 AM Central Daylight Time	08/03/2017 05:29:20 PM Central Daylight Time	08/03/2017 05:32:48 PM Central Daylight Time			08/07/2017 02:20:12 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health Align (PPO)	01	04		1			H3416	001	4	2018	Central Iowa & Western Illinois	Cedar Rapids, Central IA, and Peoria Areas	2	5279	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3416	001	5	1	04	01	H3416_001_5	7			1		08/04/2017	2018.03	08/04/2017 08:45:56 AM Central Daylight Time	08/03/2017 05:30:17 PM Central Daylight Time	08/03/2017 05:33:22 PM Central Daylight Time			08/07/2017 02:20:12 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health Align (PPO)	01	04		1			H3416	001	5	2018	Central Iowa & Western Illinois	Fort Dodge, Quad Cities, Waterloo Areas	2	3505	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3416	002	2	1	04	01	H3416_002_2	7			1		08/04/2017	2018.03	08/04/2017 08:46:41 AM Central Daylight Time	08/04/2017 10:51:50 AM Central Daylight Time	08/03/2017 05:33:55 PM Central Daylight Time			08/07/2017 02:20:12 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health Symmetry (PPO)	01	04		1			H3416	002	2	2018	Central Iowa & Western Illinois	Cedar Rapids, Central IA, and Peoria Areas	2	3519	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3416	002	3	1	04	01	H3416_002_3	7			1		08/04/2017	2018.03	08/04/2017 08:46:32 AM Central Daylight Time	08/04/2017 10:53:43 AM Central Daylight Time	08/03/2017 05:34:27 PM Central Daylight Time			08/07/2017 02:20:12 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health Symmetry (PPO)	01	04		1			H3416	002	3	2018	Central Iowa & Western Illinois	Fort Dodge, Quad Cities, Waterloo Areas	2	2337	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3416	801	0	1	04	01	H3416_801_0	3			1		06/02/2017	2018.03	06/02/2017 05:03:31 PM Central Daylight Time					06/02/2017 05:06:30 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health Calendar Year (PPO)	01	04		1			H3416	801	0	2018	Central Iowa &Western Illinois		1	600	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3416	803	0	1	04	01	H3416_803_0	2			1		06/02/2017	2018.03	06/02/2017 04:48:39 PM Central Daylight Time					06/02/2017 05:06:30 PM Central Daylight Time	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	HealthPartners UnityPoint Health	healthpartnersunitypointhealth.com	HealthPartners UnityPoint Health MA (PPO)	01	04		1			H3416	803	0	2018	Central Iowa &Western Illinois		1	0	2			2						healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	healthpartnersunitypointhealth.com	(888)360-0544		(888)360-0544		(888)360-0796		(888)360-0796										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3430	001	0	1	20	08	H3430_001_0	1			1		05/31/2017	2018.03	05/31/2017 11:04:40 AM Eastern Daylight Time		05/31/2017 11:15:29 AM Eastern Daylight Time			05/31/2017 11:18:21 AM Eastern Daylight Time	SUNCOAST PACE, INC.	Suncoast PACE, Inc.	www.suncoastpace.org	Suncoast PACE, Inc. (PACE)	08	20		1			H3430	001	0	2018	Suncoast PACE, Inc., Pinellas County		2		2			2						http://www.suncoastpace.org/	http://www.suncoastpace.org/										(866)458-2933		(727)289-0062		(866)458-2933		(727)289-0062										(866)458-2933		(727)289-0062		(866)458-2933		(727)289-0062																
H3430	002	0	1	20	08	H3430_002_0	1			1		05/31/2017	2018.03	05/31/2017 11:05:09 AM Eastern Daylight Time		05/31/2017 11:15:54 AM Eastern Daylight Time			05/31/2017 11:18:21 AM Eastern Daylight Time	SUNCOAST PACE, INC.	Suncoast PACE, Inc.	www.suncoastpace.org	Suncoast PACE, Inc. (PACE)	08	20		1			H3430	002	0	2018	Suncoast PACE, Inc., Pinellas County		2		2			2						http://www.suncoastpace.org/	http://www.suncoastpace.org/										(866)458-2933		(727)289-0062		(866)458-2933		(727)289-0062										(866)458-2933		(727)289-0062		(866)458-2933		(727)289-0062																
H3447	001	0	1	01	01	H3447_001_0	7			1		08/03/2017	2018.03	08/03/2017 02:01:53 PM Pacific Daylight Time	08/03/2017 02:58:25 PM Pacific Daylight Time	08/02/2017 12:33:21 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Local (HMO)	01	01		1			H3447	001	0	2018	Richmond Metropolitan, West & So. of Richmond Area		2	33098	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	003	0	1	01	01	H3447_003_0	5		1	1		08/04/2017	2018.03	08/04/2017 11:54:02 AM Pacific Daylight Time	08/04/2017 11:18:27 AM Pacific Daylight Time	08/02/2017 12:33:48 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue COPD (HMO SNP)	01	01		1			H3447	003	0	2018	Richmond Metropolitan, West & So. of Richmond Area		2	5054	2			1	4			00000000000100000000		www.anthem.com/medicare	www.anthem.com/medicare		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	004	0	1	01	01	H3447_004_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:11:10 PM Pacific Daylight Time	08/03/2017 03:00:53 PM Pacific Daylight Time	08/02/2017 12:34:10 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Diabetes (HMO SNP)	01	01		1			H3447	004	0	2018	Richmond Metropolitan, West & So. of Richmond Area		2	20362	2			1	4			00000010000000000000		www.anthem.com/medicare	www.anthem.com/medicare		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	005	0	1	01	01	H3447_005_0	6			1		08/03/2017	2018.03	08/03/2017 02:23:12 PM Pacific Daylight Time	08/03/2017 02:59:14 PM Pacific Daylight Time	08/02/2017 12:34:33 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Smart Fit (HMO)	01	01		1			H3447	005	0	2018	Richmond Metropolitan, West & So. of Richmond Area		2	8783	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	010	0	1	01	01	H3447_010_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:12:07 PM Pacific Daylight Time	08/03/2017 03:00:04 PM Pacific Daylight Time	08/02/2017 12:34:59 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Touch (HMO SNP)	01	01		1			H3447	010	0	2018	Richmond Metropolitan, West & So. of Richmond Area		2	2307	2			1	1	3				www.anthem.com/medicare	www.anthem.com/medicare		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(888)326-3584		(888)326-3584		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	011	0	1	01	01	H3447_011_0	6		1	1	2	06/30/2017	2018.03	06/30/2017 08:43:33 AM Eastern Daylight Time	08/07/2017 08:51:47 AM Eastern Daylight Time	08/06/2017 03:05:37 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H3447	011	0	2018	Select Counties in Virginia		2	42842	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(855)363-0724		(855)363-0724		(844)828-1338		(844)828-1338		(855)363-0724		(855)363-0724		(844)649-4313		(844)649-4313		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	012	0	1	01	01	H3447_012_0	5		1	1	2	06/04/2017	2018.03	06/04/2017 02:53:56 PM Eastern Daylight Time	08/07/2017 08:51:47 AM Eastern Daylight Time	08/06/2017 03:05:37 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H3447	012	0	2018	Select Counties in Virginia		2	23115	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(855)363-0724		(855)363-0724		(844)828-1338		(844)828-1338		(855)363-0724		(855)363-0724		(844)649-4313		(844)649-4313		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	013	0	1	01	01	H3447_013_0	5			1		08/04/2017	2018.03	08/04/2017 08:54:25 PM Eastern Daylight Time	08/07/2017 08:51:38 AM Eastern Daylight Time	08/06/2017 03:05:37 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Plus (HMO)	01	01		1			H3447	013	0	2018	Southern VA Counties		2	3349	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)363-0724		(855)363-0724		(844)828-1338		(844)828-1338		(855)363-0724		(855)363-0724		(844)649-4313		(844)649-4313		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	014	0	1	01	01	H3447_014_0	6			1		07/13/2017	2018.03	07/13/2017 07:25:27 PM Eastern Daylight Time	08/07/2017 08:51:39 AM Eastern Daylight Time	08/06/2017 03:05:37 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue Plus (HMO)	01	01		1			H3447	014	0	2018	Northern Virginia Counties		2	2158	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)363-0724		(855)363-0724		(844)828-1338		(844)828-1338		(855)363-0724		(855)363-0724		(844)649-4313		(844)649-4313		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	801	0	1	01	01	H3447_801_0	2			1		05/30/2017	2018.03	05/30/2017 10:28:49 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue EGWP (HMO)	01	01		1			H3447	801	0	2018	Virginia		1	175	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)295-7811		(855)295-7811		(888)649-5968		(888)649-5968										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3447	802	0	1	01	01	H3447_802_0	2			1		05/30/2017	2018.03	05/30/2017 10:30:50 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue EGWP MAPD (HMO)	01	01		1			H3447	802	0	2018	Virginia		1	175	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)295-7811		(855)295-7811		(888)649-5968		(888)649-5968		(855)295-7811		(855)295-7811		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	803	0	1	01	01	H3447_803_0	2			1		05/30/2017	2018.03	05/30/2017 10:32:02 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/medicare	Anthem MediBlue EGWP MAPD (HMO)	01	01		1			H3447	803	0	2018	Virginia		1	65	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)295-7811		(855)295-7811		(888)649-5968		(888)649-5968		(855)295-7811		(855)295-7811		(888)649-5968		(888)649-5968		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3447	804	0	1	01	01	H3447_804_0	7			1		06/03/2017	2018.03	06/03/2017 01:06:18 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/va/medicare	Anthem MediBlue (HMO)	01	01		1			H3447	804	0	2018	Select counties in Virginia		1	600	2			2						www.anthem.com/va/medicare	www.anthem.com/va/medicare	www.anthem.com/va/medicare	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3447	805	0	1	01	01	H3447_805_0	7			1		06/03/2017	2018.03	06/03/2017 01:06:25 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/va/medicare	Anthem MediBlue (HMO)	01	01		1			H3447	805	0	2018	Select counties in Virginia		1	600	2			2						www.anthem.com/va/medicare	www.anthem.com/va/medicare	www.anthem.com/va/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3447	806	0	1	02	01	H3447_806_0	7			1		06/03/2017	2018.03	06/03/2017 01:06:32 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HEALTHKEEPERS, INC.	Anthem HealthKeepers	www.anthem.com/va/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H3447	806	0	2018	Virginia - Select Counties		1	600	2			2						www.anthem.com/va/medicare	www.anthem.com/va/medicare	www.anthem.com/va/medicare	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H3449	005	0	1	01	01	H3449_005_0	8			1		06/01/2017	2018.03	06/01/2017 03:21:44 PM Eastern Daylight Time	08/11/2017 01:49:46 PM Eastern Daylight Time	08/07/2017 09:16:03 AM Eastern Daylight Time			08/11/2017 01:52:25 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Enhanced (HMO)	01	01		1			H3449	005	0	2018	Select North Carolina Counties		2	213264	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		2					2					2	2			
H3449	012	0	1	01	01	H3449_012_0	5			1		06/02/2017	2018.03	06/02/2017 11:47:26 AM Eastern Daylight Time	07/13/2017 05:01:51 PM Eastern Daylight Time				07/19/2017 11:31:49 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Medical Only (HMO)	01	01		1			H3449	012	0	2018	Select North Carolina Counties		2	94503	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037										(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140										2					2					2	2			
H3449	023	1	1	01	01	H3449_023_1	7			1		06/01/2017	2018.03	06/01/2017 03:24:03 PM Eastern Daylight Time	08/07/2017 09:14:15 AM Eastern Daylight Time	08/07/2017 09:15:25 AM Eastern Daylight Time			08/07/2017 09:56:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Essential (HMO)	01	01		1			H3449	023	1	2018	Select North Carolina Counties	Guilford Region	2	58884	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		2					2					2	2			
H3449	023	2	1	01	01	H3449_023_2	8			1		06/01/2017	2018.03	06/01/2017 03:24:22 PM Eastern Daylight Time	08/11/2017 01:49:46 PM Eastern Daylight Time	08/07/2017 09:15:31 AM Eastern Daylight Time			08/11/2017 01:52:25 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Essential (HMO)	01	01		1			H3449	023	2	2018	Select North Carolina Counties	Statewide Region	2	58884	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		2					2					2	2			
H3449	801	0	1	01	01	H3449_801_0	5			1		06/13/2017	2018.03	06/13/2017 11:49:24 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO EGWP (HMO)	01	01		1			H3449	801	0	2018	North Carolina Employer Groups		1	8136	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		1	1	1a;1b;2;3-1;3-3;5;6;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;15;16b;	2		1					1				
H3449	805	0	1	01	01	H3449_805_0	5			1		06/13/2017	2018.03	06/13/2017 11:53:23 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO EGWP Medical Only (HMO)	01	01		1			H3449	805	0	2018	North Carolina Employer Groups		1	2712	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037										(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140										1	1	1a;1b;2;3-1;3-3;5;6;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;15;16b;	2		1					1				
H3449	813	0	1	01	01	H3449_813_0	5			1		06/13/2017	2018.03	06/13/2017 11:54:00 AM Eastern Daylight Time					06/13/2017 03:06:39 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO EGWP Value (HMO)	01	01		1			H3449	813	0	2018	NC Employer Groups		1	50	2			2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare	(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)310-4110		(888)310-4110		(800)665-8037		(800)665-8037		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		(888)451-9957		(888)451-9957		(800)922-3140		(800)922-3140		1	1	1a;1b;2;3-1;3-3;5;6;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;15;16b;	2		1					1				
H3464	001	0	1	01	01	H3464_001_0	6			1		08/04/2017	2018.03	08/04/2017 08:48:10 AM Central Daylight Time	08/03/2017 02:23:02 PM Central Daylight Time	08/01/2017 10:34:34 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H3464	001	0	2018	Fayetteville Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3464	002	0	1	01	01	H3464_002_0	6			1		06/28/2017	2018.03	06/28/2017 09:45:17 AM Central Daylight Time	08/03/2017 02:23:41 PM Central Daylight Time	08/01/2017 10:35:01 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 4 (HMO)	01	01		1			H3464	002	0	2018	Fayetteville Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3464	003	0	1	01	01	H3464_003_0	6			1		06/01/2017	2018.03	06/01/2017 09:29:24 AM Central Daylight Time	08/03/2017 02:24:20 PM Central Daylight Time	08/01/2017 10:35:28 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H3464	003	0	2018	Little Rock Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3464	004	0	1	01	01	H3464_004_0	6			1		06/28/2017	2018.03	06/28/2017 09:45:56 AM Central Daylight Time	08/03/2017 02:24:59 PM Central Daylight Time	08/01/2017 10:35:54 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 4 (HMO)	01	01		1			H3464	004	0	2018	Little Rock Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3464	005	0	1	01	01	H3464_005_0	6			1		06/01/2017	2018.03	06/01/2017 09:30:07 AM Central Daylight Time	08/03/2017 02:25:38 PM Central Daylight Time	08/01/2017 10:36:20 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3464	005	0	2018	Hot Spring Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3464	006	0	1	01	01	H3464_006_0	6			1		06/28/2017	2018.03	06/28/2017 09:46:37 AM Central Daylight Time	08/03/2017 02:26:17 PM Central Daylight Time	08/01/2017 10:36:46 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3464	006	0	2018	Hot Spring Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	001	0	1	01	01	H3471_001_0	3			1		06/19/2017	2018.03	06/19/2017 09:16:58 AM Central Daylight Time	08/02/2017 03:20:31 PM Central Daylight Time	08/01/2017 02:43:26 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Companion Rx (HMO)	01	01		1			H3471	001	0	2018	Okanogan, Chelan, Douglas, Grant County		2	41862	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	002	0	1	01	01	H3471_002_0	3			1		06/03/2017	2018.03	06/03/2017 08:33:32 AM Central Daylight Time	08/02/2017 03:21:19 PM Central Daylight Time	08/01/2017 03:44:29 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Companion Rx Plus (HMO)	01	01		1			H3471	002	0	2018	Okanogan, Chelan, Douglas, Grant County		2	6512	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	003	0	1	01	01	H3471_003_0	2			1		06/03/2017	2018.03	06/03/2017 08:33:42 AM Central Daylight Time	06/03/2017 02:33:03 PM Central Daylight Time				06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Companion HMO (HMO)	01	01		1			H3471	003	0	2018	Okanogan, Chelan, Douglas, Grant County		2	4976	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3471	004	0	1	01	01	H3471_004_0	5			1		07/06/2017	2018.03	07/06/2017 12:45:02 PM Central Daylight Time	08/03/2017 04:24:51 PM Central Daylight Time	08/01/2017 02:44:35 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage HMO Rx (HMO)	01	01		1			H3471	004	0	2018	Yakima County		2	16332	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	005	0	1	01	01	H3471_005_0	3			1		06/03/2017	2018.03	06/03/2017 08:34:07 AM Central Daylight Time	08/02/2017 03:23:41 PM Central Daylight Time	08/01/2017 02:45:09 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage HMO Rx Plus (HMO)	01	01		1			H3471	005	0	2018	Yakima County		2	11292	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	006	0	1	01	01	H3471_006_0	3			1		07/06/2017	2018.03	07/06/2017 12:45:16 PM Central Daylight Time	06/03/2017 02:35:25 PM Central Daylight Time				07/06/2017 12:45:42 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage HMO (HMO)	01	01		1			H3471	006	0	2018	Yakima County		2	2400	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3471	007	0	1	01	01	H3471_007_0	3			1		06/03/2017	2018.03	06/03/2017 08:34:32 AM Central Daylight Time	08/02/2017 03:25:15 PM Central Daylight Time	08/01/2017 02:45:44 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Pioneer Rx (HMO)	01	01		1			H3471	007	0	2018	Thurston County		2	360	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	008	0	1	01	01	H3471_008_0	3			1		06/03/2017	2018.03	06/03/2017 08:34:48 AM Central Daylight Time	08/02/2017 03:26:02 PM Central Daylight Time	08/01/2017 02:46:18 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Pioneer Rx Plus (HMO)	01	01		1			H3471	008	0	2018	Thurston County		2	444	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	009	0	1	01	01	H3471_009_0	3			1		06/03/2017	2018.03	06/03/2017 08:35:02 AM Central Daylight Time	06/05/2017 12:57:14 PM Central Daylight Time				06/05/2017 01:29:01 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Pioneer HMO (HMO)	01	01		1			H3471	009	0	2018	Thurston County		2	240	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3471	010	0	1	01	01	H3471_010_0	4			1		06/23/2017	2018.03	06/23/2017 09:55:09 AM Central Daylight Time	08/02/2017 03:27:37 PM Central Daylight Time	08/01/2017 02:46:53 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Companion Basic Rx (HMO)	01	01		1			H3471	010	0	2018	Okanogan, Chelan, Douglas, Grant County		2	16848	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	012	0	1	01	01	H3471_012_0	4			1		08/03/2017	2018.03	08/03/2017 12:49:13 PM Central Daylight Time	08/02/2017 03:28:23 PM Central Daylight Time	08/01/2017 02:47:28 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW Pioneer Basic Rx (HMO)	01	01		1			H3471	012	0	2018	Thurston County		2	1212	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(877)795-6118		(877)795-6118		(877)795-6120		(877)795-6120		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	013	0	1	02	01	H3471_013_0	3			1		06/03/2017	2018.03	06/03/2017 08:35:38 AM Central Daylight Time	08/02/2017 03:29:10 PM Central Daylight Time	08/01/2017 03:45:48 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage POS Rx (HMO-POS)	01	02		1			H3471	013	0	2018	Yakima County		2	876	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	014	0	1	02	01	H3471_014_0	3			1		06/03/2017	2018.03	06/03/2017 12:49:39 PM Central Daylight Time	08/03/2017 01:58:06 PM Central Daylight Time	08/01/2017 03:46:53 PM Central Daylight Time			08/04/2017 02:40:31 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage POS Rx Plus (HMO-POS)	01	02		1			H3471	014	0	2018	Yakima County		2	792	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3471	015	0	1	02	01	H3471_015_0	2			1		06/03/2017	2018.03	06/03/2017 08:36:12 AM Central Daylight Time	06/03/2017 02:41:43 PM Central Daylight Time				06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Health Alliance NW SignalAdvantage POS (HMO-POS)	01	02		1			H3471	015	0	2018	Yakima County		2	324	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)795-6117		(877)795-6117		(877)642-3331		(877)642-3331										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3471	801	0	1	01	01	H3471_801_0	3			1		06/13/2017	2018.03	06/13/2017 09:37:49 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO (HMO)	01	01		1			H3471	801	0	2018	Central Washington		1	120	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3471	802	0	1	01	01	H3471_802_0	3			1		06/13/2017	2018.03	06/13/2017 09:37:59 AM Central Daylight Time					06/13/2017 09:49:43 AM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO)	01	01		1			H3471	802	0	2018	Central Washington		1	1200	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3471	803	0	1	01	01	H3471_803_0	2			1		04/26/2017	2018.03	04/26/2017 01:29:02 PM Central Daylight Time					06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO Rx - non calendar year (HMO)	01	01		1			H3471	803	0	2018	Central Washington		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3471	804	0	1	02	01	H3471_804_0	2			1		06/02/2017	2018.03	06/02/2017 02:36:52 PM Central Daylight Time					06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO-POS (HMO-POS)	01	02		1			H3471	804	0	2018	Central Washington		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463										(711)-		(711)-		(711)-		(711)-										1	2		2		1	2		2		1				
H3471	805	0	1	02	01	H3471_805_0	2			1		06/02/2017	2018.03	06/02/2017 02:37:45 PM Central Daylight Time					06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO-POS with Rx (HMO-POS)	01	02		1			H3471	805	0	2018	Central Washington		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		1				
H3471	806	0	1	02	01	H3471_806_0	2			1		06/02/2017	2018.03	06/02/2017 02:38:24 PM Central Daylight Time					06/03/2017 10:01:23 PM Central Daylight Time	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	Health Alliance Northwest	www.healthalliancemedicare.org	Medicare Employer HMO-POS with Rx (HMO-POS)	01	02		1			H3471	806	0	2018	Central Washington		1	0	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(877)750-3350		(877)750-3350		(877)561-1463		(877)531-1463		(877)750-3350		(877)750-3350		(877)561-1463		(877)561-1463		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1	2		2		1				
H3473	001	0	1	20	08	H3473_001_0	1			1		06/02/2017	2018.03	06/02/2017 12:59:27 PM Eastern Daylight Time		06/02/2017 12:56:50 PM Eastern Daylight Time			06/02/2017 01:24:30 PM Eastern Daylight Time	CHARLOTTESVILLE AREA RETIREMENT SERVICES, INC.	Blue Ridge PACE	www.riversideonline.com	Blue Ridge PACE Dual (PACE)	08	20		1			H3473	001	0	2018	Blue Ridge PACE Dual		2		2			2						www.riversideonline.com	N/A - no formulary										(800)675-6368		(434)906-0569		(800)675-6368		(434)906-0569										(800)675-6368		(434)906-0569		(800)675-6368		(434)906-0569																
H3473	002	0	1	20	08	H3473_002_0	1			1		06/02/2017	2018.03	06/02/2017 12:59:34 PM Eastern Daylight Time		06/02/2017 12:56:50 PM Eastern Daylight Time			06/02/2017 01:24:30 PM Eastern Daylight Time	CHARLOTTESVILLE AREA RETIREMENT SERVICES, INC.	Blue Ridge PACE	www.riversideonline.com	Blue Ridge PACE Medicare Only (PACE)	08	20		1			H3473	002	0	2018	Blue Ridge PACE Medicare Only		2		2			2						www.riversideonline.com	N/A - no formulary										(800)675-6368		(434)906-0569		(800)675-6368		(434)906-0569										(800)675-6368		(434)906-0569		(800)675-6368		(434)906-0569																
H3493	001	0	1	20	08	H3493_001_0	1			1		05/24/2017	2018.03	05/24/2017 05:48:27 PM Central Daylight Time		05/23/2017 03:31:46 PM Central Daylight Time			05/24/2017 05:51:42 PM Central Daylight Time	LIFE AT LOURDES, INC.	LIFE at Lourdes	https://www.lourdesnet.org/programs-and-services/l	LIFE at Lourdes, Inc (PACE)	08	20		1			H3493	001	0	2018	LIFE at Lourdes		2		2			2						www.lourdesnet.org	www.lourdesnet.org										(856)675-3355		(856)675-3355		(856)675-3355		(856)675-3355										(856)675-3355		(856)675-3355		(856)675-3355		(856)675-3355																
H3493	002	0	1	20	08	H3493_002_0	1			1		05/24/2017	2018.03	05/24/2017 05:49:10 PM Central Daylight Time		05/23/2017 03:31:46 PM Central Daylight Time			05/24/2017 05:51:42 PM Central Daylight Time	LIFE AT LOURDES, INC.	LIFE at Lourdes	www.lourdesmed.org	LIFE at Lourdes, Inc (PACE)	08	20		1			H3493	002	0	2018	LIFE at Lourdes		2		2			2						www.lourdesnet.org	www.lourdesnet.org										(856)675-3355		(856)675-3355		(856)675-3355		(856)675-3355										(856)675-3355		(856)675-3355		(856)675-3355		(856)675-3355																
H3499	001	0	1	01	01	H3499_001_0	2			1		08/02/2017	2018.03	08/02/2017 10:26:10 AM Eastern Daylight Time	08/04/2017 04:35:00 PM Pacific Daylight Time	08/04/2017 04:35:25 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H3499	001	0	2018	Central Indiana		2		2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H3499	002	0	1	01	01	H3499_002_0	2			1		08/02/2017	2018.03	08/02/2017 10:26:18 AM Eastern Daylight Time	08/04/2017 04:35:01 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H3499	002	0	2018	North East Indiana		2		2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H3499	003	0	1	01	01	H3499_003_0	2			1		08/02/2017	2018.03	08/02/2017 10:26:33 AM Eastern Daylight Time	08/04/2017 04:35:01 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.coordinatedcarehealth.com	Allwell Medicare (HMO)	01	01		1			H3499	003	0	2018	South West Indiana		2		2			2						www.centene.com	www.centene.com	www.allwell.coordinatedcarehealth.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H3503	003	0	1	18	06	H3503_003_0	2			2		07/06/2017	2018.03	07/06/2017 05:42:57 PM Central Daylight Time					07/06/2017 05:43:17 PM Central Daylight Time	SANFORD HEART OF AMERICA HEALTH PLAN	Sanford Heart of America Health Plan	www.sanfordhealthplan.com/heartofamerica	Sanford Heart of America Health Plan (Cost)	06	18		1			H3503	003	0	2018	North Central, Central and Eastern North Dakota		2	334	2			2								www3.viiad.com/shp/public/hoamc.asp	(877)652-1845		(701)417-6500		(877)652-1845		(701)417-6500										(877)652-1844		(877)652-1844		(877)652-1844		(877)652-1844										2					2					2	2			
H3517	001	0	1	20	08	H3517_001_0	2			1		05/31/2017	2018.03	05/31/2017 11:49:36 AM Pacific Daylight Time		07/19/2017 10:05:58 AM Pacific Daylight Time			07/19/2017 10:17:12 AM Pacific Daylight Time	HUMBOLDT SENIOR RESOURCE CENTER, INC.	Redwood Coast PACE	www.humsenior.org	Redwood  Coast PACE-Dual (PACE)	08	20		1			H3517	001	0	2018	Redwood Coast PACE-Dual		2		2			2						www.pharmastarpbm.com	www.pharmastarpbm.com	n/a									(707)443-9747		(707)443-9747		(707)443-9747		(707)443-9747										(711)-		(711)-		(711)-		(711)-																
H3517	002	0	1	20	08	H3517_002_0	2			1		05/31/2017	2018.03	05/31/2017 11:50:19 AM Pacific Daylight Time		07/19/2017 10:05:53 AM Pacific Daylight Time			07/19/2017 10:17:12 AM Pacific Daylight Time	HUMBOLDT SENIOR RESOURCE CENTER, INC.	Redwood Coast PACE	www.humsenior.org	Redwood Coast PACE-Medicare Only (PACE)	08	20		1			H3517	002	0	2018	Redwood Coast PACE-Medicare Only		2		2			2						www.pharmastarpbm.com	www.pharmastarpbm.com										(707)443-9747		(707)443-9747		(707)443-9747		(707)443-9747										(711)-		(711)-		(711)-		(711)-																
H3528	003	0	1	01	01	H3528_003_0	8			1		07/06/2017	2018.03	07/06/2017 02:21:36 PM Eastern Daylight Time	07/03/2017 10:29:49 AM Eastern Daylight Time				07/06/2017 02:27:05 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Choice Plan 2 (HMO)	01	01		1			H3528	003	0	2018	State of Connecticut		2	22367	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220										(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710										2					2					2	2			
H3528	006	0	1	02	01	H3528_006_0	10			1		07/19/2017	2018.03	07/19/2017 02:38:50 PM Eastern Daylight Time	08/04/2017 03:30:55 PM Eastern Daylight Time	08/01/2017 09:30:33 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Flex Plan 1 (HMO-POS)	01	02		1			H3528	006	0	2018	State of Connecticut		2	5877	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	010	0	1	01	01	H3528_010_0	10			1		08/10/2017	2018.03	08/10/2017 12:29:35 PM Eastern Daylight Time	08/10/2017 09:50:53 AM Eastern Daylight Time	08/01/2017 09:30:58 AM Eastern Daylight Time			08/10/2017 02:12:59 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Passage Plan 1 (HMO)	01	01		1			H3528	010	0	2018	State of Connecticut		2	99151	2			2						www.connecticare.com/medicare	www.connecticare.com/Medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	011	1	1	02	01	H3528_011_1	11			1		07/12/2017	2018.03	07/12/2017 01:30:18 PM Eastern Daylight Time	08/04/2017 03:32:18 PM Eastern Daylight Time	08/01/2017 09:31:24 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Flex Plan 3 (HMO-POS)	01	02		1			H3528	011	1	2018	State of Connecticut	Hartford, Litchfield, Middlesex, Tolland counties	2	173670	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	011	2	1	02	01	H3528_011_2	11			1		07/12/2017	2018.03	07/12/2017 01:30:39 PM Eastern Daylight Time	08/04/2017 03:33:03 PM Eastern Daylight Time	08/01/2017 09:31:49 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Flex Plan 3 (HMO-POS)	01	02		1			H3528	011	2	2018	State of Connecticut	Fairfield, New Haven, New London, Windham counties	2	181056	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	012	1	1	02	01	H3528_012_1	11			1		07/05/2017	2018.03	07/05/2017 07:31:25 AM Eastern Daylight Time	08/04/2017 03:33:51 PM Eastern Daylight Time	08/01/2017 09:32:14 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Flex Plan 2 (HMO-POS)	01	02		1			H3528	012	1	2018	Counties: HTFD, LIT, MID, NH, NL, TOL, WIN	Hartford, Litchfield, Middlesex, Tolland counties	2	27738	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	012	2	1	02	01	H3528_012_2	11			1		07/05/2017	2018.03	07/05/2017 07:32:12 AM Eastern Daylight Time	08/04/2017 03:34:35 PM Eastern Daylight Time	08/01/2017 09:32:40 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Flex Plan 2 (HMO-POS)	01	02		1			H3528	012	2	2018	Counties: HTFD, LIT, MID, NH, NL, TOL, WIN	New Haven, New London, Windham counties	2	20869	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	013	1	1	01	01	H3528_013_1	12			1		07/05/2017	2018.03	07/05/2017 07:32:38 AM Eastern Daylight Time	08/04/2017 03:35:21 PM Eastern Daylight Time	08/01/2017 09:33:05 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Choice Plan 1 (HMO)	01	01		1			H3528	013	1	2018	Counties: HTFD, LIT, MID, NH, NL, TOL, WIN	Hartford, Litchfield, Middlesex, Tolland counties	2	19328	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	013	2	1	01	01	H3528_013_2	12			1		07/05/2017	2018.03	07/05/2017 07:33:06 AM Eastern Daylight Time	08/04/2017 03:36:03 PM Eastern Daylight Time	08/01/2017 09:33:31 AM Eastern Daylight Time			08/07/2017 04:53:08 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare Choice Plan 1 (HMO)	01	01		1			H3528	013	2	2018	Counties: HTFD, LIT, MID, NH, NL, TOL, WIN	New Haven, New London, Windham counties	2	15212	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		2					2					2	2			
H3528	801	0	1	01	01	H3528_801_0	4			1		06/01/2017	2018.03	06/01/2017 12:03:48 PM Eastern Daylight Time					06/04/2017 08:20:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare EGHP (HMO)	01	01		1			H3528	801	0	2018	U.S and Territories		1	4902	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1					1				
H3528	805	0	1	01	01	H3528_805_0	4			1		06/01/2017	2018.03	06/01/2017 01:11:39 PM Eastern Daylight Time					06/04/2017 08:20:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare EGHP (HMO)	01	01		1			H3528	805	0	2018	U.S and Territories		1	0	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220										(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710										1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1					1				
H3528	806	0	1	02	01	H3528_806_0	4			1		06/01/2017	2018.03	06/01/2017 01:13:01 PM Eastern Daylight Time					06/04/2017 08:20:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare EGHP (HMO-POS)	01	02		1			H3528	806	0	2018	U.S and Territories		1	6692	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710		1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1				
H3528	807	0	1	02	01	H3528_807_0	4			1		06/01/2017	2018.03	06/01/2017 01:14:04 PM Eastern Daylight Time					06/04/2017 08:20:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	ConnectiCare EGHP (HMO-POS)	01	02		1			H3528	807	0	2018	U.S and Territories		1	0	2			2						www.connecticare.com/medicare	www.connecticare.com/medicare	www.connecticare.com/medicare	(800)224-2273		(800)224-2273		(877)224-8220		(877)224-8220										(800)842-9710		(800)842-9710		(800)842-9710		(800)842-9710										1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1	1	1a;1b;2;3-3;5;6;7e;7h;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;15;	2		1				
H3533	001	0	1	01	01	H3533_001_0	4			1		08/02/2017	2018.03	08/02/2017 01:32:02 PM Eastern Daylight Time	08/05/2017 10:05:51 AM Eastern Daylight Time	08/04/2017 09:52:42 AM Eastern Daylight Time			08/06/2017 09:06:26 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-001 (HMO)	01	01		1			H3533	001	0	2018	Oneida, Onondaga and Oswego counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	002	0	1	01	01	H3533_002_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 09:51:16 AM Eastern Daylight Time	08/05/2017 10:08:11 AM Eastern Daylight Time	08/04/2017 09:52:42 AM Eastern Daylight Time			08/06/2017 09:06:26 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H3533-002 (HMO SNP)	01	01		1			H3533	002	0	2018	Select Counties in New York		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	004	0	1	01	01	H3533_004_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 09:51:33 AM Eastern Daylight Time	08/05/2017 10:03:01 AM Eastern Daylight Time	08/04/2017 09:52:43 AM Eastern Daylight Time			08/06/2017 09:06:26 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H3533-004 (HMO SNP)	01	01		1			H3533	004	0	2018	Select Counties in New York		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	006	0	1	01	01	H3533_006_0	5			1		08/02/2017	2018.03	08/02/2017 01:32:27 PM Eastern Daylight Time	08/05/2017 10:02:29 AM Eastern Daylight Time	08/04/2017 09:52:43 AM Eastern Daylight Time			08/06/2017 09:06:26 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-006 (HMO)	01	01		1			H3533	006	0	2018	Capital Region		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	010	0	1	01	01	H3533_010_0	5			1		07/11/2017	2018.03	07/11/2017 12:23:30 PM Eastern Daylight Time	08/05/2017 10:04:09 AM Eastern Daylight Time	08/04/2017 09:52:44 AM Eastern Daylight Time			08/06/2017 09:11:55 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-010 (HMO)	01	01		1			H3533	010	0	2018	Nassau and Suffolk (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	013	0	1	01	01	H3533_013_0	4			1		06/28/2017	2018.03	06/28/2017 10:26:58 AM Eastern Daylight Time	08/05/2017 10:06:25 AM Eastern Daylight Time	08/04/2017 09:52:44 AM Eastern Daylight Time			08/06/2017 09:11:55 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-013 (HMO)	01	01		1			H3533	013	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	020	0	1	01	01	H3533_020_0	4			1		08/02/2017	2018.03	08/02/2017 01:32:46 PM Eastern Daylight Time	08/05/2017 10:04:43 AM Eastern Daylight Time	08/04/2017 09:52:45 AM Eastern Daylight Time			08/06/2017 09:11:55 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-020 (HMO)	01	01		1			H3533	020	0	2018	Southern Tier Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	021	0	1	01	01	H3533_021_0	5			1		06/28/2017	2018.03	06/28/2017 10:27:19 AM Eastern Daylight Time	08/05/2017 10:09:24 AM Eastern Daylight Time	08/04/2017 09:52:45 AM Eastern Daylight Time			08/06/2017 09:11:55 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-021 (HMO)	01	01		1			H3533	021	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	023	0	1	01	01	H3533_023_0	4			1		06/28/2017	2018.03	06/28/2017 10:17:41 AM Eastern Daylight Time	08/05/2017 10:09:58 AM Eastern Daylight Time	08/04/2017 09:52:46 AM Eastern Daylight Time			08/06/2017 09:02:54 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-023 (HMO)	01	01		1			H3533	023	0	2018	Select Counties in New York City and Long Island		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	027	0	1	01	01	H3533_027_0	5			1		08/02/2017	2018.03	08/02/2017 01:48:13 PM Eastern Daylight Time	08/05/2017 10:15:00 AM Eastern Daylight Time	08/04/2017 09:52:47 AM Eastern Daylight Time			08/06/2017 09:02:54 AM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Gold Plus H3533-027 (HMO)	01	01		1			H3533	027	0	2018	Select Counties in New York City and Long Island		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3533	802	0	1	01	01	H3533_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:23:20 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H3533	802	0	2018	Select Counties in NY		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3533	803	0	1	01	01	H3533_803_0	3			1		06/13/2017	2018.03	06/13/2017 10:23:34 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Humana Health Company of New York, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H3533	803	0	2018	Select Counties in NY		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3536	002	0	1	01	01	H3536_002_0	6			1		06/05/2017	2018.03	06/05/2017 05:55:49 PM Eastern Daylight Time	08/07/2017 08:51:40 AM Eastern Daylight Time	08/06/2017 03:05:38 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H3536	002	0	2018	Hillsborough and Rockingham Counties		2	9908	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2473		(855)310-2473		(844)368-4243		(844)368-4243		(855)310-2473		(855)310-2473		(844)368-4242		(844)368-4242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3536	003	0	1	01	01	H3536_003_0	6			1		06/05/2017	2018.03	06/05/2017 05:57:01 PM Eastern Daylight Time	08/07/2017 08:51:40 AM Eastern Daylight Time	08/06/2017 03:05:38 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H3536	003	0	2018	Cheshire, Merrimack, and Strafford Counties		2	4607	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2473		(855)310-2473		(844)368-4243		(844)368-4243		(855)310-2473		(855)310-2473		(844)368-4242		(844)368-4242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3536	004	0	1	01	01	H3536_004_0	8			1		08/04/2017	2018.03	08/04/2017 09:15:52 AM Eastern Daylight Time	08/07/2017 08:51:41 AM Eastern Daylight Time	08/06/2017 03:05:38 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Coordination Plus (HMO)	01	01		1			H3536	004	0	2018	Select Counties in New Hampshire		2	12522	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2473		(855)310-2473		(844)467-1557		(844)467-1557		(855)310-2473		(855)310-2473		(844)467-1558		(844)467-1558		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3536	801	0	1	01	01	H3536_801_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:03 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/nh/medicare	Anthem MediBlue (HMO)	01	01		1			H3536	801	0	2018	Select counties in New Hampshire		1	600	2			2						www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	(855)251-8824		(855)251-8824		(877)411-1647		(877)411-1647		(855)251-8824		(855)251-8824		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3536	802	0	1	01	01	H3536_802_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:10 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/nh/medicare	Anthem MediBlue (HMO)	01	01		1			H3536	802	0	2018	Select Counties in New Hampshire		1	600	2			2						www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	(855)251-8824		(855)251-8824		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3536	803	0	1	02	01	H3536_803_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:17 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	MATTHEW THORNTON HEALTH PLAN, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/nh/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H3536	803	0	2018	New Hampshire - Select Counties		1	600	2			2						www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	www.anthem.com/nh/medicare	(855)251-8824		(855)251-8824		(877)411-1647		(877)411-1647		(855)251-8824		(855)251-8824		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H3561	001	0	1	01	01	H3561_001_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:07:22 AM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time			08/04/2017 07:17:34 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS, INC.	HEALTH NET COMMUNITY SOLUTIONS, INC.	www.healthnet.com/medicare	Health Net Seniority Plus Amber II Premier (HMO SNP)	01	01		1			H3561	001	0	2018	Fresno, CA		2		2			1	3		2		2	https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3561	002	0	1	01	01	H3561_002_0	3			1		08/03/2017	2018.03	08/03/2017 10:12:13 AM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time			08/04/2017 07:17:34 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS, INC.	HEALTH NET COMMUNITY SOLUTIONS, INC.	www.healthnet.com/medicare	Health Net Seniority Plus Sapphire Premier (HMO)	01	01		1			H3561	002	0	2018	Fresno, L.A., Orange, San Diego, San Francisco		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3561	004	0	1	01	01	H3561_004_0	4			1		08/03/2017	2018.03	08/03/2017 10:31:24 AM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time	08/04/2017 04:34:08 PM Pacific Daylight Time			08/04/2017 07:17:34 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS, INC.	HEALTH NET COMMUNITY SOLUTIONS, INC.	www.healthnet.com/medicare	Health Net Seniority Plus Sapphire Premier (HMO)	01	01		1			H3561	004	0	2018	Riverside and San Bernardino Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(800)431-9007		(800)431-9007		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3572	001	0	1	01	01	H3572_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 12:52:42 PM Pacific Daylight Time	08/04/2017 11:07:35 AM Pacific Daylight Time	08/04/2017 11:07:36 AM Pacific Daylight Time			08/04/2017 12:53:19 PM Pacific Daylight Time	AHF MCO OF GEORGIA, INC.	AHF	www.php-ga.org	PHP (HMO SNP)	01	01		1			H3572	001	0	2018	Fulton County, Georgia		2	1122	2			1	4			00000000001000000000		www.php-ga.org/provider-find	www.php-ga.org/for-members/drug-benefit/formulary	www.php-ga.org/provider-find	(833)267-6768		(833)267-6768		(833)267-6768		(833)267-6768		(833)267-6769		(833)267-6769		(833)267-6768		(833)267-6768		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3597	001	0	1	01	01	H3597_001_0	4			1		08/01/2017	2018.03	08/01/2017 07:14:12 PM Central Daylight Time	08/02/2017 02:48:04 PM Central Daylight Time	07/31/2017 04:40:10 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3597	001	0	2018	Southern ME		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3597	005	0	1	01	01	H3597_005_0	3			1		06/27/2017	2018.03	06/27/2017 08:53:21 PM Eastern Daylight Time	08/02/2017 02:49:52 PM Central Daylight Time	07/31/2017 04:40:36 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3597	005	0	2018	Northern and Additional Maine		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3597	007	0	1	01	01	H3597_007_0	3			1		08/01/2017	2018.03	08/01/2017 06:52:01 PM Central Daylight Time	08/02/2017 02:50:38 PM Central Daylight Time	07/31/2017 04:41:01 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (HMO)	01	01		1			H3597	007	0	2018	Mid Maine		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3597	009	0	1	01	01	H3597_009_0	3			1		08/02/2017	2018.03	08/02/2017 11:52:28 AM Central Daylight Time	08/03/2017 09:25:26 AM Central Daylight Time	07/31/2017 04:41:27 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (HMO)	01	01		1			H3597	009	0	2018	Northern and Additional Maine		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3597	801	0	1	01	01	H3597_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:30:23 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3597	801	0	2018	Maine		1	220	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3597	802	0	1	01	01	H3597_802_0	2			1		05/30/2017	2018.03	05/30/2017 11:30:32 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (ME)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3597	802	0	2018	Maine		1	130	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	http://www.aetnamedicaredocfind.com/	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3613	001	0	1	20	08	H3613_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:39 PM Eastern Daylight Time		05/24/2017 01:06:37 PM Eastern Daylight Time			05/24/2017 01:13:26 PM Eastern Daylight Time	MCGREGOR PACE	McGregor PACE	http://www.mcgregorpace.org/	McGregor PACE Dual Eligibles (PACE)	08	20		1			H3613	001	0	2018	McGregor PACE Cuyahoga County		2		2			2						http://www.catamaranrx.com/	http://www.catamaranrx.com/										(216)791-3580		(216)791-3580		(216)791-3580		(216)791-3580										(800)325-2223		(800)325-2223		(800)325-2223		(800)325-2223																
H3613	002	0	1	20	08	H3613_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:59 PM Eastern Daylight Time		05/24/2017 01:06:50 PM Eastern Daylight Time			05/24/2017 01:13:26 PM Eastern Daylight Time	MCGREGOR PACE	McGregor PACE	http://www.mcgregorpace.org/	McGregor PACE Medicare Only Eligibles (PACE)	08	20		1			H3613	002	0	2018	McGregor PACE Cuyahoga County		2		2			2						http://www.catamaranrx.com/	http://www.catamaranrx.com/										(216)791-3580		(216)791-3580		(216)202-1650		(216)202-1650										(800)325-2223		(800)325-2223		(800)325-2223		(800)325-2223																
H3653	004	0	1	01	01	H3653_004_0	6			1		06/01/2017	2018.03	06/01/2017 07:33:36 AM Eastern Daylight Time	08/07/2017 09:24:31 AM Eastern Daylight Time	08/07/2017 09:24:32 AM Eastern Daylight Time			08/07/2017 09:25:56 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Enhanced Medical and Drug (HMO)	01	01		1			H3653	004	0	2018	Paramount Elite - Enhanced (Northern OH / SE Mich)		2	163251	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		2					2					2	2			
H3653	015	0	1	01	01	H3653_015_0	6			1		08/03/2017	2018.03	08/03/2017 11:41:05 AM Eastern Daylight Time	08/07/2017 09:24:32 AM Eastern Daylight Time	08/07/2017 09:24:32 AM Eastern Daylight Time			08/07/2017 09:25:56 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Standard Medical and Drug (HMO)	01	01		1			H3653	015	0	2018	Paramount Elite - Standard (Northern OH / SE Mich)		2	54629	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		2					2					2	2			
H3653	018	0	1	01	01	H3653_018_0	4			1		05/18/2017	2018.03	05/18/2017 09:04:38 AM Eastern Daylight Time	06/05/2017 09:16:35 AM Eastern Daylight Time				06/05/2017 09:18:08 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Enhanced Medical Only (HMO)	01	01		1			H3653	018	0	2018	Paramount Elite - Medical Only (North OH/ SE Mich)		2	1997	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525										(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670										2					2					2	2			
H3653	803	0	1	01	01	H3653_803_0	1			1		05/18/2017	2018.03	05/18/2017 01:15:34 PM Eastern Daylight Time					05/24/2017 09:51:12 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Emp Group A/B No Rx (HMO)	01	01		1			H3653	803	0	2018	Paramount Elite - Emp Group A/B No Rx		1	14487	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525										(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670										1	1	1a;1b;2;5;6;7h;8b1;9a;9b;9c;11a;11b;15;	2		1					1				
H3653	806	0	2	01	01	H3653_806_0	1			1		05/18/2017	2018.03	05/18/2017 01:21:59 PM Eastern Daylight Time					05/24/2017 09:51:12 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Emp Group B Only No Rx (HMO)	01	01		2	2		H3653	806	0	2018	Paramount Elite - Emp Group B Only No Rx		1	1134	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525										(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670										1	1	1a;1b;2;5;6;7h;8b1;9a;9b;9c;11a;11b;15;	2		1					1				
H3653	809	0	1	01	01	H3653_809_0	1			1		05/18/2017	2018.03	05/18/2017 01:28:01 PM Eastern Daylight Time					05/24/2017 09:51:12 AM Eastern Daylight Time	PARAMOUNT CARE, INC.	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite-Emp Group A/B Rx (HMO)	01	01		1			H3653	809	0	2018	Paramount Elite-Emp Group A/B Rx		1	827	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670		1	1	1a;1b;2;5;6;7h;8b1;9a;9b;9c;11a;11b;15;	2		1					1				
H3655	032	0	1	01	01	H3655_032_0	5			1		08/07/2017	2018.03	08/07/2017 02:41:14 PM Eastern Daylight Time	08/07/2017 08:51:41 AM Eastern Daylight Time	08/06/2017 03:05:39 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Essential (HMO)	01	01		1			H3655	032	0	2018	Select Counties in Ohio		2	1622748	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7796		(855)690-7796		(800)797-5957		(800)797-5957		(855)690-7796		(855)690-7796		(844)364-2116		(844)364-2116		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3655	033	0	1	01	01	H3655_033_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 10:01:51 AM Eastern Daylight Time	08/07/2017 08:51:42 AM Eastern Daylight Time	08/06/2017 03:05:39 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H3655	033	0	2018	Select Counties in Ohio		2	139656	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(844)879-3610		(844)879-3610		(844)467-1561		(844)467-1561		(844)879-3610		(844)879-3610		(844)467-1562		(844)467-1562		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3655	034	0	1	01	01	H3655_034_0	5			1		05/30/2017	2018.03	05/30/2017 10:55:51 AM Eastern Daylight Time	08/07/2017 08:51:42 AM Eastern Daylight Time	08/06/2017 03:05:39 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H3655	034	0	2018	Select Counties in Ohio		2	51084	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7796		(855)690-7796		(800)797-5957		(800)797-5957		(855)690-7796		(855)690-7796		(844)364-2116		(844)364-2116		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3655	038	0	1	01	01	H3655_038_0	6			1		08/04/2017	2018.03	08/04/2017 10:05:16 AM Eastern Daylight Time	08/07/2017 08:51:43 AM Eastern Daylight Time	08/06/2017 03:05:39 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Prime Select (HMO)	01	01		1			H3655	038	0	2018	Select counties in OH		2	29748	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7796		(855)690-7796		(800)797-5957		(800)797-5957		(855)690-7796		(855)690-7796		(844)364-2116		(844)364-2116		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3655	801	0	1	01	01	H3655_801_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:31 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/oh/medicare	Anthem Senior Advantage (HMO)	01	01		1			H3655	801	0	2018	Ohio		1	6103	2			2						www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3655	803	0	1	01	01	H3655_803_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:51 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/oh/medicare	Anthem Senior Advantage (HMO)	01	01		1			H3655	803	0	2018	Ohio		1	600	2			2						www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H3655	805	0	1	02	01	H3655_805_0	7			1		06/03/2017	2018.03	06/03/2017 01:07:58 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/oh/medicare	Anthem Senior Advantage (HMO-POS)	01	02		1			H3655	805	0	2018	Ohio		1	600	2			2						www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	www.anthem.com/oh/medicare	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H3660	028	0	1	02	01	H3660_028_0	5			1		08/02/2017	2018.03	08/02/2017 04:01:17 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Emerald (HMO-POS)	01	02		1			H3660	028	0	2018	Northeast Ohio		2	21420	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	029	0	1	02	01	H3660_029_0	5			1		08/02/2017	2018.03	08/02/2017 04:01:34 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Sapphire (HMO-POS)	01	02		1			H3660	029	0	2018	Northeast Ohio		2	72328	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	044	0	1	01	01	H3660_044_0	5			1		08/02/2017	2018.03	08/02/2017 04:01:50 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Ruby (HMO)	01	01		1			H3660	044	0	2018	Northeast Ohio		2	77947	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	047	0	1	01	01	H3660_047_0	5			1		08/02/2017	2018.03	08/02/2017 04:02:13 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Ruby (HMO)	01	01		1			H3660	047	0	2018	Northwest Ohio		2	7257	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	048	0	1	02	01	H3660_048_0	5			1		08/02/2017	2018.03	08/02/2017 04:02:31 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Sapphire (HMO-POS)	01	02		1			H3660	048	0	2018	Northwest Ohio		2	1735	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	049	0	1	01	01	H3660_049_0	5			1		08/02/2017	2018.03	08/02/2017 04:02:51 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Topaz (HMO)	01	01		1			H3660	049	0	2018	Northwest Ohio		2	4276	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	050	0	1	01	01	H3660_050_0	5			1		08/02/2017	2018.03	08/02/2017 04:03:04 PM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time	08/04/2017 09:33:52 AM Eastern Daylight Time			08/04/2017 09:35:39 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Topaz (HMO)	01	01		1			H3660	050	0	2018	Northeast Ohio		2	116395	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H3660	801	0	1	01	01	H3660_801_0	2			1		05/25/2017	2018.03	05/25/2017 03:10:42 PM Eastern Daylight Time					06/02/2017 11:28:58 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Employer Plan with Part D (HMO)	01	01		1			H3660	801	0	2018	Nationwide Service Area		1	2450	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		2					1				
H3660	802	0	1	01	01	H3660_802_0	2			1		05/25/2017	2018.03	05/25/2017 03:10:56 PM Eastern Daylight Time					06/02/2017 11:28:58 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Employer Plan without Part D (HMO)	01	01		1			H3660	802	0	2018	Nationwide Service Area		1	90	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440										(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750										1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		2					1				
H3660	805	0	1	02	01	H3660_805_0	2			1		05/25/2017	2018.03	05/25/2017 03:11:07 PM Eastern Daylight Time					06/02/2017 11:28:58 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Employer Plan with Part D (HMO-POS)	01	02		1			H3660	805	0	2018	Nationwide Service Area		1	9300	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1				
H3660	806	0	1	02	01	H3660_806_0	2			1		05/25/2017	2018.03	05/25/2017 03:11:17 PM Eastern Daylight Time					06/02/2017 11:28:58 AM Eastern Daylight Time	SUMMACARE INC.	SummaCare Medicare Advantage Plans	www.summacare.com/medicare	SummaCare Medicare Employer Plan without Part D (HMO-POS)	01	02		1			H3660	806	0	2018	Nationwide Service Area		1	90	2			2						www.summacare.com/medicare	http://medicare.summacare.com/member/drug_benefits/FindaDrug.aspx	www.summacare.com/medicare	(800)996-6250		(330)996-8885		(888)464-8440		(330)996-8440										(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750										1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1	1	1a;1b;2;7d;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1				
H3664	014	0	1	02	01	H3664_014_0	1			1		05/22/2017	2018.03	05/22/2017 04:21:39 PM Eastern Daylight Time	06/01/2017 01:28:12 PM Eastern Daylight Time				06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Basic - MA Only (HMO-POS)	01	02		1			H3664	014	0	2018	Operating in 12 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424										(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460										2					2					2	2			
H3664	017	0	1	02	01	H3664_017_0	3			1		08/04/2017	2018.03	08/04/2017 05:30:46 PM Eastern Daylight Time	08/07/2017 08:25:52 AM Eastern Daylight Time	08/07/2017 08:25:52 AM Eastern Daylight Time			08/07/2017 08:28:52 AM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Plus (HMO-POS)	01	02		1			H3664	017	0	2018	Operating in 12 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		2					2					2	2			
H3664	020	0	1	02	01	H3664_020_0	3			1		08/04/2017	2018.03	08/04/2017 05:31:26 PM Eastern Daylight Time	08/07/2017 08:25:52 AM Eastern Daylight Time	08/07/2017 08:25:52 AM Eastern Daylight Time			08/07/2017 08:28:52 AM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Classic (HMO-POS)	01	02		1			H3664	020	0	2018	Operating in 12 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		2					2					2	2			
H3664	021	0	1	02	01	H3664_021_0	3			1		08/04/2017	2018.03	08/04/2017 05:31:51 PM Eastern Daylight Time	08/07/2017 08:25:53 AM Eastern Daylight Time	08/07/2017 08:25:53 AM Eastern Daylight Time			08/07/2017 08:28:52 AM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Aultimate (HMO-POS)	01	02		1			H3664	021	0	2018	Operating in 12 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		2					2					2	2			
H3664	801	0	1	02	01	H3664_801_0	1			1		05/04/2017	2018.03	05/04/2017 04:47:15 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group HMO  - CY (HMO-POS)	01	02		1			H3664	801	0	2018	National Service Area		1	7680	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3664	802	0	1	02	01	H3664_802_0	1			1		05/04/2017	2018.03	05/04/2017 04:47:24 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group HMO MA-Only (HMO-POS)	01	02		1			H3664	802	0	2018	National Service Area		1	996	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424										(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460										1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3664	803	0	1	02	01	H3664_803_0	1			1		05/04/2017	2018.03	05/04/2017 04:43:17 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group - Non CY (HMO-POS)	01	02		1			H3664	803	0	2018	National Service Area		1	0	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3664	805	0	2	02	01	H3664_805_0	1			1		05/04/2017	2018.03	05/04/2017 04:37:25 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	Part B Only MA-PD (HMO-POS)	01	02		2	2		H3664	805	0	2018	Part B Only MA-PD National Service Area		1	0	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		1	1	1a;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3664	806	0	2	02	01	H3664_806_0	1			1		05/04/2017	2018.03	05/04/2017 04:45:03 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	Part B Only MA (HMO-POS)	01	02		2	2		H3664	806	0	2018	Part B Only MA National Service Area		1	0	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424										(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460										1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3664	807	0	1	02	01	H3664_807_0	1			1		05/04/2017	2018.03	05/04/2017 04:47:04 PM Eastern Daylight Time					06/01/2017 01:52:33 PM Eastern Daylight Time	AULTCARE HEALTH INSURING CORPORATION	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group HMO - CY (HMO-POS)	01	02		1			H3664	807	0	2018	National Service Area		1	71616	2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)577-5084		(330)363-7407		(855)877-1049		(330)363-7424		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		(800)617-7446		(330)363-7460		1	1	1a;1b;2;3-1;3-2;3-3;5;6;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		1	2		2		1				
H3668	005	0	1	01	01	H3668_005_0	4			1		08/04/2017	2018.03	08/04/2017 03:15:59 PM Eastern Daylight Time	08/04/2017 01:19:22 PM Eastern Daylight Time	08/04/2017 09:10:14 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Classic Preferred (HMO)	01	01		1			H3668	005	0	2018	Greater Central Ohio and Dayton Area		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	011	0	1	01	01	H3668_011_0	4			1		08/04/2017	2018.03	08/04/2017 10:58:32 PM Eastern Daylight Time	08/04/2017 01:21:16 PM Eastern Daylight Time	08/04/2017 09:11:50 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Essential Care (HMO)	01	01		1			H3668	011	0	2018	Greater Central Ohio and Dayton Area		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	013	0	1	01	01	H3668_013_0	3			1		05/30/2017	2018.03	05/30/2017 10:20:18 AM Eastern Daylight Time	06/05/2017 01:08:36 PM Eastern Daylight Time				06/05/2017 03:07:28 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Medical Only (HMO)	01	01		1			H3668	013	0	2018	Central and Southern Ohio		2		1	1		2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3668	014	0	1	01	01	H3668_014_0	4			1		08/04/2017	2018.03	08/04/2017 03:16:13 PM Eastern Daylight Time	08/04/2017 01:26:10 PM Eastern Daylight Time	08/04/2017 09:12:50 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Southeast OH Classic Preferred (HMO)	01	01		1			H3668	014	0	2018	Southeast Ohio		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	015	0	1	01	01	H3668_015_0	4			1		08/04/2017	2018.03	08/04/2017 03:16:18 PM Eastern Daylight Time	08/04/2017 01:27:14 PM Eastern Daylight Time	08/04/2017 09:13:38 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Southeast OH Essential Care (HMO)	01	01		1			H3668	015	0	2018	Southeast Ohio		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	016	0	1	01	01	H3668_016_0	4			1		08/04/2017	2018.03	08/04/2017 03:16:23 PM Eastern Daylight Time	08/04/2017 01:28:24 PM Eastern Daylight Time	08/04/2017 09:14:22 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Southwest OH Classic Preferred (HMO)	01	01		1			H3668	016	0	2018	Greater Cincinnati and Champaign County		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	017	0	1	01	01	H3668_017_0	4			1		08/04/2017	2018.03	08/04/2017 03:16:28 PM Eastern Daylight Time	08/04/2017 01:29:22 PM Eastern Daylight Time	08/04/2017 09:15:06 AM Eastern Daylight Time			08/05/2017 09:34:35 PM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	MediGold Southwest OH Essential Care (HMO)	01	01		1			H3668	017	0	2018	Greater Cincinnati and Champaign County		2		2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3668	801	0	1	01	01	H3668_801_0	1			1		05/22/2017	2018.03	05/22/2017 10:33:04 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Medical Only (HMO)	01	01		1			H3668	801	0	2018	Central, Southeast and Southwest OH		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3668	802	0	1	01	01	H3668_802_0	1			1		05/26/2017	2018.03	05/26/2017 08:52:26 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Classic (HMO)	01	01		1			H3668	802	0	2018	Central, Southeast and Southwest OH		1	6684	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	803	0	1	01	01	H3668_803_0	1			1		05/26/2017	2018.03	05/26/2017 08:56:54 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Custom (HMO)	01	01		1			H3668	803	0	2018	Central, Southeast and Southwest OH		1	2964	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	804	0	1	01	01	H3668_804_0	1			1		05/22/2017	2018.03	05/22/2017 10:35:29 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Classic (HMO)	01	01		1			H3668	804	0	2018	Central, Southeast and Southwest OH		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	805	0	1	01	01	H3668_805_0	1			1		05/22/2017	2018.03	05/22/2017 10:35:40 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southeast OH Medical Only (HMO)	01	01		1			H3668	805	0	2018	Southeast Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3668	806	0	1	01	01	H3668_806_0	1			1		05/22/2017	2018.03	05/22/2017 10:35:50 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southeast OH Classic (HMO)	01	01		1			H3668	806	0	2018	Southeast Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	807	0	1	01	01	H3668_807_0	1			1		05/22/2017	2018.03	05/22/2017 10:36:00 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southeast OH Custom (HMO)	01	01		1			H3668	807	0	2018	Southeast Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	808	0	1	01	01	H3668_808_0	1			1		05/22/2017	2018.03	05/22/2017 10:36:13 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southwest OH Medical Only (HMO)	01	01		1			H3668	808	0	2018	Southwest Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3668	809	0	1	01	01	H3668_809_0	1			1		05/22/2017	2018.03	05/22/2017 10:36:23 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southwest OH Classic (HMO)	01	01		1			H3668	809	0	2018	Southwest Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3668	810	0	1	01	01	H3668_810_0	1			1		05/22/2017	2018.03	05/22/2017 10:36:34 AM Eastern Daylight Time					06/02/2017 09:40:15 AM Eastern Daylight Time	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	www.MediGold.com	EGWP MediGold Southwest OH Custom (HMO)	01	01		1			H3668	810	0	2018	Southwest Ohio		1	12	2			2						www.MediGold.com	www.MediGold.com	www.MediGold.com	(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(800)240-3851		(614)546-3110		(800)964-4525		(800)964-4525		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3672	013	0	1	01	01	H3672_013_0	6			1		07/27/2017	2018.03	07/27/2017 09:16:02 PM Eastern Daylight Time	08/02/2017 05:01:40 PM Eastern Daylight Time	08/02/2017 04:23:28 PM Eastern Daylight Time			08/03/2017 02:11:41 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Option II (HMO)	01	01		1			H3672	013	0	2018	East Central Ohio		2	33000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3672	014	0	1	01	01	H3672_014_0	4			1		07/27/2017	2018.03	07/27/2017 09:16:37 PM Eastern Daylight Time	06/04/2017 09:51:18 PM Eastern Daylight Time				07/27/2017 09:25:19 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Option I, MA Only (HMO)	01	01		1			H3672	014	0	2018	East Central Ohio		2	6000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3672	018	0	1	01	01	H3672_018_0	5			1		08/03/2017	2018.03	08/03/2017 01:42:00 PM Eastern Daylight Time	08/03/2017 02:05:14 PM Eastern Daylight Time	08/02/2017 04:23:28 PM Eastern Daylight Time			08/03/2017 02:11:41 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Option IV (HMO)	01	01		1			H3672	018	0	2018	East Central Ohio		2	30000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3672	019	0	1	01	01	H3672_019_0	7		1	1	2	08/02/2017	2018.03	08/02/2017 04:16:31 PM Eastern Daylight Time	08/02/2017 05:10:11 PM Eastern Daylight Time	08/02/2017 04:23:29 PM Eastern Daylight Time			08/03/2017 02:11:41 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare SNP (HMO SNP)	01	01		1			H3672	019	0	2018	Southeastern Ohio, West Virginia		2	8000	2			1	3		2		2	www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3672	020	0	1	01	01	H3672_020_0	5			1		07/27/2017	2018.03	07/27/2017 09:18:49 PM Eastern Daylight Time	08/02/2017 05:14:12 PM Eastern Daylight Time	08/02/2017 04:23:29 PM Eastern Daylight Time			08/03/2017 02:11:41 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Option II (HMO)	01	01		1			H3672	020	0	2018	Southeastern OH, West Virginia		2	75000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3672	021	0	1	01	01	H3672_021_0	4			1		07/27/2017	2018.03	07/27/2017 09:19:43 PM Eastern Daylight Time	06/04/2017 09:59:49 PM Eastern Daylight Time				07/27/2017 09:25:19 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Option I, MA Only (HMO)	01	01		1			H3672	021	0	2018	Southeastern OH, West Virginia		2	6000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3672	023	0	1	01	01	H3672_023_0	5			1		07/27/2017	2018.03	07/27/2017 09:20:12 PM Eastern Daylight Time	08/02/2017 05:19:36 PM Eastern Daylight Time	08/02/2017 04:23:29 PM Eastern Daylight Time			08/03/2017 02:11:41 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare Capitol Plan (HMO)	01	01		1			H3672	023	0	2018	Kanawha and Surrounding Counties		2	2000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3672	024	0	1	01	01	H3672_024_0	4			1		07/27/2017	2018.03	07/27/2017 09:20:42 PM Eastern Daylight Time	06/04/2017 10:03:41 PM Eastern Daylight Time				07/27/2017 09:25:19 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare Capitol Plan, MA Only (HMO)	01	01		1			H3672	024	0	2018	Kanawha and Surrounding Counties		2	100	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3672	805	0	1	01	01	H3672_805_0	1			1		05/17/2017	2018.03	05/17/2017 02:31:21 PM Eastern Daylight Time					06/02/2017 11:40:34 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureCare - Employer (HMO)	01	01		1			H3672	805	0	2018	East Ohio and West Virginia, National		1	12000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3706	001	0	1	01	01	H3706_001_0	6			1		08/07/2017	2018.03	08/07/2017 04:00:29 PM Central Daylight Time	08/07/2017 09:50:20 AM Central Daylight Time	08/01/2017 10:57:36 AM Central Daylight Time			08/07/2017 04:03:13 PM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations Classic (HMO)	01	01		1			H3706	001	0	2018	Oklahoma (Partial)		2	109500	2			2						www.GlobalHealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(866)494-3927		(405)280-5555		(844)280-5555		(405)280-5555		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3706	009	0	1	01	01	H3706_009_0	5			1		07/05/2017	2018.03	07/05/2017 02:58:09 PM Central Daylight Time	06/05/2017 06:18:54 PM Central Daylight Time				07/06/2017 05:47:28 AM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations Value (HMO)	01	01		1			H3706	009	0	2018	Oklahoma (Partial)		2	3000	2			2						www.GlobalHealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3706	018	0	1	01	01	H3706_018_0	6			1		08/07/2017	2018.03	08/07/2017 01:43:49 PM Central Daylight Time	08/04/2017 04:14:06 PM Central Daylight Time	08/01/2017 10:59:38 AM Central Daylight Time			08/07/2017 04:03:13 PM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations Select (HMO)	01	01		1			H3706	018	0	2018	Oklahoma (Partial)		2	15000	2			2						www.GlobalHhealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(866)494-3927		(405)280-5555		(844)280-5555		(405)280-5555		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3706	803	0	1	01	01	H3706_803_0	4			1		04/14/2017	2018.03	04/14/2017 06:41:35 AM Central Daylight Time					06/05/2017 06:19:37 PM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations EGHP CY (HMO)	01	01		1			H3706	803	0	2018	Oklahoma (Partial)		1	22500	2			2						www.GlobalHealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(866)494-3927		(405)280-5555		(844)280-5555		(405)280-5555		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;11a;11b;11c;12;14d;14e2;15;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;12;14d;14e2;18a;	1					1				
H3706	804	0	1	01	01	H3706_804_0	4			1		04/14/2017	2018.03	04/14/2017 06:44:11 AM Central Daylight Time					06/05/2017 06:19:37 PM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations EGHP Non CY (HMO)	01	01		1			H3706	804	0	2018	Oklahoma (Partial)		1	0	2			2						www.GlobalHealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;11a;11b;11c;12;14d;14e2;15;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;12;14d;14e2;18a;	1					1				
H3706	807	0	1	01	01	H3706_807_0	4			1		04/14/2017	2018.03	04/14/2017 06:46:59 AM Central Daylight Time					06/05/2017 06:19:37 PM Central Daylight Time	GLOBALHEALTH, INC.	GlobalHealth	www.GlobalHealth.com/medicare	Generations EGHP MA only (HMO)	01	01		1			H3706	807	0	2018	Oklahoma (Partial)		1	0	2			2						www.GlobalHealth.com/provider-search	www.GlobalHealth.com/medicare/member-materials	www.GlobalHealth.com/provider-search	(844)280-5555		(405)280-5555		(844)280-5555		(405)280-5555										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;11a;11b;11c;12;14d;14e2;15;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7h;7i;8b1;8b2;9a;9b;9d;12;14d;14e2;18a;	1					1				
H3708	001	0	1	01	01	H3708_001_0	6		1	1		05/26/2017	2018.03	05/26/2017 10:17:04 AM Central Daylight Time	08/04/2017 03:44:13 PM Central Daylight Time	08/04/2017 03:44:13 PM Central Daylight Time			08/04/2017 03:45:29 PM Central Daylight Time	OKLAHOMA SUPERIOR SELECT, INC.	Tribute Health Plan of Oklahoma	www.tributehealthplans.com	Tribute Health Plan of Oklahoma (HMO SNP)	01	01		1			H3708	001	0	2018	Greater Ardmore Metro Area		2	5240	2			1	1	2				www.tributehealthplans.com	www.tributehealthplans.com	www.tributehealthplans.com	(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(866)583-4649		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H3749	001	0	1	01	01	H3749_001_0	5			1		05/25/2017	2018.03	05/25/2017 11:19:03 AM Central Daylight Time	08/03/2017 02:19:06 PM Central Daylight Time	08/01/2017 10:37:12 AM Central Daylight Time			08/04/2017 03:13:15 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H3749	001	0	2018	Oklahoma City Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3749	017	0	1	01	01	H3749_017_0	5			1		05/30/2017	2018.03	05/30/2017 11:58:02 AM Central Daylight Time	08/03/2017 02:19:45 PM Central Daylight Time	08/01/2017 10:37:40 AM Central Daylight Time			08/04/2017 03:13:15 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H3749	017	0	2018	Tulsa Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3749	018	0	1	01	01	H3749_018_0	4			1		08/02/2017	2018.03	08/02/2017 02:16:28 PM Central Daylight Time	08/03/2017 02:20:23 PM Central Daylight Time	08/01/2017 10:38:09 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H3749	018	0	2018	Oklahoma City Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3749	020	0	1	01	01	H3749_020_0	5			1		08/02/2017	2018.03	08/02/2017 02:17:08 PM Central Daylight Time	08/03/2017 02:21:05 PM Central Daylight Time	08/01/2017 10:38:35 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H3749	020	0	2018	Tulsa Metro Area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3749	801	0	1	01	01	H3749_801_0	2			1		06/08/2017	2018.03	06/08/2017 11:30:59 AM Central Daylight Time					06/13/2017 04:54:58 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	801	0	2018	OK Employer Sponsored Plan Service Area		1	756	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H3749	803	0	1	01	01	H3749_803_0	2			1		06/08/2017	2018.03	06/08/2017 11:31:23 AM Central Daylight Time					06/13/2017 04:54:58 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	803	0	2018	OK Employer Sponsored Plan Service Area		1	13176	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3749	804	0	1	01	01	H3749_804_0	1			1		05/25/2017	2018.03	05/25/2017 12:39:55 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	804	0	2018	OK Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H3755	001	0	1	01	01	H3755_001_0	7			1		07/20/2017	2018.03	07/20/2017 10:40:22 AM Central Daylight Time	08/06/2017 02:51:25 PM Central Daylight Time	08/06/2017 02:51:25 PM Central Daylight Time			08/07/2017 11:09:05 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan (HMO)	www.ccok.com	Senior Health Plan Platinum (HMO)	01	01		1			H3755	001	0	2018	Tulsa Metro Area		2	191643	2			2						http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	http://www.ccok.com/rxformulary?Switch=2	www.ccok.com	(800)642-8065		(918)594-5323		(800)642-8065		(918)594-5323		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5211		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H3755	002	0	1	01	01	H3755_002_0	4			1		07/19/2017	2018.03	07/19/2017 01:30:15 PM Central Daylight Time	06/05/2017 11:19:59 AM Central Daylight Time				07/19/2017 02:15:25 PM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan (HMO)	www.ccok.com	Senior Health Plan Silver (HMO)	01	01		1			H3755	002	0	2018	Tulsa Metro Area		2	24287	2			2						http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	http://www.ccok.com/rxformulary?Switch=2	www.ccok.com	(800)642-8065		(918)594-5323		(800)642-8065		(918)594-5323										(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353										2					2					2	2			
H3755	004	0	1	01	01	H3755_004_0	7			1		07/20/2017	2018.03	07/20/2017 10:40:34 AM Central Daylight Time	08/06/2017 02:51:26 PM Central Daylight Time	08/06/2017 02:51:26 PM Central Daylight Time			08/07/2017 11:09:05 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan (HMO)	www.ccok.com	Senior Health Plan Platinum Plus (HMO)	01	01		1			H3755	004	0	2018	Tulsa Metro Area		2	57251	2			2						http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	http://www.ccok.com/rxformulary?Switch=2	www.ccok.com	(800)642-8065		(918)594-5323		(800)642-8065		(918)594-5323		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5323		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H3755	005	0	1	01	01	H3755_005_0	7			1		08/06/2017	2018.03	08/06/2017 03:35:54 PM Central Daylight Time	08/06/2017 02:51:26 PM Central Daylight Time	08/06/2017 02:51:26 PM Central Daylight Time			08/07/2017 11:09:05 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan (HMO)	www.ccok.com	Senior Health Plan Silver Plus (HMO)	01	01		1			H3755	005	0	2018	Tulsa Metro Area		2	10500	2			2						http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	http://www.ccok.com/rxformulary?Switch=2	www.ccok.com	(800)642-8065		(918)594-5323		(800)642-8065		(918)594-5323		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5323		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H3755	801	0	1	01	01	H3755_801_0	2			1		05/30/2017	2018.03	05/30/2017 09:40:35 AM Central Daylight Time					06/05/2017 11:22:03 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan (HMO)	www.ccok.com	Senior Health EGHP+D (HMO)	01	01		1			H3755	801	0	2018	Tulsa Metro Area		1	24807	2			2						http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	http://www.ccok.com/rxformulary?Switch=2	www.ccok.com	(800)642-8065		(918)594-5323		(800)642-8065		(918)594-5323		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5323		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H3765	001	0	1	01	01	H3765_001_0	4			1		08/03/2017	2018.03	08/03/2017 02:12:15 PM Central Daylight Time	08/02/2017 01:35:18 PM Central Daylight Time	08/01/2017 02:06:24 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	HEARTLANDPLAINS HEALTH	HeartlandPlains Health	www.HeartlandPlainsHealth.com	Classic Plus Rx (HMO)	01	01		1			H3765	001	0	2018	Lincoln - Omaha Metropolitan Areas		2		2			2						www.HeartlandPlainsHealth.com	www.HeartlandPlainsHealth.com	www.HeartlandPlainsHealth.com	(866)792-0184		(866)792-0184		(866)792-0184		(866)792-0184		(866)792-0184		(866)792-0184		(866)792-0184		(866)792-0184		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H3794	001	0	1	01	01	H3794_001_0	5		1	1		07/07/2017	2018.03	07/07/2017 11:38:31 AM Central Daylight Time	08/03/2017 02:16:43 PM Central Daylight Time	08/01/2017 10:39:01 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3794	001	0	2018	Kenosha and Rock counties		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3794	002	0	1	01	01	H3794_002_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 10:37:28 AM Central Daylight Time	08/03/2017 02:17:21 PM Central Daylight Time	08/01/2017 10:39:29 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete LP1 (HMO SNP)	01	01		1			H3794	002	0	2018	Select Counties in Wisconsin		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	001	0	1	01	01	H3805_001_0	3			1		06/01/2017	2018.03	06/01/2017 09:45:03 AM Central Daylight Time	08/03/2017 01:48:01 PM Central Daylight Time	08/01/2017 10:39:55 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3805	001	0	2018	Select counties in Western Oregon		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	007	0	1	01	01	H3805_007_0	3			1		05/25/2017	2018.03	05/25/2017 11:31:52 AM Central Daylight Time	08/04/2017 08:31:18 AM Central Daylight Time	08/01/2017 10:40:23 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3805	007	0	2018	Benton, Lane, and Linn counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	012	0	1	01	01	H3805_012_0	3			1		08/02/2017	2018.03	08/02/2017 05:21:23 PM Central Daylight Time	08/03/2017 01:49:21 PM Central Daylight Time	08/01/2017 10:40:50 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	012	0	2018	Select counties in Western Oregon		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	013	0	1	01	01	H3805_013_0	3			1		08/02/2017	2018.03	08/02/2017 04:34:22 PM Central Daylight Time	08/04/2017 08:31:50 AM Central Daylight Time	08/01/2017 10:41:16 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	013	0	2018	Benton, Lane, and Linn counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	014	0	1	01	01	H3805_014_0	3			1		05/25/2017	2018.03	05/25/2017 11:32:23 AM Central Daylight Time	08/03/2017 01:50:35 PM Central Daylight Time	08/01/2017 10:41:42 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3805	014	0	2018	Select counties in western Washington		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	015	0	1	01	01	H3805_015_0	3			1		05/25/2017	2018.03	05/25/2017 11:32:33 AM Central Daylight Time	08/03/2017 01:51:14 PM Central Daylight Time	08/01/2017 10:42:08 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H3805	015	0	2018	Select counties in western Washington		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	016	0	1	01	01	H3805_016_0	3			1		08/02/2017	2018.03	08/02/2017 04:35:42 PM Central Daylight Time	08/03/2017 01:51:53 PM Central Daylight Time	08/01/2017 10:42:35 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	016	0	2018	Clark and Cowlitz counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	017	0	1	01	01	H3805_017_0	3			1		08/02/2017	2018.03	08/02/2017 04:36:12 PM Central Daylight Time	08/03/2017 01:52:30 PM Central Daylight Time	08/01/2017 10:43:03 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	017	0	2018	King county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	018	0	1	01	01	H3805_018_0	3			1		08/02/2017	2018.03	08/02/2017 04:37:40 PM Central Daylight Time	08/03/2017 01:57:48 PM Central Daylight Time	08/01/2017 10:43:29 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	018	0	2018	Thurston and Lewis Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	019	0	1	01	01	H3805_019_0	3			1		05/25/2017	2018.03	05/25/2017 11:33:21 AM Central Daylight Time	08/03/2017 01:58:21 PM Central Daylight Time	08/01/2017 10:43:55 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	019	0	2018	Kitsap and Pierce Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	020	0	1	01	01	H3805_020_0	3			1		08/02/2017	2018.03	08/02/2017 04:38:45 PM Central Daylight Time	08/03/2017 01:58:53 PM Central Daylight Time	08/01/2017 10:44:28 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3805	020	0	2018	Snohomish county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	021	0	1	01	01	H3805_021_0	4			1		06/01/2017	2018.03	06/01/2017 09:45:33 AM Central Daylight Time	08/03/2017 01:59:26 PM Central Daylight Time	08/01/2017 10:44:54 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3805	021	0	2018	Skagit and Whatcom Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3805	801	0	1	01	01	H3805_801_0	3			1		06/05/2017	2018.03	06/05/2017 03:39:27 PM Central Daylight Time					06/05/2017 03:44:32 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	801	0	2018	OR Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3805	803	0	1	01	01	H3805_803_0	4			1		06/08/2017	2018.03	06/08/2017 11:31:44 AM Central Daylight Time					06/13/2017 04:57:04 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	803	0	2018	OR Employer Sponsored Plan Service Area		1	2664	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3805	804	0	1	01	01	H3805_804_0	3			1		06/05/2017	2018.03	06/05/2017 03:41:11 PM Central Daylight Time					06/05/2017 03:44:32 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	804	0	2018	OR Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3805	805	0	1	01	01	H3805_805_0	3			1		06/05/2017	2018.03	06/05/2017 03:41:46 PM Central Daylight Time					06/05/2017 03:44:32 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	805	0	2018	Select counties in Washington		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3805	806	0	1	01	01	H3805_806_0	4			1		06/15/2017	2018.03	06/15/2017 09:58:55 AM Central Daylight Time					06/15/2017 10:00:39 AM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	806	0	2018	Select counties in Washington		1	3540	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3805	807	0	1	01	01	H3805_807_0	4			1		06/08/2017	2018.03	06/08/2017 11:46:32 AM Central Daylight Time					06/13/2017 04:57:04 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	807	0	2018	Select counties in Washington		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H3809	001	0	1	20	08	H3809_001_0	1			1		05/31/2017	2018.03	05/31/2017 09:56:28 AM Pacific Daylight Time		05/31/2017 09:12:54 AM Pacific Daylight Time			05/31/2017 09:58:16 AM Pacific Daylight Time	PROVIDENCE HEALTH & SERVICES - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	Providence ElderPlace Portland (dual eligible) (PACE)	08	20		1			H3809	001	0	2018	Portland Metro area and North Coast		2		2			2						http://oregon.providence.org/our-services/p/providence-long-term-care-pharmacy-for-clinicians-hp/ove	http://oregon.providence.org/our-services/p/providence-elderplace-prescription-medications/										(855)415-6048		(503)215-6556		(855)415-6048		(503)215-6556										(800)848-4442		(503)215-6556		(800)848-4442		(503)215-6556																
H3809	002	0	1	20	08	H3809_002_0	1			1		05/31/2017	2018.03	05/31/2017 09:56:51 AM Pacific Daylight Time		05/31/2017 09:13:25 AM Pacific Daylight Time			05/31/2017 09:58:16 AM Pacific Daylight Time	PROVIDENCE HEALTH & SERVICES - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	Providence ElderPlace Portland (private pay) (PACE)	08	20		1			H3809	002	0	2018	Portland Metro area and North Coast		2		2			2						http://oregon.providence.org/our-services/p/providence-long-term-care-pharmacy-for-clinicians-hp/ove	http://oregon.providence.org/our-services/p/providence-elderplace-prescription-medications/										(855)415-6048		(503)215-6556		(855)415-6048		(503)215-6556										(800)848-4442		(503)215-6556		(800)848-4442		(503)215-6556																
H3810	001	0	1	01	01	H3810_001_0	4			1		07/17/2017	2018.03	07/17/2017 09:51:11 AM Pacific Daylight Time	06/05/2017 05:01:25 PM Pacific Daylight Time				07/17/2017 09:55:19 AM Pacific Daylight Time	ALLCARE HEALTH PLAN, INC.	AllCare Advantage	www.AllCareHealth.com/Advantage	AllCare Advantage Gold (HMO)	01	01		1			H3810	001	0	2018	Counties:  JO, JA, DO*		2	5068	2			2						www.AllCareHealth.com/Advantage/Pharmacy	www.AllCareHealth.com/Advantage/Formulary	www.AllCareHealth.com/Advantage/Providers	(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2					2	2			
H3810	003	0	1	01	01	H3810_003_0	12			1		08/09/2017	2018.03	08/09/2017 08:11:52 AM Pacific Daylight Time	08/09/2017 10:26:41 AM Pacific Daylight Time	08/09/2017 10:27:38 AM Pacific Daylight Time			08/09/2017 10:32:41 AM Pacific Daylight Time	ALLCARE HEALTH PLAN, INC.	AllCare Advantage	www.AllCareHealth.com/Advantage	AllCare Advantage Gold Plus Rx (HMO)	01	01		1			H3810	003	0	2018	Counties: JO, JA, DO*		2	17694	2			2						www.AllCareHealth.com/Advantage/Pharmacy	www.AllCareHealth.com/Advantage/Formulary	www.AllCareHealth.com/Advantage/Providers	(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3810	020	0	1	01	01	H3810_020_0	13			1		08/09/2017	2018.03	08/09/2017 08:11:59 AM Pacific Daylight Time	08/09/2017 10:26:16 AM Pacific Daylight Time	08/09/2017 10:27:13 AM Pacific Daylight Time			08/09/2017 10:32:41 AM Pacific Daylight Time	ALLCARE HEALTH PLAN, INC.	AllCare Advantage	www.AllCareHealth.com/Advantage	AllCare Advantage Preferred Rx (HMO)	01	01		1			H3810	020	0	2018	Josephine, Jackson, Douglas*		2	18600	2			2						www.AllCareHealth.com/Advantage/Pharmacy	www.AllCareHealth.com/Advantage/Formulary	www.AllCareHealth.com/Advantage/Providers	(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(888)460-0185		(541)471-4106		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3811	001	0	1	01	01	H3811_001_0	1			1		06/05/2017	2018.03	06/05/2017 10:54:04 AM Pacific Daylight Time	06/05/2017 11:36:33 AM Pacific Daylight Time				06/05/2017 12:05:12 PM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	https://medicare.samhealthplans.org	Samaritan Advantage Conventional Plan (HMO)	01	01		1			H3811	001	0	2018	Benton, Lincoln and Linn counties		2		2			2						www.samhealth.org/Medicare	www.samhealth.org/Medicare	https://medicare.samhealthplans.org	(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2					2	2			
H3811	002	0	1	01	01	H3811_002_0	5			1		08/07/2017	2018.03	08/07/2017 03:23:31 PM Pacific Daylight Time	08/07/2017 08:24:25 AM Pacific Daylight Time	08/07/2017 08:24:25 AM Pacific Daylight Time			08/07/2017 03:44:34 PM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	https://medicare.samhealthplans.org	Samaritan Advantage Premier Plan (HMO)	01	01		1			H3811	002	0	2018	Benton, Lincoln and Linn counties		2		2			2						www.samhealth.org/Medicare	www.samhealth.org/Medicare	https://medicare.samhealthplans.org	(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3811	003	0	1	01	01	H3811_003_0	4		1	1	2	08/07/2017	2018.03	08/07/2017 07:08:12 PM Pacific Daylight Time	08/07/2017 08:24:23 AM Pacific Daylight Time	08/07/2017 08:24:24 AM Pacific Daylight Time			08/07/2017 07:08:56 PM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	https://medicare.samhealthplans.org	Samaritan Advantage Special Needs Plan (HMO SNP)	01	01		1			H3811	003	0	2018	Benton, Linn and Lincoln counties		2		2			1	3		2		2	www.samhealth.org/Medicare	www.samhealth.org/Medicare	https://medicare.samhealthplans.org	(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3811	009	0	1	01	01	H3811_009_0	5			1		07/24/2017	2018.03	07/24/2017 10:54:48 AM Pacific Daylight Time	08/07/2017 08:24:24 AM Pacific Daylight Time	08/07/2017 08:24:24 AM Pacific Daylight Time			08/07/2017 03:50:10 PM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	https://medicare.samhealthplans.org	Samaritan Advantage Premier Plan Plus (HMO)	01	01		1			H3811	009	0	2018	Benton, Lincoln, and Linn counties		2		2			2						www.samhealth.org/Medicare	www.samhealth.org/Medicare	https://medicare.samhealthplans.org	(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)832-4580		(541)768-4550		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3813	001	0	1	04	01	H3813_001_0	6			1		07/06/2017	2018.03	07/06/2017 11:00:55 AM Pacific Daylight Time	07/16/2017 11:50:10 AM Pacific Daylight Time				07/19/2017 02:11:01 PM Pacific Daylight Time	MODA HEALTH PLAN, INC.	Moda Health Plan, Inc.	www.modahealth.com/medicare	Moda Health PPO (PPO)	01	04		1			H3813	001	0	2018	State of Oregon		2	27252	2			2						www.modahealth.com/medicare	www.modahealth.com/medicare	www.modahealth.com/medicare	(877)299-9062		(503)265-4762		(888)217-2375		(503)265-2975										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3813	006	0	1	04	01	H3813_006_0	9			1		08/02/2017	2018.03	08/02/2017 09:52:18 AM Pacific Daylight Time	08/07/2017 10:39:48 AM Pacific Daylight Time	08/03/2017 02:49:50 PM Pacific Daylight Time			08/07/2017 08:46:34 AM Pacific Daylight Time	MODA HEALTH PLAN, INC.	Moda Health Plan, Inc.	www.modahealth.com/medicare	Moda Health PPORX (PPO)	01	04		1			H3813	006	0	2018	State of Oregon		2	83767	2			2						www.modahealth.com/medicare	www.modahealth.com/medicare	www.modahealth.com/medicare	(877)299-9062		(503)265-4762		(888)217-2375		(503)265-2975		(888)786-7509		(503)265-4709		(888)217-2375		(503)265-2975		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3813	802	0	1	04	01	H3813_802_0	4			1		07/06/2017	2018.03	07/06/2017 11:16:36 AM Pacific Daylight Time					07/06/2017 11:23:25 AM Pacific Daylight Time	MODA HEALTH PLAN, INC.	Moda Health Plan, Inc.	www.modahealth.com/medicare	Moda Health PPORX Employer Option (PPO)	01	04		1			H3813	802	0	2018	State of Oregon		1	96000	2			2						www.modahealth.com/medicare	www.modahealth.com/medicare	www.modahealth.com/medicare	(877)299-9061		(503)265-4762		(877)299-9061		(503)265-4762		(888)786-7509		(503)265-4709		(888)786-7509		(503)265-4709		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3814	007	0	1	01	01	H3814_007_0	7		1	1	2	08/03/2017	2018.03	08/03/2017 07:18:52 PM Pacific Daylight Time	08/04/2017 11:24:34 AM Pacific Daylight Time	07/31/2017 05:17:57 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Special Needs Plan (HMO SNP)	01	01		1			H3814	007	0	2018	Douglas and Klamath Counties		2	24168	2			1	3		2		2	atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2					2	2			
H3814	029	0	1	01	01	H3814_029_0	7		1	1	2	08/03/2017	2018.03	08/03/2017 07:13:06 PM Pacific Daylight Time	08/04/2017 11:29:28 AM Pacific Daylight Time	07/31/2017 05:30:37 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Special Needs Plan (Rogue) (HMO SNP)	01	01		1			H3814	029	0	2018	Josephine and Jackson Counties		2	3420	2			1	3		2		2	atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2					2	2			
H3815	001	0	1	01	01	H3815_001_0	5			1		08/03/2017	2018.03	08/03/2017 11:55:22 AM Pacific Daylight Time	08/02/2017 02:28:32 PM Pacific Daylight Time	07/31/2017 04:07:28 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan My Choice (HMO)	01	01		1			H3815	001	0	2018	LA, No Orange, San Bernardino & Riverside Counties		2	103965	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	006	0	1	02	01	H3815_006_0	4			1		08/03/2017	2018.03	08/03/2017 11:56:57 AM Pacific Daylight Time	08/02/2017 02:03:28 PM Pacific Daylight Time	07/31/2017 04:08:48 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan My Choice (HMO-POS)	01	02		1			H3815	006	0	2018	Stanislaus, San Joaquin Counties		2	87773	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	007	0	1	01	01	H3815_007_0	4			1		08/03/2017	2018.03	08/03/2017 12:02:59 PM Pacific Daylight Time	08/02/2017 02:05:00 PM Pacific Daylight Time	07/31/2017 04:10:44 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan My Choice (HMO)	01	01		1			H3815	007	0	2018	Santa Clara County		2	64773	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	008	0	1	01	01	H3815_008_0	5			1		08/03/2017	2018.03	08/03/2017 11:58:09 AM Pacific Daylight Time	08/02/2017 02:06:46 PM Pacific Daylight Time	07/31/2017 04:11:40 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan Platinum (HMO)	01	01		1			H3815	008	0	2018	Los Angeles and North Orange Counties		2	36783	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	009	0	1	01	01	H3815_009_0	4			1		08/03/2017	2018.03	08/03/2017 11:59:50 AM Pacific Daylight Time	08/02/2017 03:14:22 PM Pacific Daylight Time	07/31/2017 04:13:14 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan CalPlus (HMO)	01	01		1			H3815	009	0	2018	Counties: Riv, SanB, Stan, San Joaquin, SC, LA, OC		2	65958	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	010	0	1	01	01	H3815_010_0	4		1	1		08/03/2017	2018.03	08/03/2017 12:00:52 PM Pacific Daylight Time	08/02/2017 02:08:20 PM Pacific Daylight Time	07/31/2017 04:15:26 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan Heart & Diabetes (HMO SNP)	01	01		1			H3815	010	0	2018	Los Angeles and North Orange Counties		2	7344	2			1	4			00000000000000000010		www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	011	0	1	01	01	H3815_011_0	4			1		08/03/2017	2018.03	08/03/2017 12:01:45 PM Pacific Daylight Time	08/02/2017 02:10:20 PM Pacific Daylight Time	07/31/2017 04:16:54 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan AllCare Preferred Plan (HMO)	01	01		1			H3815	011	0	2018	Stanislaus County		2	70798	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3815	013	0	1	01	01	H3815_013_0	3			1		08/03/2017	2018.03	08/03/2017 12:02:23 PM Pacific Daylight Time	08/02/2017 02:49:58 PM Pacific Daylight Time	07/31/2017 04:18:16 PM Pacific Daylight Time			08/03/2017 12:09:02 PM Pacific Daylight Time	ALIGNMENT HEALTH PLAN	Alignment Health Plan	www.alignmenthealthplan.com	Alignment Health Plan smartHMO (HMO)	01	01		1			H3815	013	0	2018	Los Angeles and North Orange Counties		2	4734	2			2						www.alignmenthealthplan.com	www.alignmenthealthplan.com	www.alignmenthealthplan.com	(866)634-2247		(323)728-7232	5550	(888)979-2247		(323)728-7232	5551	(844)227-7615		(844)227-7615		(888)979-2247		(323)728-7232	5551	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3817	007	1	1	04	01	H3817_007_1	8			1		07/07/2017	2018.03	07/07/2017 01:11:35 PM Mountain Daylight Time	06/04/2017 08:13:50 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H3817	007	1	2018	Select Counties in Oregon/Clark Co, WA	Metro	2	17052	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3817	007	2	1	04	01	H3817_007_2	8			1		07/07/2017	2018.03	07/07/2017 01:11:59 PM Mountain Daylight Time	06/04/2017 08:15:06 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H3817	007	2	2018	Select Counties in Oregon/Clark Co, WA	Non-Metro	2	29316	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3817	008	1	1	04	01	H3817_008_1	9			1		07/07/2017	2018.03	07/07/2017 01:12:23 PM Mountain Daylight Time	08/04/2017 04:54:56 PM Mountain Daylight Time	08/01/2017 06:47:53 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H3817	008	1	2018	Select Counties in Oregon/Clark Co, WA	Metro	2	159838	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3817	008	2	1	04	01	H3817_008_2	9			1		07/07/2017	2018.03	07/07/2017 01:12:48 PM Mountain Daylight Time	08/04/2017 04:56:30 PM Mountain Daylight Time	08/01/2017 06:48:52 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H3817	008	2	2018	Select Counties in Oregon/Clark Co, WA	Non-Metro	2	192974	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3817	009	1	1	04	01	H3817_009_1	8			1		06/01/2017	2018.03	06/01/2017 12:18:48 PM Mountain Daylight Time	08/04/2017 04:58:11 PM Mountain Daylight Time	08/01/2017 06:49:50 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H3817	009	1	2018	Select Counties in Oregon/Clark Co, WA	Metro	2	58611	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3817	009	2	1	04	01	H3817_009_2	8			1		05/11/2017	2018.03	05/11/2017 02:16:20 PM Mountain Daylight Time	08/04/2017 04:59:44 PM Mountain Daylight Time	08/01/2017 06:50:48 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H3817	009	2	2018	Select Counties in Oregon/Clark Co, WA	Non-Metro	2	63790	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3817	801	0	1	04	01	H3817_801_0	3			1		05/15/2017	2018.03	05/15/2017 03:16:30 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H3817	801	0	2018	Nationwide except territories		1	27810	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H3817	802	0	1	04	01	H3817_802_0	3			1		05/15/2017	2018.03	05/15/2017 03:16:48 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H3817	802	0	2018	Nationwide except territories		1	28965	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H3818	002	0	1	01	01	H3818_002_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 02:02:06 PM Pacific Daylight Time	08/04/2017 01:36:50 PM Pacific Daylight Time	07/31/2017 01:30:30 PM Pacific Daylight Time			08/04/2017 02:03:24 PM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health	www.familycareinc.org	FamilyCare Community (HMO SNP)	01	01		1			H3818	002	0	2018	Portland Metro and Clatsop Counties		2	30977	2			1	3		1		1	www.familycareinc.org	www.familycareinc.org	www.familycareinc.org	(866)798-2273		(503)345-5702		(866)225-2273		(503)345-5701		(866)798-2273		(503)345-5702		(866)225-2273		(503)345-5701		(800)735-2900		(711)-		(800)735-2900		(711)-		(800)735-2900		(711)-		(800)735-2900		(711)-		2					1					1	2			
H3818	003	0	1	01	01	H3818_003_0	7			1		08/04/2017	2018.03	08/04/2017 02:02:14 PM Pacific Daylight Time	08/04/2017 01:39:32 PM Pacific Daylight Time	07/31/2017 01:29:54 PM Pacific Daylight Time			08/04/2017 02:03:24 PM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health	www.familycareinc.org	FamilyCare Advantage Rx (HMO)	01	01		1			H3818	003	0	2018	Portland Metro and Clatsop Counties		2	26610	2			2						www.familycareinc.org	www.familycareinc.org	www.familycareinc.org	(866)798-2273		(503)345-5702		(866)225-2273		(503)345-5701		(866)798-2273		(503)345-5702		(866)225-2273		(503)345-5701		(800)735-2900		(711)-		(800)735-2900		(711)-		(800)735-2900		(711)-		(800)735-2900		(711)-		2					2					2	2			
H3822	001	0	1	01	01	H3822_001_0	7			1		08/04/2017	2018.03	08/04/2017 10:17:02 AM Mountain Daylight Time	08/04/2017 03:50:52 PM Central Daylight Time	08/01/2017 03:50:27 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getblueil.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H3822	001	0	2018	Cook, DuPage, Will and Kane counties		2	197536	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	002	0	1	01	01	H3822_002_0	7			1		08/04/2017	2018.03	08/04/2017 12:47:57 PM Central Daylight Time	08/04/2017 03:52:33 PM Central Daylight Time	08/01/2017 03:50:58 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getbluenm.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H3822	002	0	2018	Bernalillo, Sandoval, Torrence and Valencia cntys		2	85275	2			2						www.getbluenm.com/mapd/pharmacies	www.getbluenm.com/mapd/druglist	www.getbluenm.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	003	0	1	01	01	H3822_003_0	7			1		08/04/2017	2018.03	08/04/2017 10:04:53 AM Mountain Daylight Time	08/04/2017 03:54:32 PM Central Daylight Time	08/01/2017 03:51:30 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getbluenm.com/mapd	Blue Cross Medicare Advantage Premier (HMO)	01	01		1			H3822	003	0	2018	Bernalillo, Sandoval, Torrence, Valencia cnty		2	20137	2			2						www.getbluenm.com/mapd/pharmacies	www.getbluenm.com/mapd/druglist	www.getbluenm.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	006	0	1	01	01	H3822_006_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 10:05:00 AM Mountain Daylight Time	08/08/2017 10:25:48 AM Central Daylight Time	08/01/2017 03:52:02 PM Central Daylight Time			08/08/2017 01:35:01 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getbluenm.com/dsnp	Blue Cross Medicare Advantage Dual Care (HMO SNP)	01	01		1			H3822	006	0	2018	Bernalillo, Sandoval, Torrance and Valencia		2	5215	2			1	3		2		2	www.getbluenm.com/dsnp/pharmacies	www.getbluenm.com/dsnp/druglist	www.getbluenm.com/dsnp/providers	(877)688-1813		(877)688-1813		(877)583-8129		(877)583-8129		(877)688-1813		(877)688-1813		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	007	0	1	02	01	H3822_007_0	7			1		08/04/2017	2018.03	08/04/2017 01:02:41 PM Central Daylight Time	08/04/2017 04:56:11 PM Central Daylight Time	08/01/2017 03:52:34 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getblueil.com/mapd	Blue Cross Medicare Advantage Basic Plus (HMO-POS)	01	02		1			H3822	007	0	2018	Cook, DuPage, Kane and Will counties		2	57729	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	008	0	1	02	01	H3822_008_0	7			1		08/04/2017	2018.03	08/04/2017 01:02:53 PM Central Daylight Time	08/04/2017 04:22:51 PM Central Daylight Time	08/01/2017 03:53:05 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getblueil.com/mapd	Blue Cross Medicare Advantage Premier Plus (HMO-POS)	01	02		1			H3822	008	0	2018	Cook, DuPage, Kane and Will counties		2	31161	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	009	0	1	01	01	H3822_009_0	7			1		08/04/2017	2018.03	08/04/2017 10:22:37 AM Mountain Daylight Time	08/04/2017 04:24:27 PM Central Daylight Time	08/01/2017 03:53:37 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getbluemt.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H3822	009	0	2018	Missoula		2	186	2			2						www.getbluemt.com/pharmacies	www.getbluemt.com/druglist	www.getbluemt.com/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	010	0	1	02	01	H3822_010_0	7			1		08/04/2017	2018.03	08/04/2017 10:22:13 AM Mountain Daylight Time	08/04/2017 04:26:05 PM Central Daylight Time	08/01/2017 03:54:08 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.getblueil.com/mapd	Blue Cross Medicare Advantage Elite (HMO-POS)	01	02		1			H3822	010	0	2018	Dupage and Will Counties		2	3663	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3822	801	0	1	01	01	H3822_801_0	1			1		05/18/2017	2018.03	05/18/2017 11:08:47 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	801	0	2018	State of Illinois		1	92981	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	802	0	1	01	01	H3822_802_0	1			1		05/18/2017	2018.03	05/18/2017 11:09:19 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	802	0	2018	State of New Mexico		1	45659	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	805	0	1	01	01	H3822_805_0	1			1		05/18/2017	2018.03	05/18/2017 11:10:04 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	805	0	2018	State of Illinois		1	10939	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	806	0	1	01	01	H3822_806_0	1			1		05/18/2017	2018.03	05/18/2017 11:10:25 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	806	0	2018	State of New Mexico		1	1	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	809	0	1	01	01	H3822_809_0	1			1		05/18/2017	2018.03	05/18/2017 11:10:52 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	809	0	2018	State of Illinois		1	5470	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	810	0	1	01	01	H3822_810_0	1			1		05/18/2017	2018.03	05/18/2017 11:11:15 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3822	810	0	2018	State of New Mexico		1	1	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	813	0	1	01	01	H3822_813_0	1			1		05/18/2017	2018.03	05/18/2017 11:12:10 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H3822	813	0	2018	State of MT		1	1	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	814	0	1	01	01	H3822_814_0	1			1		05/18/2017	2018.03	05/18/2017 11:12:32 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H3822	814	0	2018	State of MT		1	1	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3822	815	0	1	01	01	H3822_815_0	1			1		05/18/2017	2018.03	05/18/2017 11:12:41 AM Mountain Daylight Time					05/30/2017 11:46:35 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross Blue Shield of IL, MT, NM	www.hcsc.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H3822	815	0	2018	State of MT		1	1	2			2						www.myprime.com	www.myprime.com	www.hcsc.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3832	007	0	1	04	01	H3832_007_0	11			1		08/05/2017	2018.03	08/05/2017 11:02:16 AM Hawaiian Standard Time	08/04/2017 04:40:57 AM Hawaiian Standard Time	07/31/2017 10:45:56 AM Hawaiian Standard Time			08/05/2017 02:24:26 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Standard (PPO)	01	04		1			H3832	007	0	2018	Hawaii, Kalawao, Kauai and Maui counties		2	23877	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3832	008	0	1	04	01	H3832_008_0	9			1		07/19/2017	2018.03	07/19/2017 10:07:26 AM Hawaiian Standard Time	08/04/2017 04:43:38 AM Hawaiian Standard Time	07/31/2017 10:46:56 AM Hawaiian Standard Time			08/05/2017 02:27:12 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Standard Plus (PPO)	01	04		1			H3832	008	0	2018	Hawaii, Kalawao, Kauai and Maui counties		2	59235	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3832	009	0	1	04	01	H3832_009_0	7			1		07/19/2017	2018.03	07/19/2017 10:09:02 AM Hawaiian Standard Time	08/04/2017 04:47:09 AM Hawaiian Standard Time	07/31/2017 10:47:47 AM Hawaiian Standard Time			08/05/2017 02:29:46 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Complete (PPO)	01	04		1			H3832	009	0	2018	Honolulu County		2	35856	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3832	010	0	1	04	01	H3832_010_0	6			1		07/19/2017	2018.03	07/19/2017 10:10:21 AM Hawaiian Standard Time	08/04/2017 04:49:48 AM Hawaiian Standard Time	07/31/2017 10:48:45 AM Hawaiian Standard Time			08/05/2017 02:31:24 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Complete Plus (PPO)	01	04		1			H3832	010	0	2018	Honolulu County		2	160561	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3832	011	0	1	04	01	H3832_011_0	8		1	1	2	08/07/2017	2018.03	08/07/2017 10:03:43 AM Hawaiian Standard Time	08/04/2017 08:07:17 AM Hawaiian Standard Time	07/31/2017 10:49:38 AM Hawaiian Standard Time			08/07/2017 10:06:48 AM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Dual Care (PPO SNP)	01	04		1			H3832	011	0	2018	Hawaii, Kalawao, Kauai, Maui and Honolulu counties		2	4668	2			1	3		1		1	www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3832	801	0	1	04	01	H3832_801_0	1			1		05/30/2017	2018.03	05/30/2017 12:01:29 PM Hawaiian Standard Time					06/03/2017 02:32:03 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage EGWP with Drug CY (PPO)	01	04		1			H3832	801	0	2018	National		1	57330	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14a;15;	2		1									
H3832	802	0	1	04	01	H3832_802_0	1			1		05/30/2017	2018.03	05/30/2017 12:03:00 PM Hawaiian Standard Time					06/03/2017 02:36:17 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage EGWP with Drug NCY (PPO)	01	04		1			H3832	802	0	2018	National		1	0	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14a;15;	2		1									
H3832	805	0	1	04	01	H3832_805_0	1			1		05/26/2017	2018.03	05/26/2017 05:12:43 PM Hawaiian Standard Time					06/03/2017 02:40:56 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage EGWP CY (PPO)	01	04		1			H3832	805	0	2018	National		1	26581	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14a;15;	2		1									
H3832	807	0	1	04	01	H3832_807_0	1			1		05/26/2017	2018.03	05/26/2017 05:14:48 PM Hawaiian Standard Time					06/03/2017 02:48:19 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	HMSA Akamai Advantage	www.hmsa.com/advantage	HMSA Akamai Advantage Union Group Plan MAPD (PPO)	01	04		1			H3832	807	0	2018	National		1	59130	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14a;15;	2		1									
H3864	002	0	1	01	01	H3864_002_0	4			1		07/18/2017	2018.03	07/18/2017 05:15:33 PM Pacific Daylight Time	07/10/2017 02:06:30 PM Pacific Daylight Time				07/19/2017 03:45:00 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials 2 (HMO)	01	01		1			H3864	002	0	2018	Central, Eastern Oregon and Mid-Columbia Gorge		2	22002	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2					2	2			
H3864	006	0	1	01	01	H3864_006_0	8			1		07/18/2017	2018.03	07/18/2017 05:16:03 PM Pacific Daylight Time	08/04/2017 08:42:25 AM Pacific Daylight Time	08/01/2017 01:26:12 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 6 (HMO)	01	01		1			H3864	006	0	2018	Central, Eastern Oregon and Mid-Columbia Gorge		2	15633	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	014	0	1	02	01	H3864_014_0	7			1		07/18/2017	2018.03	07/18/2017 05:16:30 PM Pacific Daylight Time	08/04/2017 08:42:26 AM Pacific Daylight Time	08/01/2017 01:26:42 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Choice Rx 14 (HMO-POS)	01	02		1			H3864	014	0	2018	Central, Eastern Oregon and Mid-Columbia Gorge		2	60679	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	021	0	1	01	01	H3864_021_0	7			1		07/18/2017	2018.03	07/18/2017 05:16:58 PM Pacific Daylight Time	08/04/2017 08:42:27 AM Pacific Daylight Time	08/01/2017 01:27:06 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 21 (HMO)	01	01		1			H3864	021	0	2018	Eastern Idaho		2	20678	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	024	0	1	02	01	H3864_024_0	7			1		07/18/2017	2018.03	07/18/2017 05:17:19 PM Pacific Daylight Time	08/04/2017 08:42:27 AM Pacific Daylight Time	08/01/2017 01:27:34 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Choice Rx 24 (HMO-POS)	01	02		1			H3864	024	0	2018	Southwestern Idaho		2	69585	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	026	1	1	01	01	H3864_026_1	7			1		07/18/2017	2018.03	07/18/2017 05:17:40 PM Pacific Daylight Time	08/04/2017 08:42:28 AM Pacific Daylight Time	08/01/2017 01:28:02 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 26 (HMO)	01	01		1			H3864	026	1	2018	Lane, Coos and Curry Counties	Coos and Curry Counties	2	5045	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	026	2	1	01	01	H3864_026_2	7			1		07/18/2017	2018.03	07/18/2017 05:18:00 PM Pacific Daylight Time	08/04/2017 08:42:29 AM Pacific Daylight Time	08/01/2017 01:28:32 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 26 (HMO)	01	01		1			H3864	026	2	2018	Lane, Coos and Curry Counties	Lane County	2	19683	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	027	0	1	01	01	H3864_027_0	6			1		07/18/2017	2018.03	07/18/2017 05:18:41 PM Pacific Daylight Time	08/04/2017 08:42:30 AM Pacific Daylight Time	08/01/2017 01:29:00 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 27 (HMO)	01	01		1			H3864	027	0	2018	Central, Eastern Oregon and Mid-Columbia Gorge		2	23407	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	028	1	1	01	01	H3864_028_1	8			1		07/19/2017	2018.03	07/19/2017 03:41:40 PM Pacific Daylight Time	08/04/2017 08:42:31 AM Pacific Daylight Time	08/01/2017 01:29:30 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 28 (HMO)	01	01		1			H3864	028	1	2018	Portland MSA	Oregon	2	1481	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	028	2	1	01	01	H3864_028_2	8			1		07/19/2017	2018.03	07/19/2017 03:41:48 PM Pacific Daylight Time	08/04/2017 08:42:32 AM Pacific Daylight Time	08/01/2017 01:30:00 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 28 (HMO)	01	01		1			H3864	028	2	2018	Portland MSA	Washington	2	2952	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	029	0	1	01	01	H3864_029_0	7			1		07/18/2017	2018.03	07/18/2017 05:20:02 PM Pacific Daylight Time	08/04/2017 08:42:33 AM Pacific Daylight Time	08/01/2017 01:30:26 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 29 (HMO)	01	01		1			H3864	029	0	2018	Yellowstone County		2	3564	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	030	0	1	01	01	H3864_030_0	4			1		07/18/2017	2018.03	07/18/2017 05:20:23 PM Pacific Daylight Time	07/10/2017 02:06:31 PM Pacific Daylight Time				07/19/2017 03:45:00 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare 30 (HMO)	01	01		1			H3864	030	0	2018	Yellowstone County		2	912	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2					2	2			
H3864	031	1	1	01	01	H3864_031_1	8			1		07/19/2017	2018.03	07/19/2017 03:42:03 PM Pacific Daylight Time	08/04/2017 08:42:34 AM Pacific Daylight Time	08/01/2017 01:30:52 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 31 (HMO)	01	01		1			H3864	031	1	2018	Portland MSA	Oregon	2	2988	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	031	2	1	01	01	H3864_031_2	8			1		07/19/2017	2018.03	07/19/2017 03:42:12 PM Pacific Daylight Time	08/04/2017 08:42:35 AM Pacific Daylight Time	08/01/2017 01:31:18 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 31 (HMO)	01	01		1			H3864	031	2	2018	Portland MSA	Washington	2	12348	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	032	0	1	01	01	H3864_032_0	7			1		07/18/2017	2018.03	07/18/2017 05:21:31 PM Pacific Daylight Time	08/04/2017 08:42:36 AM Pacific Daylight Time	08/01/2017 03:42:16 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare MyCare Rx 32 (HMO)	01	01		1			H3864	032	0	2018	Southwest Idaho		2	38562	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H3864	801	0	1	01	01	H3864_801_0	2			1		06/14/2017	2018.03	06/14/2017 08:11:08 AM Pacific Daylight Time					06/14/2017 02:07:24 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials 801 (HMO)	01	01		1			H3864	801	0	2018	Statewide - Oregon, Idaho, Montana and Washington		1	1200	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										1	1	1a;1b;2;5;6;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1					1				
H3864	803	0	1	01	01	H3864_803_0	2			1		06/14/2017	2018.03	06/14/2017 08:11:23 AM Pacific Daylight Time					06/14/2017 02:07:24 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 803 (HMO)	01	01		1			H3864	803	0	2018	Statewide - Oregon, Idaho, Montana and Washington		1	11808	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		1	1	1a;1b;2;5;6;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1					1				
H3890	001	0	1	04	01	H3890_001_0	5			1		08/03/2017	2018.03	08/03/2017 09:15:02 AM Eastern Daylight Time	08/03/2017 03:04:56 PM Eastern Daylight Time	08/03/2017 07:32:54 PM Eastern Daylight Time			08/04/2017 02:09:18 PM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	http://www.hopkinsmedicare.com/	Johns Hopkins Advantage MD (PPO)	01	04		1			H3890	001	0	2018	Counties: AA BL BC CV CR FR HW MG SS WH WC WR		2	37492	2			2						http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3890	002	0	1	04	01	H3890_002_0	5			1		08/04/2017	2018.03	08/04/2017 02:08:24 PM Eastern Daylight Time	08/03/2017 03:06:54 PM Eastern Daylight Time	08/03/2017 07:33:38 PM Eastern Daylight Time			08/04/2017 02:09:18 PM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	http://www.hopkinsmedicare.com/	Johns Hopkins Advantage MD Plus (PPO)	01	04		1			H3890	002	0	2018	Counties: AA BL BC CV CR FR HW MG SS WH WC WR		2	89512	2			2						http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	http://www.hopkinsmedicare.com/	(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(877)293-5325		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3890	801	0	1	04	01	H3890_801_0	3			1		05/30/2017	2018.03	05/30/2017 03:23:23 PM Eastern Daylight Time					06/02/2017 07:47:44 AM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	www.hopkinsmedicare.com	Johns Hopkins Advantage MD Group Plan CY (PPO)	01	04		1			H3890	801	0	2018	All Counties in Maryland		1	1200	2			2						www.hopkinsmedicare.com	www.hopkinsmedicare.com	www.hopkinsmedicare.com	(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;	2		1									
H3890	802	0	1	04	01	H3890_802_0	3			1		05/30/2017	2018.03	05/30/2017 03:23:32 PM Eastern Daylight Time					06/02/2017 07:47:44 AM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	www.hopkinsmedicare.com	Johns Hopkins Advantage MD Group Plan Non-CY (PPO)	01	04		1			H3890	802	0	2018	All Counties in Maryland		1	0	2			2						www.hopkinsmedicare.com	www.hopkinsmedicare.com	www.hopkinsmedicare.com	(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;	2		1									
H3890	803	0	1	04	01	H3890_803_0	3			1		05/30/2017	2018.03	05/30/2017 03:24:06 PM Eastern Daylight Time					06/02/2017 07:47:44 AM Eastern Daylight Time	HOPKINS HEALTH ADVANTAGE, INC.	Johns Hopkins HealthCare	www.hopkinsmedicare.com	Johns Hopkins Advantage MD Group Plan MA Only (PPO)	01	04		1			H3890	803	0	2018	All Counties in Maryland		1	0	2			2						www.hopkinsmedicare.com	www.hopkinsmedicare.com	www.hopkinsmedicare.com	(877)293-5325		(877)293-5325		(888)403-7682		(888)403-7682										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;	2		1									
H3907	002	0	1	01	01	H3907_002_0	4	1		1		06/04/2017	2018.03	06/04/2017 03:29:21 PM Eastern Daylight Time	06/02/2017 06:57:17 PM Eastern Daylight Time				06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life (HMO)	01	01		1			H3907	002	0	2018	Western and North Eastern PA		2	224430	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765										(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629										2					2					2	2			
H3907	006	0	1	01	01	H3907_006_0	3	1		1		06/04/2017	2018.03	06/04/2017 03:23:06 PM Eastern Daylight Time	08/02/2017 08:12:37 PM Eastern Daylight Time	08/01/2017 12:28:50 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx Enhanced (HMO)	01	01		1			H3907	006	0	2018	Western and North Eastern PA		2	58255	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	029	0	1	01	01	H3907_029_0	4	1		1		06/30/2017	2018.03	06/30/2017 02:32:01 PM Eastern Daylight Time	08/03/2017 08:17:00 AM Eastern Daylight Time	08/01/2017 12:30:32 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	029	0	2018	Western and North Eastern PA		2	766257	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	032	0	1	01	01	H3907_032_0	5	2	1	1		06/04/2017	2018.03	06/04/2017 04:03:52 PM Eastern Daylight Time	08/02/2017 04:00:22 PM Eastern Daylight Time	08/01/2017 12:32:37 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	www.upmchealthplan.com/snp	UPMC for Life Options (HMO SNP)	01	01		1			H3907	032	0	2018	Allegheny, Erie, Washington PA Counties		2	1836	2			1	1	3				https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/snp	(800)606-8648		(800)606-8648		(866)405-8762		(866)405-8762		(800)606-8648		(800)606-8648		(866)405-8762		(866)405-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		2					2					2	2			
H3907	037	0	1	01	01	H3907_037_0	3	1		1		06/04/2017	2018.03	06/04/2017 03:30:07 PM Eastern Daylight Time	08/02/2017 08:33:32 PM Eastern Daylight Time	08/01/2017 12:34:29 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Deductible with Rx (HMO)	01	01		1			H3907	037	0	2018	Western and North Eastern PA		2	460061	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	039	0	1	01	01	H3907_039_0	7	2		1		08/01/2017	2018.03	08/01/2017 12:54:09 PM Eastern Daylight Time	08/02/2017 04:01:20 PM Eastern Daylight Time	08/01/2017 12:37:02 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Deductible with Rx (HMO)	01	01		1			H3907	039	0	2018	South Central PA		2	9942	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	040	0	1	01	01	H3907_040_0	6	2		1		08/01/2017	2018.03	08/01/2017 12:53:42 PM Eastern Daylight Time	08/02/2017 04:02:20 PM Eastern Daylight Time	08/01/2017 12:38:40 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	040	0	2018	South Central PA		2	5946	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	042	0	1	01	01	H3907_042_0	6	2		1		06/04/2017	2018.03	06/04/2017 03:35:55 PM Eastern Daylight Time	08/02/2017 04:03:20 PM Eastern Daylight Time	08/01/2017 12:41:28 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	042	0	2018	Bucks, Chester, Montgomery, Philadelphia Counties		2	1305	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	043	0	1	01	01	H3907_043_0	7	2		1		06/04/2017	2018.03	06/04/2017 03:31:42 PM Eastern Daylight Time	08/02/2017 04:04:28 PM Eastern Daylight Time	08/01/2017 01:24:27 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Deductible with Rx (HMO)	01	01		1			H3907	043	0	2018	Bucks, Chester, Montgomery, Philadelphia Counties		2	2222	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	044	0	1	01	01	H3907_044_0	7	2		1		08/03/2017	2018.03	08/03/2017 04:46:19 PM Eastern Daylight Time	08/02/2017 04:05:20 PM Eastern Daylight Time	08/01/2017 01:26:10 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Deductible with Rx (HMO)	01	01		1			H3907	044	0	2018	Delaware County		2	3864	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	045	0	1	01	01	H3907_045_0	9	2		1		08/03/2017	2018.03	08/03/2017 04:48:32 PM Eastern Daylight Time	08/02/2017 04:06:20 PM Eastern Daylight Time	08/01/2017 10:46:36 AM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Premier Rx (HMO)	01	01		1			H3907	045	0	2018	Berks County		2	4119	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	046	0	1	01	01	H3907_046_0	8	2		1		08/03/2017	2018.03	08/03/2017 04:50:06 PM Eastern Daylight Time	08/02/2017 04:07:16 PM Eastern Daylight Time	08/01/2017 10:49:44 AM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Premier Rx (HMO)	01	01		1			H3907	046	0	2018	Allegheny and Beaver County		2	48973	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	047	0	1	01	01	H3907_047_0	7	2		1		06/04/2017	2018.03	06/04/2017 03:36:42 PM Eastern Daylight Time	08/02/2017 04:08:20 PM Eastern Daylight Time	08/01/2017 01:28:43 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	047	0	2018	Berks County		2	2385	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	048	0	1	01	01	H3907_048_0	6	2		1		06/04/2017	2018.03	06/04/2017 03:37:14 PM Eastern Daylight Time	08/02/2017 04:09:22 PM Eastern Daylight Time	08/01/2017 01:31:35 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	048	0	2018	Delaware County		2	2256	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2					2	2			
H3907	801	0	1	01	01	H3907_801_0	2			1		06/03/2017	2018.03	06/03/2017 10:43:33 AM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC Employer Group (HMO)	01	01		1			H3907	801	0	2018	Western Pennsylvania		1	113806	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765										(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629										1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1					1				
H3907	802	0	1	01	01	H3907_802_0	2			1		06/01/2017	2018.03	06/01/2017 02:37:14 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC Employer Group Rx (HMO)	01	01		1			H3907	802	0	2018	Western Pennsylvania		1	48971	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1					1				
H3907	803	0	1	01	01	H3907_803_0	2			1		06/01/2017	2018.03	06/01/2017 01:03:35 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH PLAN, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare	UPMC Employer Group Rx (HMO)	01	01		1			H3907	803	0	2018	Western Pennsylvania		1	12	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	http://www.upmchealthplan.com/medicare	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1					1				
H3908	001	0	1	20	08	H3908_001_0	1			1		05/23/2017	2018.03	05/23/2017 02:35:51 PM Eastern Daylight Time		05/22/2017 02:04:20 PM Eastern Daylight Time			05/23/2017 02:39:50 PM Eastern Daylight Time	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	Mercy LIFE - West Philadelphia	http://www.mercylife-westphila.org	Trinity Health LIFE Pennsylvania (PACE)	08	20		1			H3908	001	0	2018	Philadelphia and Delaware County, PA		2		2			2						www.CareKinesis.com	www.LIFEUPENN.org										(267)787-8300		(267)787-8300		(215)573-7200		(215)573-7200										(800)654-5984		(800)654-5984		(215)573-7200		(215)573-7200																
H3908	002	0	1	20	08	H3908_002_0	1			1		05/23/2017	2018.03	05/23/2017 02:36:51 PM Eastern Daylight Time		05/22/2017 02:04:26 PM Eastern Daylight Time			05/23/2017 02:39:50 PM Eastern Daylight Time	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	Mercy LIFE - West Philadelphia	http://www.mercylife-westphila.org	Trinity Health LIFE Pennsylvania (PACE)	08	20		1			H3908	002	0	2018	Philadelphia and Delaware County, PA		2		2			2						www.CareKinesis.com	www.LIFEUPENN.org										(267)787-8300		(267)787-8300		(215)573-7200		(215)573-7200										(800)654-5984		(800)654-5984		(215)573-7200		(215)573-7200																
H3909	001	0	1	04	01	H3909_001_0	4			1		05/30/2017	2018.03	05/30/2017 01:58:11 PM Eastern Daylight Time	08/02/2017 03:18:34 PM Eastern Daylight Time	08/03/2017 08:35:04 AM Eastern Daylight Time			08/04/2017 03:03:27 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65 PPO	www.ibxmedicare.com	Personal Choice 65 Rx (PPO)	01	04		1			H3909	001	0	2018	Bucks, Philadelphia Counties		2	35823	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3909	007	0	1	04	01	H3909_007_0	2			1		05/30/2017	2018.03	05/30/2017 01:58:36 PM Eastern Daylight Time	07/25/2017 02:10:40 PM Eastern Daylight Time				07/26/2017 05:11:53 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65 PPO	www.ibxmedicare.com	Personal Choice 65 Medical Only (PPO)	01	04		1			H3909	007	0	2018	Bucks, Philadelphia Counties		2	2963	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3909	009	0	1	04	01	H3909_009_0	3			1		05/30/2017	2018.03	05/30/2017 01:58:57 PM Eastern Daylight Time	08/02/2017 03:22:12 PM Eastern Daylight Time	08/03/2017 08:35:04 AM Eastern Daylight Time			08/04/2017 03:03:27 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65 PPO	www.ibxmedicare.com	Personal Choice 65 Rx (PPO)	01	04		1			H3909	009	0	2018	Chester, Delaware, Montgomery Counties		2	53169	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3909	801	0	1	04	01	H3909_801_0	1			1		05/30/2017	2018.03	05/30/2017 01:59:26 PM Eastern Daylight Time					05/30/2017 02:27:39 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65 PPO	www.ibxmedicare.com	Personal Choice 65 Group Medical Only (PPO)	01	04		1			H3909	801	0	2018	National		1	7404	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;11c;15;	2		1									
H3909	802	0	1	04	01	H3909_802_0	1			1		05/30/2017	2018.03	05/30/2017 02:11:31 PM Eastern Daylight Time					05/30/2017 02:29:55 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65 PPO	www.ibxmedicare.com	Personal Choice 65 Group Rx (PPO)	01	04		1			H3909	802	0	2018	National		1	15821	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(888)718-3333		(888)718-3333		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;11c;15;	2		1									
H3916	001	0	1	04	01	H3916_001_0	10			1		07/19/2017	2018.03	07/19/2017 10:45:23 AM Eastern Daylight Time	08/01/2017 04:36:25 PM Eastern Daylight Time	08/02/2017 11:46:57 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Classic (PPO)	01	04		1			H3916	001	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	002	0	1	04	01	H3916_002_0	11			1		07/19/2017	2018.03	07/19/2017 10:45:41 AM Eastern Daylight Time	08/01/2017 04:37:57 PM Eastern Daylight Time	08/02/2017 11:50:19 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Classic (PPO)	01	04		1			H3916	002	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	005	0	1	04	01	H3916_005_0	10			1		07/19/2017	2018.03	07/19/2017 10:46:08 AM Eastern Daylight Time	08/01/2017 04:38:29 PM Eastern Daylight Time	08/02/2017 11:51:46 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Deluxe (PPO)	01	04		1			H3916	005	0	2018	Central and Northeastern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	012	0	1	04	01	H3916_012_0	9			1		07/19/2017	2018.03	07/19/2017 10:46:32 AM Eastern Daylight Time	07/25/2017 11:11:20 AM Eastern Daylight Time				07/26/2017 03:37:38 PM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Basic (PPO)	01	04		1			H3916	012	0	2018	Central and Northeastern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478										(711)-		(711)-		(711)-		(711)-										2					2						2			
H3916	015	0	1	04	01	H3916_015_0	10			1		07/19/2017	2018.03	07/19/2017 10:47:13 AM Eastern Daylight Time	08/01/2017 04:39:35 PM Eastern Daylight Time	08/02/2017 11:53:48 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Standard (PPO)	01	04		1			H3916	015	0	2018	Central and Northeastern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	018	0	1	04	01	H3916_018_0	10			1		07/19/2017	2018.03	07/19/2017 10:52:38 AM Eastern Daylight Time	08/01/2017 04:40:06 PM Eastern Daylight Time	08/02/2017 11:55:12 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO ValueRx (PPO)	01	04		1			H3916	018	0	2018	Central and Northeastern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	022	0	1	04	01	H3916_022_0	10			1		07/19/2017	2018.03	07/19/2017 10:53:00 AM Eastern Daylight Time	08/01/2017 04:40:39 PM Eastern Daylight Time	08/02/2017 11:56:40 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Select (PPO)	01	04		1			H3916	022	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	024	0	1	04	01	H3916_024_0	11			1		07/19/2017	2018.03	07/19/2017 10:53:25 AM Eastern Daylight Time	08/01/2017 04:41:11 PM Eastern Daylight Time	08/02/2017 11:58:39 AM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO Select (PPO)	01	04		1			H3916	024	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3916	032	0	1	04	01	H3916_032_0	10			1		07/19/2017	2018.03	07/19/2017 10:54:03 AM Eastern Daylight Time	08/01/2017 04:41:42 PM Eastern Daylight Time	08/02/2017 12:00:11 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO ValueRx (PPO)	01	04		1			H3916	032	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	033	0	1	04	01	H3916_033_0	11			1		07/19/2017	2018.03	07/19/2017 10:54:31 AM Eastern Daylight Time	08/01/2017 04:42:14 PM Eastern Daylight Time	08/02/2017 12:01:38 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO ValueRx (PPO)	01	04		1			H3916	033	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3916	034	1	1	04	01	H3916_034_1	10			1		07/19/2017	2018.03	07/19/2017 10:54:55 AM Eastern Daylight Time	08/01/2017 04:42:47 PM Eastern Daylight Time	08/02/2017 12:02:53 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO Signature (PPO)	01	04		1			H3916	034	1	2018	North Central	Lehigh Valley	2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	034	3	1	04	01	H3916_034_3	10			1		07/19/2017	2018.03	07/19/2017 10:55:21 AM Eastern Daylight Time	08/01/2017 04:43:19 PM Eastern Daylight Time	08/02/2017 12:04:05 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO Signature (PPO)	01	04		1			H3916	034	3	2018	North Central	Harrisburg	2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	034	4	1	04	01	H3916_034_4	10			1		07/19/2017	2018.03	07/19/2017 10:55:45 AM Eastern Daylight Time	08/01/2017 04:43:51 PM Eastern Daylight Time	08/02/2017 12:05:26 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO Signature (PPO)	01	04		1			H3916	034	4	2018	North Central	North Central	2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	035	1	1	04	01	H3916_035_1	10			1		07/19/2017	2018.03	07/19/2017 10:56:11 AM Eastern Daylight Time	08/01/2017 04:44:22 PM Eastern Daylight Time	08/02/2017 12:06:46 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO Signature (PPO)	01	04		1			H3916	035	1	2018	Western PA	Southwest	2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	035	2	1	04	01	H3916_035_2	10			1		07/19/2017	2018.03	07/19/2017 10:56:43 AM Eastern Daylight Time	08/01/2017 04:44:58 PM Eastern Daylight Time	08/02/2017 12:08:16 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO Signature (PPO)	01	04		1			H3916	035	2	2018	Western PA	West Central	2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	036	0	1	04	01	H3916_036_0	11			1		07/19/2017	2018.03	07/19/2017 10:57:15 AM Eastern Daylight Time	08/01/2017 04:45:28 PM Eastern Daylight Time	08/02/2017 12:09:34 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare Plus PPO Distinct (PPO)	01	04		1			H3916	036	0	2018	Counties: TA, LG, SN, CN		2	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(888)757-2946		(888)757-2946		(844)785-1787		(844)785-1787		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3916	801	0	1	04	01	H3916_801_0	8			1		07/12/2017	2018.03	07/12/2017 11:47:32 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO MA PA CALENDAR (PPO)	01	04		1			H3916	801	0	2018	Pennsylvania		1	207947	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3916	802	0	1	04	01	H3916_802_0	8			1		07/12/2017	2018.03	07/12/2017 11:47:46 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO MAPD PA CALENDAR (PPO)	01	04		1			H3916	802	0	2018	Pennsylvania		1	449540	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3916	804	0	1	04	01	H3916_804_0	8			1		07/12/2017	2018.03	07/12/2017 11:48:04 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Freedom Blue PPO MAPD PA Non-Calendar (PPO)	01	04		1			H3916	804	0	2018	Pennsylvania		1	1	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3916	805	0	1	04	01	H3916_805_0	8			1		07/12/2017	2018.03	07/12/2017 11:48:19 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO MA PA Calendar (PPO)	01	04		1			H3916	805	0	2018	Pennsylvania		1	0	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3916	806	0	1	04	01	H3916_806_0	8			1		07/12/2017	2018.03	07/12/2017 11:48:37 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO PA MAPD Calendar (PPO)	01	04		1			H3916	806	0	2018	Pennsylvania		1	30108	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3916	807	0	1	04	01	H3916_807_0	8			1		07/12/2017	2018.03	07/12/2017 11:48:52 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR HEALTH COMPANY	Highmark Senior Health Company	www.highmarkblueshield.com/medicare	Community Blue Medicare PPO MAPD Calendar (PPO)	01	04		1			H3916	807	0	2018	Pennsylvania		1	0	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(800)550-8722		(800)550-8722		(866)743-5478		(866)743-5478		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3917	001	0	1	20	08	H3917_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:50 PM Eastern Daylight Time		05/24/2017 09:29:38 AM Eastern Daylight Time			05/24/2017 01:11:57 PM Eastern Daylight Time	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	http://www.commlife.org/	Pittsburgh Care Partnership, Inc. (PACE)	08	20		1			H3917	001	0	2018	Allegheny, Westmoreland Counties (Partial of each)		2		2			2						www.commlife.org	www.commlife.org										(866)419-1693		(412)464-2101		(866)419-1693		(412)464-2101										(711)-		(711)-		(711)-		(711)-																
H3917	002	0	1	20	08	H3917_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:41 PM Eastern Daylight Time		05/24/2017 09:29:39 AM Eastern Daylight Time			05/24/2017 01:11:57 PM Eastern Daylight Time	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	http://www.commlife.org/	Pittsburgh Care Partnership, Inc. (PACE)	08	20		1			H3917	002	0	2018	Allegheny, Westmoreland Counties (Partial of each)		2		2			2						www.commlife.org	www.commlife.org										(866)419-1693		(412)464-2101		(866)419-1693		(412)464-2101										(711)-		(711)-		(711)-		(711)-																
H3918	001	0	1	20	08	H3918_001_0	1			1		05/24/2017	2018.03	05/24/2017 03:18:44 PM Eastern Daylight Time		05/24/2017 09:02:51 AM Eastern Daylight Time			05/24/2017 03:28:52 PM Eastern Daylight Time	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	LIFE Pittsburgh Dual Eligibles Pharmacy (PACE)	08	20		1			H3918	001	0	2018	Partial Allegheny*		2		2			2						none	not applicable -- no formulary										(412)388-8042		(412)388-8042		(412)388-8042		(412)388-8042										(412)388-8042		(412)388-8042		(412)388-8042		(412)388-8042																
H3918	002	0	1	20	08	H3918_002_0	1			1		05/24/2017	2018.03	05/24/2017 03:22:46 PM Eastern Daylight Time		05/24/2017 09:02:20 AM Eastern Daylight Time			05/24/2017 03:28:52 PM Eastern Daylight Time	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	LIFE Pittsburgh Medicare Only Pharmacy (PACE)	08	20		1			H3918	002	0	2018	Partial Allegheny *		2		2			2						none	not applicable -- no formulary										(412)388-8042		(412)388-8042		(412)388-8042		(412)388-8042										(412)388-8042		(412)388-8042		(412)388-8042		(412)388-8042																
H3919	001	0	1	20	08	H3919_001_0	2			1		05/25/2017	2018.03	05/25/2017 05:26:23 PM Eastern Daylight Time		05/26/2017 12:26:11 PM Eastern Daylight Time			05/26/2017 12:29:10 PM Eastern Daylight Time	ST. AGNES CONTINUING CARE CENTER	Mercy LIFE	www.mercylife.org	Mercy LIFE (PACE)	08	20		1			H3919	001	0	2018	Philadelphia & Delaware Counties		2		2			2						www.mercylife.org	www.mercylife.org										(215)339-4747		(215)339-4747		(215)339-4747		(215)339-4747										(215)339-4747		(215)339-4747		(215)339-4747		(215)339-4747																
H3919	002	0	1	20	08	H3919_002_0	1			1		05/25/2017	2018.03	05/25/2017 05:27:32 PM Eastern Daylight Time		05/25/2017 05:15:33 PM Eastern Daylight Time			05/25/2017 05:30:07 PM Eastern Daylight Time	ST. AGNES CONTINUING CARE CENTER	Mercy LIFE	www.mercylife.org	Mercy LIFE (PACE)	08	20		1			H3919	002	0	2018	Philadelphia & Delaware Counties		2		2			2						www.mercylife.org	www.mercylife.org										(215)339-4747		(215)339-4747		(215)339-4747		(215)339-4747										(215)339-4747		(215)339-4747		(215)339-4747		(215)339-4747																
H3923	013	0	1	04	01	H3923_013_0	7			1		07/11/2017	2018.03	07/11/2017 02:29:10 PM Eastern Daylight Time	08/02/2017 10:16:42 AM Eastern Daylight Time	08/02/2017 10:28:10 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	www.capitalbluemedicare.com	BlueJourney Classic (PPO)	01	04		1			H3923	013	0	2018	21 Counties in Central PA		2	113200	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3923	017	0	1	04	01	H3923_017_0	7			1		07/11/2017	2018.03	07/11/2017 02:28:17 PM Eastern Daylight Time	08/02/2017 10:18:16 AM Eastern Daylight Time	08/02/2017 10:29:36 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	www.capitalbluemedicare.com	BlueJourney Prime (PPO)	01	04		1			H3923	017	0	2018	21 Counties in Central PA		2	51958	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3923	801	0	1	04	01	H3923_801_0	3			1		06/04/2017	2018.03	06/04/2017 11:06:24 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	www.capitalbluemedicare.com	BlueJourney ERP with Rx (PPO)	01	04		1			H3923	801	0	2018	National		1	6982	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3923	802	0	1	04	01	H3923_802_0	3			1		06/04/2017	2018.03	06/04/2017 10:39:56 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	www.capitalbluemedicare.com	BlueJourney ERP without Rx (PPO)	01	04		1			H3923	802	0	2018	National		1	13198	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3923	803	0	1	04	01	H3923_803_0	3			1		06/04/2017	2018.03	06/04/2017 10:40:37 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	www.capitalbluemedicare.com	BlueJourney ERP Non-Calendar with Rx (PPO)	01	04		1			H3923	803	0	2018	National		1	24	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(866)987-4213		(866)987-4213		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H3924	059	3	1	04	01	H3924_059_3	5			1		07/06/2017	2018.03	07/06/2017 12:43:56 PM Eastern Daylight Time	08/07/2017 09:19:37 AM Eastern Daylight Time	08/07/2017 09:19:48 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	059	4	1	04	01	H3924_059_4	5			1		06/09/2017	2018.03	06/09/2017 11:08:39 AM Eastern Daylight Time	08/07/2017 09:19:38 AM Eastern Daylight Time	08/07/2017 09:19:48 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	059	6	1	04	01	H3924_059_6	5			1		06/09/2017	2018.03	06/09/2017 11:08:40 AM Eastern Daylight Time	08/07/2017 09:19:38 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	6	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	059	7	1	04	01	H3924_059_7	5			1		06/09/2017	2018.03	06/09/2017 11:08:41 AM Eastern Daylight Time	08/07/2017 09:19:38 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	7	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	059	8	1	04	01	H3924_059_8	5			1		06/09/2017	2018.03	06/09/2017 11:08:42 AM Eastern Daylight Time	08/07/2017 09:19:38 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	8	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	059	9	1	04	01	H3924_059_9	5			1		06/09/2017	2018.03	06/09/2017 11:08:43 AM Eastern Daylight Time	08/07/2017 09:19:38 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Advantage Rx (PPO)	01	04		1			H3924	059	9	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	3	1	04	01	H3924_060_3	5			1		08/03/2017	2018.03	08/03/2017 04:56:31 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	4	1	04	01	H3924_060_4	5			1		08/03/2017	2018.03	08/03/2017 04:59:41 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	6	1	04	01	H3924_060_6	5			1		08/03/2017	2018.03	08/03/2017 04:59:57 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	6	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	7	1	04	01	H3924_060_7	5			1		08/03/2017	2018.03	08/03/2017 05:00:12 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	7	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	8	1	04	01	H3924_060_8	5			1		08/03/2017	2018.03	08/03/2017 05:00:26 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	8	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	060	9	1	04	01	H3924_060_9	5			1		08/03/2017	2018.03	08/03/2017 05:00:45 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:49 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Complete Rx (PPO)	01	04		1			H3924	060	9	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3924	803	0	1	04	01	H3924_803_0	3			1		05/25/2017	2018.03	05/25/2017 11:20:28 AM Eastern Daylight Time					06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Rx EGWP PA (PPO)	01	04		1			H3924	803	0	2018	Pike County Pennsylvania		1	600	2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H3925	001	0	1	20	08	H3925_001_0	2			1		05/25/2017	2018.03	05/25/2017 11:55:29 AM Eastern Daylight Time		07/21/2017 10:50:57 AM Eastern Daylight Time			07/21/2017 11:03:04 AM Eastern Daylight Time	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifepa.com	Senior LIFE Johnstown Dual Eligible (PACE)	08	20		1			H3925	001	0	2018	Senior LIFE Cambria Somerset County Dual		2	2650	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H3925	002	0	1	20	08	H3925_002_0	2			1		05/25/2017	2018.03	05/25/2017 11:55:32 AM Eastern Daylight Time		07/21/2017 10:50:56 AM Eastern Daylight Time			07/21/2017 11:03:04 AM Eastern Daylight Time	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifejohnstown.com	Senior LIFE Johnstown MC Only (PACE)	08	20		1			H3925	002	0	2018	Senior LIFE Cambria Somerset County MC Only		2	12	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H3928	001	0	1	01	01	H3928_001_0	5			1		08/02/2017	2018.03	08/02/2017 02:45:26 PM Eastern Daylight Time	08/02/2017 02:23:02 PM Central Daylight Time	07/31/2017 04:41:56 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH, INC. (LA)	Coventry Health Care	www.coventry-medicare.com	Advantra (HMO)	01	01		1			H3928	001	0	2018	New Orleans - Baton Rouge Metro Parishes		2	100	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)360-6626		(888)360-6626		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3928	002	0	1	01	01	H3928_002_0	4			1		06/28/2017	2018.03	06/28/2017 06:39:44 AM Central Daylight Time	08/02/2017 02:28:20 PM Central Daylight Time	07/31/2017 04:42:23 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH, INC. (LA)	Coventry Health Care	www.coventry-medicare.com	Advantra (HMO)	01	01		1			H3928	002	0	2018	Bossier, Caddo and Saint Tammany Parishes		2	100	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(888)360-6626		(888)360-6626		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3928	801	0	1	01	01	H3928_801_0	1			1		05/31/2017	2018.03	05/31/2017 08:04:19 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH, INC. (LA)	Coventry Health Care	http://www.la.chcadvantra.com	Advantra (HMO)	01	01		1			H3928	801	0	2018	Louisiana - Employer Group Plan CYD with RX		1	120	2			2						http://www.PharmacyLocator.coventry-medicare.com	http://Formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(888)360-6626		(888)360-6626		(855)338-7027		(855)338-7027		(844)741-8423		(844)741-8423		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3928	803	0	1	01	01	H3928_803_0	1			1		05/31/2017	2018.03	05/31/2017 08:04:14 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH, INC. (LA)	Coventry Health Care	http://www.la.chcadvantra.com	Advantra (HMO)	01	01		1			H3928	803	0	2018	Louisiana Employer Group CYD No RX		1	120	2			2						http://www.PharmacyLocator.coventry-medicare.com	http://Formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(888)360-6626		(888)360-6626		(855)338-7027		(855)338-7027										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3930	001	0	1	01	01	H3930_001_0	2		1	1		06/03/2017	2018.03	06/03/2017 11:04:43 PM Eastern Daylight Time	06/05/2017 02:07:57 PM Eastern Daylight Time	06/05/2017 02:02:07 PM Eastern Daylight Time			06/05/2017 02:40:46 PM Eastern Daylight Time	SPARTAN PLAN NY, INC.	Spartan Plan NY, Inc.	www.sunriseadvantage.com	Spartan Plan NY I-SNP (HMO SNP)	01	01		1			H3930	001	0	2018	New York (partial)		2	1730	2			1	1	3				www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3930	002	0	1	01	01	H3930_002_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:05:22 AM Central Daylight Time	08/07/2017 10:57:46 AM Central Daylight Time	08/07/2017 10:58:00 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN NY, INC.	Spartan Plan NY, Inc.	www.sunriseadvantage.com	Spartan Plan NY C-SNP (HMO SNP)	01	01		1			H3930	002	0	2018	New York (partial)		2	4525	2			1	4			00000100000000000000		www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3930	003	0	1	01	01	H3930_003_0	4			1		08/07/2017	2018.03	08/07/2017 11:05:25 AM Central Daylight Time	08/07/2017 10:57:47 AM Central Daylight Time	08/07/2017 10:58:00 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN NY, INC.	Spartan Plan NY, Inc.	www.sunriseadvantage.com	Spartan Plan NY (HMO)	01	01		1			H3930	003	0	2018	New York (partial)		2	1764	2			2						www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	004	0	1	01	01	H3931_004_0	5			1		07/13/2017	2018.03	07/13/2017 07:40:31 PM Eastern Daylight Time	08/03/2017 01:19:13 PM Eastern Daylight Time	07/31/2017 05:38:12 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3931	004	0	2018	Bucks, Chester, Delaware and Montgomery counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	055	0	1	01	01	H3931_055_0	2			1		06/30/2017	2018.03	06/30/2017 03:00:22 PM Eastern Daylight Time	05/30/2017 12:54:27 PM Eastern Daylight Time				07/07/2017 10:24:19 AM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3931	055	0	2018	Bucks County		2		2			2						www.aetnamedicare.com/findpharmacy2016	http://www.aetnamedicare.com/2016formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3931	064	0	1	01	01	H3931_064_0	3			1		06/30/2017	2018.03	06/30/2017 05:02:43 PM Eastern Daylight Time	08/03/2017 01:20:20 PM Eastern Daylight Time	07/31/2017 05:38:33 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	064	0	2018	Bucks, Chester, Delaware and Montgomery counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	065	0	1	01	01	H3931_065_0	3			1		06/27/2017	2018.03	06/27/2017 07:37:12 PM Eastern Daylight Time	08/03/2017 01:21:40 PM Eastern Daylight Time	07/31/2017 05:38:55 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	065	0	2018	Philadelphia County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	070	0	1	01	01	H3931_070_0	4			1		07/13/2017	2018.03	07/13/2017 07:40:48 PM Eastern Daylight Time	08/03/2017 01:22:50 PM Eastern Daylight Time	07/31/2017 05:39:17 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Silver Plan (HMO)	01	01		1			H3931	070	0	2018	Pennsylvania		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	081	0	1	01	01	H3931_081_0	5			1		08/02/2017	2018.03	08/02/2017 04:22:52 PM Eastern Daylight Time	08/02/2017 04:04:12 PM Central Daylight Time	07/31/2017 04:42:48 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	081	0	2018	Raleigh/Charlotte and Surrounding Area		2	31500	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	087	0	1	01	01	H3931_087_0	4			1		08/02/2017	2018.03	08/02/2017 12:38:58 PM Eastern Daylight Time	08/02/2017 04:05:14 PM Central Daylight Time	07/31/2017 04:43:14 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	http://www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H3931	087	0	2018	Raleigh/Durham and Surrounding area		2		2			2						http://www.aetnamedicare.com/findpharmacy2016	http://www.aetnamedicare.com/2016formulary	http://www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	091	0	1	01	01	H3931_091_0	4			1		08/02/2017	2018.03	08/02/2017 09:23:30 AM Eastern Daylight Time	08/03/2017 01:24:15 PM Eastern Daylight Time	07/31/2017 05:39:37 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare PinnacleHealth Prime Plan (HMO)	01	01		1			H3931	091	0	2018	Cumberland and Dauphin counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	092	0	1	01	01	H3931_092_0	3			1		08/02/2017	2018.03	08/02/2017 10:27:21 AM Mountain Daylight Time	08/03/2017 03:13:25 PM Eastern Daylight Time	07/31/2017 05:36:41 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H3931	092	0	2018	Maricopa County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	093	0	1	01	01	H3931_093_0	4			1		08/01/2017	2018.03	08/01/2017 04:54:28 PM Mountain Daylight Time	08/02/2017 02:37:30 PM Eastern Daylight Time	07/31/2017 05:37:10 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H3931	093	0	2018	Denver and Surrounding Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	094	0	1	01	01	H3931_094_0	3			1		08/01/2017	2018.03	08/01/2017 01:09:53 PM Mountain Daylight Time	08/02/2017 02:42:40 PM Eastern Daylight Time	07/31/2017 05:37:40 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	094	0	2018	Clark County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	095	0	1	01	01	H3931_095_0	3			1		06/27/2017	2018.03	06/27/2017 07:37:48 PM Eastern Daylight Time	08/01/2017 06:28:36 PM Eastern Daylight Time	07/31/2017 05:40:00 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	095	0	2018	District of Columbia		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	096	0	1	01	01	H3931_096_0	4			1		07/19/2017	2018.03	07/19/2017 04:11:32 PM Eastern Daylight Time	08/01/2017 06:31:11 PM Eastern Daylight Time	07/31/2017 05:40:22 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H3931	096	0	2018	Fairfax County and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	097	0	1	01	01	H3931_097_0	3			1		06/27/2017	2018.03	06/27/2017 07:38:13 PM Eastern Daylight Time	08/01/2017 06:32:10 PM Eastern Daylight Time	07/31/2017 05:40:46 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Connect Plus (HMO)	01	01		1			H3931	097	0	2018	Southern Maryland		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	098	0	1	01	01	H3931_098_0	5			1		08/02/2017	2018.03	08/02/2017 11:52:13 AM Eastern Daylight Time	08/02/2017 11:30:27 AM Eastern Daylight Time	07/31/2017 05:41:08 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	098	0	2018	Richmond and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	099	0	1	01	01	H3931_099_0	3			1		06/27/2017	2018.03	06/27/2017 07:38:39 PM Eastern Daylight Time	08/01/2017 06:39:10 PM Eastern Daylight Time	07/31/2017 05:41:29 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	099	0	2018	Danville and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	100	0	1	01	01	H3931_100_0	3			1		08/02/2017	2018.03	08/02/2017 11:52:36 AM Eastern Daylight Time	08/02/2017 11:27:42 AM Eastern Daylight Time	07/31/2017 05:41:51 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	100	0	2018	Newport News and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	101	0	1	01	01	H3931_101_0	3			1		08/02/2017	2018.03	08/02/2017 11:53:06 AM Eastern Daylight Time	08/02/2017 11:29:01 AM Eastern Daylight Time	07/31/2017 05:42:14 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	101	0	2018	Roanoke and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	102	0	1	01	01	H3931_102_0	4			1		07/13/2017	2018.03	07/13/2017 07:41:26 PM Eastern Daylight Time	08/03/2017 01:25:30 PM Eastern Daylight Time	07/31/2017 05:42:35 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	102	0	2018	New Castle, Kent and Sussex Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	104	0	1	01	01	H3931_104_0	3			1		08/02/2017	2018.03	08/02/2017 09:24:23 AM Eastern Daylight Time	08/03/2017 01:27:09 PM Eastern Daylight Time	07/31/2017 05:42:56 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (HMO)	01	01		1			H3931	104	0	2018	New Castle, Kent and Sussex Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	105	0	1	01	01	H3931_105_0	4			1		08/02/2017	2018.03	08/02/2017 09:26:22 AM Eastern Daylight Time	08/03/2017 01:28:21 PM Eastern Daylight Time	07/31/2017 05:43:18 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Main Line Health Prime Plan (HMO)	01	01		1			H3931	105	0	2018	Chester, Delaware and Montgomery counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	106	0	1	01	01	H3931_106_0	6			1		08/02/2017	2018.03	08/02/2017 12:16:04 PM Eastern Daylight Time	08/03/2017 03:53:53 PM Eastern Daylight Time	07/31/2017 05:38:10 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	106	0	2018	Cook, Du Page, IL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	107	0	1	01	01	H3931_107_0	8			1		08/02/2017	2018.03	08/02/2017 04:24:22 PM Eastern Daylight Time	08/03/2017 09:26:21 AM Eastern Daylight Time	07/31/2017 05:43:39 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	107	0	2018	Cleveland and NE OH Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	108	0	1	01	01	H3931_108_0	3			1		08/02/2017	2018.03	08/02/2017 08:36:04 PM Eastern Daylight Time	08/03/2017 09:27:53 AM Eastern Daylight Time	07/31/2017 05:44:00 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	108	0	2018	Columbus OH Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	109	0	1	01	01	H3931_109_0	3			1		08/02/2017	2018.03	08/02/2017 04:31:59 PM Eastern Daylight Time	08/03/2017 09:29:13 AM Eastern Daylight Time	07/31/2017 05:44:21 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	109	0	2018	Toledo and Cincinnati Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	110	0	1	01	01	H3931_110_0	3			1		06/27/2017	2018.03	06/27/2017 07:40:34 PM Eastern Daylight Time	08/03/2017 09:31:29 AM Eastern Daylight Time	07/31/2017 05:44:44 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H3931	110	0	2018	Dayton		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	112	0	1	01	01	H3931_112_0	3			1		08/02/2017	2018.03	08/02/2017 09:27:04 AM Eastern Daylight Time	08/03/2017 01:29:25 PM Eastern Daylight Time	07/31/2017 05:45:05 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	http://www.aetnamedicare.com	Aetna Medicare Choice Plan (HMO)	01	01		1			H3931	112	0	2018	Southeastern and Central PA		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	115	0	1	01	01	H3931_115_0	3			1		08/01/2017	2018.03	08/01/2017 04:56:47 PM Mountain Daylight Time	08/02/2017 02:43:24 PM Eastern Daylight Time	07/31/2017 05:38:39 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (HMO)	01	01		1			H3931	115	0	2018	Washoe County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	116	0	1	01	01	H3931_116_0	4			1		06/28/2017	2018.03	06/28/2017 06:40:19 AM Central Daylight Time	08/02/2017 04:06:06 PM Central Daylight Time	07/31/2017 04:43:39 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	116	0	2018	Nashville and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	118	0	1	01	01	H3931_118_0	3			1		08/02/2017	2018.03	08/02/2017 04:36:03 PM Eastern Daylight Time	08/03/2017 09:34:22 AM Eastern Daylight Time	07/31/2017 05:45:26 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	118	0	2018	Louisville		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	119	0	1	01	01	H3931_119_0	4			1		08/02/2017	2018.03	08/02/2017 09:28:26 AM Eastern Daylight Time	08/03/2017 01:30:27 PM Eastern Daylight Time	07/31/2017 05:45:47 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Mon Valley Prime (HMO)	01	01		1			H3931	119	0	2018	Washington County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	120	0	1	01	01	H3931_120_0	4			1		08/01/2017	2018.03	08/01/2017 07:21:56 PM Central Daylight Time	08/02/2017 02:52:14 PM Central Daylight Time	07/31/2017 04:41:53 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	120	0	2018	Plymouth County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	122	0	1	01	01	H3931_122_0	3			1		08/01/2017	2018.03	08/01/2017 07:27:32 PM Central Daylight Time	08/02/2017 02:53:08 PM Central Daylight Time	07/31/2017 04:42:19 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	122	0	2018	Greater Boston area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	123	0	1	01	01	H3931_123_0	3			1		08/01/2017	2018.03	08/01/2017 07:27:21 PM Central Daylight Time	08/02/2017 02:54:00 PM Central Daylight Time	07/31/2017 04:42:46 PM Central Daylight Time			08/04/2017 04:24:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	123	0	2018	Worcester County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	124	0	1	01	01	H3931_124_0	3			1		06/27/2017	2018.03	06/27/2017 07:41:24 PM Eastern Daylight Time	08/01/2017 07:04:14 PM Eastern Daylight Time	07/31/2017 05:46:09 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare UVA Health System Prime Plan (HMO)	01	01		1			H3931	124	0	2018	Charlottesville and Surrounding area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	125	0	1	01	01	H3931_125_0	5			1		08/02/2017	2018.03	08/02/2017 02:44:43 PM Eastern Daylight Time	08/02/2017 02:31:08 PM Central Daylight Time	07/31/2017 04:44:05 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	125	0	2018	Central and Southwest AL Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	126	0	1	01	01	H3931_126_0	3			1		08/03/2017	2018.03	08/03/2017 10:22:18 AM Central Daylight Time	08/03/2017 02:57:55 PM Eastern Daylight Time	07/31/2017 05:39:09 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3931	126	0	2018	King, Pierce and Snohomish counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	127	0	1	01	01	H3931_127_0	4			1		08/02/2017	2018.03	08/02/2017 09:27:01 AM Mountain Daylight Time	08/03/2017 02:58:52 PM Eastern Daylight Time	07/31/2017 05:39:38 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (HMO)	01	01		1			H3931	127	0	2018	King, Pierce and Snohomish counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	129	0	1	01	01	H3931_129_0	3			1		08/02/2017	2018.03	08/02/2017 03:13:02 PM Mountain Daylight Time	08/04/2017 11:20:30 AM Eastern Daylight Time	07/31/2017 05:40:06 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (HMO)	01	01		1			H3931	129	0	2018	Pima County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	130	0	1	01	01	H3931_130_0	4			1		06/28/2017	2018.03	06/28/2017 08:57:33 AM Central Daylight Time	08/03/2017 03:17:40 PM Eastern Daylight Time	07/31/2017 05:40:35 PM Eastern Daylight Time			08/04/2017 06:20:35 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (HMO)	01	01		1			H3931	130	0	2018	Maricopa and Pinal counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3931	801	0	1	01	01	H3931_801_0	2			1		05/30/2017	2018.03	05/30/2017 05:28:15 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3931	801	0	2018	Pennsylvania		1	27540	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3931	804	0	1	01	01	H3931_804_0	2			1		05/30/2017	2018.03	05/30/2017 05:43:15 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3931	804	0	2018	Pennsylvania		1	67260	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3942	001	0	1	20	08	H3942_001_0	1			1		05/25/2017	2018.03	05/25/2017 03:10:47 PM Eastern Daylight Time		05/25/2017 01:18:14 PM Eastern Daylight Time			05/25/2017 03:12:34 PM Eastern Daylight Time	ELDERHAUS INC.	Elderhaus PACE	www.elderhaus.com	Elderhaus PACE (PACE)	08	20		1			H3942	001	0	2018	Elderhaus PACE-New Hanover County		2		2			2						www.elderhaus.com	www.elderhaus.com										(888)343-8209		(910)343-8209		(888)343-8209		(910)343-8209										(888)343-8209		(910)343-8209		(888)343-8209		(910)343-8209																
H3942	002	0	1	20	08	H3942_002_0	1			1		05/25/2017	2018.03	05/25/2017 03:10:50 PM Eastern Daylight Time		05/25/2017 01:17:59 PM Eastern Daylight Time			05/25/2017 03:12:34 PM Eastern Daylight Time	ELDERHAUS INC.	Elderhaus PACE	www.elderhaus.com	Elderhaus PACE (PACE)	08	20		1			H3942	002	0	2018	Elderhaus PACE-Brunswick County		2		2			2						www.elderhaus.com	www.elderhaus.com										(888)343-8209		(910)343-8209		(888)343-8209		(910)343-8209										(888)343-8209		(910)343-8209		(888)343-8209		(910)343-8209																
H3949	009	0	1	01	01	H3949_009_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:18:58 PM Central Daylight Time	08/03/2017 11:51:36 AM Central Daylight Time	08/01/2017 02:05:46 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H3949	009	0	2018	Select Pennsylvania Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	013	0	1	01	01	H3949_013_0	5			1		06/28/2017	2018.03	06/28/2017 09:19:08 PM Central Daylight Time	08/03/2017 11:51:58 AM Central Daylight Time	08/01/2017 02:06:06 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Plus (HMO)	01	01		1			H3949	013	0	2018	Select Pennsylvania Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	016	0	1	01	01	H3949_016_0	4		1	1		05/19/2017	2018.03	05/19/2017 11:15:35 AM Central Daylight Time	08/03/2017 11:52:20 AM Central Daylight Time	08/01/2017 02:06:26 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Traditions (HMO SNP)	01	01		1			H3949	016	0	2018	Select Pennsylvania Counties		2		2			1	1	1				www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	024	0	1	01	01	H3949_024_0	5		1	1		08/03/2017	2018.03	08/03/2017 10:18:19 AM Central Daylight Time	08/03/2017 11:52:42 AM Central Daylight Time	08/01/2017 02:06:46 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Achieve (HMO SNP)	01	01		1			H3949	024	0	2018	Select Pennsylvania Counties		2		2			1	4			00000010000000000000		www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	026	0	1	01	01	H3949_026_0	3			1		05/16/2017	2018.03	05/16/2017 04:36:03 PM Central Daylight Time	05/30/2017 10:14:03 AM Central Daylight Time				06/02/2017 09:44:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H3949	026	0	2018	Select Pennsylvania Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3949	028	0	1	01	01	H3949_028_0	4			1		08/03/2017	2018.03	08/03/2017 10:29:57 AM Central Daylight Time	08/03/2017 11:53:03 AM Central Daylight Time	08/01/2017 02:07:07 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring PreventiveCare (HMO)	01	01		1			H3949	028	0	2018	Select Pennsylvania Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	030	0	1	01	01	H3949_030_0	5			1		06/28/2017	2018.03	06/28/2017 09:19:31 PM Central Daylight Time	08/03/2017 11:53:25 AM Central Daylight Time	08/01/2017 02:07:29 PM Central Daylight Time			08/04/2017 04:00:28 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H3949	030	0	2018	Select Pennsylvania Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(800)668-3813		(800)668-3813		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3949	804	0	1	01	01	H3949_804_0	3			1		05/23/2017	2018.03	05/23/2017 03:10:55 PM Central Daylight Time					06/02/2017 09:44:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H3949	804	0	2018	Statewide PA		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(800)856-7657		(800)856-7657		(888)281-7867		(888)281-7867		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14e1;15;16b;17a;	1	1a;3-1;3-2;3-3;7b;7d;12;	1					1				
H3949	806	0	1	02	01	H3949_806_0	3			1		05/23/2017	2018.03	05/23/2017 02:51:18 PM Central Daylight Time					06/02/2017 09:44:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier Rx CY (HMO-POS)	01	02		1			H3949	806	0	2018	Statewide PA		1	24	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(800)856-7657		(800)856-7657		(888)281-7867		(888)281-7867		(800)856-7657		(800)856-7657		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14e1;15;16b;17a;	1	1a;3-1;3-2;3-3;7b;7d;12;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;3-1;3-2;3-3;7b;7d;12;	1				
H3952	008	0	1	01	01	H3952_008_0	3	1		1		05/30/2017	2018.03	05/30/2017 01:49:28 PM Eastern Daylight Time	07/25/2017 01:45:56 PM Eastern Daylight Time				07/26/2017 05:23:32 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Preferred Medical Only (HMO)	01	01		1			H3952	008	0	2018	Bucks, Philadelphia Counties		2	18762	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3952	020	0	1	01	01	H3952_020_0	3	1		1		05/30/2017	2018.03	05/30/2017 01:49:48 PM Eastern Daylight Time	08/02/2017 02:57:00 PM Eastern Daylight Time	08/03/2017 08:35:04 AM Eastern Daylight Time			08/04/2017 03:18:02 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Preferred Rx (HMO)	01	01		1			H3952	020	0	2018	Bucks, Philadelphia Counties		2	83244	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	044	0	1	01	01	H3952_044_0	2	1		1		05/30/2017	2018.03	05/30/2017 01:50:06 PM Eastern Daylight Time	07/25/2017 01:49:28 PM Eastern Daylight Time				07/26/2017 05:23:32 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Preferred Medical Only (HMO)	01	01		1			H3952	044	0	2018	Chester, Delaware, Montgomery Counties		2	9466	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3952	045	0	1	01	01	H3952_045_0	3	1		1		05/30/2017	2018.03	05/30/2017 01:50:28 PM Eastern Daylight Time	08/02/2017 03:00:12 PM Eastern Daylight Time	08/03/2017 08:35:04 AM Eastern Daylight Time			08/04/2017 03:18:02 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Preferred Rx (HMO)	01	01		1			H3952	045	0	2018	Chester, Delaware, Montgomery Counties		2	48912	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	048	0	1	01	01	H3952_048_0	2	1		1		05/30/2017	2018.03	05/30/2017 01:50:54 PM Eastern Daylight Time	07/25/2017 01:53:10 PM Eastern Daylight Time				07/26/2017 05:23:32 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Select Medical Only (HMO)	01	01		1			H3952	048	0	2018	Bucks, Philadelphia Counties		2	29535	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3952	049	0	1	01	01	H3952_049_0	3	1		1		05/30/2017	2018.03	05/30/2017 01:51:20 PM Eastern Daylight Time	08/02/2017 03:05:30 PM Eastern Daylight Time	08/03/2017 08:35:06 AM Eastern Daylight Time			08/04/2017 03:42:52 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Select Rx (HMO)	01	01		1			H3952	049	0	2018	Bucks, Philadelphia Counties		2	291341	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	050	0	1	01	01	H3952_050_0	2	1		1		05/30/2017	2018.03	05/30/2017 01:51:37 PM Eastern Daylight Time	07/25/2017 01:57:10 PM Eastern Daylight Time				07/26/2017 05:23:32 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Select Medical Only (HMO)	01	01		1			H3952	050	0	2018	Chester, Delaware, Montgomery Counties		2	31419	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3952	051	0	1	01	01	H3952_051_0	3	1		1		05/30/2017	2018.03	05/30/2017 01:51:56 PM Eastern Daylight Time	08/02/2017 03:09:40 PM Eastern Daylight Time	08/03/2017 08:35:06 AM Eastern Daylight Time			08/04/2017 03:42:52 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Select Rx (HMO)	01	01		1			H3952	051	0	2018	Chester, Delaware, Montgomery Counties		2	207027	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	053	0	1	01	01	H3952_053_0	3	2		1		08/03/2017	2018.03	08/03/2017 01:57:08 PM Eastern Daylight Time	08/02/2017 03:11:20 PM Eastern Daylight Time	08/03/2017 08:35:06 AM Eastern Daylight Time			08/04/2017 03:47:21 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Focus Rx (HMO)	01	01		1			H3952	053	0	2018	Philadelphia, Bucks		2	161297	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	054	0	1	01	01	H3952_054_0	3	2		1		08/03/2017	2018.03	08/03/2017 01:59:57 PM Eastern Daylight Time	08/02/2017 03:13:14 PM Eastern Daylight Time	08/03/2017 08:35:06 AM Eastern Daylight Time			08/04/2017 03:47:21 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Focus Rx (HMO)	01	01		1			H3952	054	0	2018	Chester, Delaware, Montgomery		2	82905	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	055	0	1	01	01	H3952_055_0	5	2		1		08/03/2017	2018.03	08/03/2017 01:51:19 PM Eastern Daylight Time	08/03/2017 09:17:08 AM Eastern Daylight Time	08/03/2017 08:35:06 AM Eastern Daylight Time			08/04/2017 03:50:23 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Basic Rx (HMO)	01	01		1			H3952	055	0	2018	Philadelphia, Bucks		2	17003	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	056	0	1	01	01	H3952_056_0	5	2		1		08/03/2017	2018.03	08/03/2017 10:37:23 AM Eastern Daylight Time	08/03/2017 09:18:50 AM Eastern Daylight Time	08/03/2017 08:35:02 AM Eastern Daylight Time			08/04/2017 03:50:23 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Basic Rx (HMO)	01	01		1			H3952	056	0	2018	Chester, Delaware, Montgomery		2	12091	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3952	802	0	1	01	01	H3952_802_0	2			1		05/30/2017	2018.03	05/30/2017 01:54:21 PM Eastern Daylight Time					06/01/2017 09:22:48 AM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Group Medical Only (HMO)	01	01		1			H3952	802	0	2018	Bucks,Chester,Delaware,Montgomery,Philadelphia Cty		1	17514	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;11c;15;	2		1					1				
H3952	804	0	1	01	01	H3952_804_0	1			1		05/30/2017	2018.03	05/30/2017 01:57:43 PM Eastern Daylight Time					05/30/2017 02:33:09 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65 HMO	www.ibxmedicare.com	Keystone 65 Group Rx (HMO)	01	01		1			H3952	804	0	2018	Bucks,Chester,Delaware,Montgomery,Philadelphia Cty		1	37592	2			2						www.ibxmedicare.com	www.ibxmedicare.com	www.ibxmedicare.com	(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(800)645-3965		(800)645-3965		(877)393-6733		(877)393-6733		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;11c;15;	2		1					1				
H3954	097	0	1	01	01	H3954_097_0	4	2	1	1	2	08/03/2017	2018.03	08/03/2017 04:49:12 PM Eastern Daylight Time	08/07/2017 09:19:39 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Secure Rx (HMO SNP)	01	01		1			H3954	097	0	2018	Pennsylvania		2		2			1	3		2		1	www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	156	1	1	01	01	H3954_156_1	4	1		1		07/05/2017	2018.03	07/05/2017 06:06:08 PM Eastern Daylight Time	06/04/2017 07:33:59 PM Eastern Daylight Time				07/05/2017 06:12:47 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	1	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	156	2	1	01	01	H3954_156_2	5	1		1		05/25/2017	2018.03	05/25/2017 11:58:23 AM Eastern Daylight Time	07/18/2017 01:30:29 PM Eastern Daylight Time				07/18/2017 04:01:20 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	2	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	156	3	1	01	01	H3954_156_3	5	1		1		05/25/2017	2018.03	05/25/2017 11:58:40 AM Eastern Daylight Time	07/18/2017 01:30:31 PM Eastern Daylight Time				07/18/2017 04:01:20 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	156	4	1	01	01	H3954_156_4	3	1		1		05/25/2017	2018.03	05/25/2017 11:58:58 AM Eastern Daylight Time	06/04/2017 07:33:59 PM Eastern Daylight Time				06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	156	5	1	01	01	H3954_156_5	5	1		1		05/25/2017	2018.03	05/25/2017 11:59:18 AM Eastern Daylight Time	07/18/2017 01:30:33 PM Eastern Daylight Time				07/18/2017 04:01:20 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	5	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	156	6	1	01	01	H3954_156_6	3	1		1		05/25/2017	2018.03	05/25/2017 11:59:40 AM Eastern Daylight Time	06/04/2017 07:34:00 PM Eastern Daylight Time				06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage (HMO)	01	01		1			H3954	156	6	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	157	1	1	01	01	H3954_157_1	6	1		1		07/05/2017	2018.03	07/05/2017 06:08:26 PM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	1	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	157	2	1	01	01	H3954_157_2	7	1		1		06/09/2017	2018.03	06/09/2017 11:17:01 AM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	2	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	157	3	1	01	01	H3954_157_3	5	1		1		06/09/2017	2018.03	06/09/2017 11:17:18 AM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	157	4	1	01	01	H3954_157_4	6	1		1		06/09/2017	2018.03	06/09/2017 11:32:22 AM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	157	5	1	01	01	H3954_157_5	6	1		1		06/09/2017	2018.03	06/09/2017 11:32:42 AM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	5	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	157	6	1	01	01	H3954_157_6	5	1		1		06/09/2017	2018.03	06/09/2017 11:32:58 AM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Advantage Rx (HMO)	01	01		1			H3954	157	6	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	1	1	01	01	H3954_158_1	6	1		1		08/07/2017	2018.03	08/07/2017 01:18:57 PM Eastern Daylight Time	08/07/2017 09:19:40 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	1	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	2	1	01	01	H3954_158_2	5	1		1		08/07/2017	2018.03	08/07/2017 01:19:30 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:50 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	2	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	3	1	01	01	H3954_158_3	5	1		1		08/07/2017	2018.03	08/07/2017 01:20:02 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	4	1	01	01	H3954_158_4	5	1		1		08/07/2017	2018.03	08/07/2017 01:19:31 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	5	1	01	01	H3954_158_5	5	1		1		08/07/2017	2018.03	08/07/2017 01:19:31 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	5	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	158	6	1	01	01	H3954_158_6	5	1		1		08/07/2017	2018.03	08/07/2017 01:20:15 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Complete Rx (HMO)	01	01		1			H3954	158	6	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	1	1	01	01	H3954_159_1	4	2		1		08/03/2017	2018.03	08/03/2017 04:33:21 PM Eastern Daylight Time	08/07/2017 09:19:41 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	1	2018	Pennsylvania	Central - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	2	1	01	01	H3954_159_2	4	2		1		08/03/2017	2018.03	08/03/2017 04:36:05 PM Eastern Daylight Time	08/07/2017 09:19:42 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	2	2018	Pennsylvania	Northeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	3	1	01	01	H3954_159_3	4	2		1		08/03/2017	2018.03	08/03/2017 04:36:16 PM Eastern Daylight Time	08/07/2017 09:19:42 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	3	2018	Pennsylvania	South - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	4	1	01	01	H3954_159_4	4	2		1		08/03/2017	2018.03	08/03/2017 04:36:23 PM Eastern Daylight Time	08/07/2017 09:19:42 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	4	2018	Pennsylvania	Southeast - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	5	1	01	01	H3954_159_5	4	2		1		08/03/2017	2018.03	08/03/2017 04:36:35 PM Eastern Daylight Time	08/07/2017 09:19:42 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	5	2018	Pennsylvania	West - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	159	6	1	01	01	H3954_159_6	4	2		1		08/03/2017	2018.03	08/03/2017 04:37:15 PM Eastern Daylight Time	08/07/2017 09:19:42 AM Eastern Daylight Time	08/07/2017 09:19:51 AM Eastern Daylight Time			08/07/2017 08:06:05 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Essential Rx (HMO)	01	01		1			H3954	159	6	2018	Pennsylvania	Southwest - Pennsylvania	2		2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	801	0	1	01	01	H3954_801_0	3			1		05/26/2017	2018.03	05/26/2017 01:47:29 PM Eastern Daylight Time					06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic (Employer Group) (HMO)	01	01		1			H3954	801	0	2018	Pennsylvania		1	67061	2			2						www.geisingergold.com	https://www.thehealthplan.com/pharmacy/pharmacy.aspx?strip=true&style=OneGeisinger	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3954	802	0	1	01	01	H3954_802_0	3			1		05/26/2017	2018.03	05/26/2017 01:47:51 PM Eastern Daylight Time					06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Rx (Employer Group) (HMO)	01	01		1			H3954	802	0	2018	Pennsylvania		1	9529	2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3954	805	0	1	01	01	H3954_805_0	3			1		05/25/2017	2018.03	05/25/2017 11:23:42 AM Eastern Daylight Time					06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Classic Rx EGWP New Jersey (HMO)	01	01		1			H3954	805	0	2018	Monmouth & Ocean Counties, NJ		1	600	2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	003	0	1	01	01	H3957_003_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:34:23 AM Eastern Daylight Time	08/01/2017 04:46:02 PM Eastern Daylight Time	08/02/2017 12:13:16 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Standard (HMO)	01	01		1			H3957	003	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	006	0	1	01	01	H3957_006_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:35:21 AM Eastern Daylight Time	08/01/2017 04:46:33 PM Eastern Daylight Time	08/02/2017 12:15:59 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Standard (HMO)	01	01		1			H3957	006	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	020	0	1	01	01	H3957_020_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:36:15 AM Eastern Daylight Time	08/01/2017 04:47:06 PM Eastern Daylight Time	08/02/2017 12:17:34 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Deluxe (HMO)	01	01		1			H3957	020	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	021	0	1	01	01	H3957_021_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:36:58 AM Eastern Daylight Time	08/01/2017 04:47:38 PM Eastern Daylight Time	08/02/2017 12:19:51 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Deluxe (HMO)	01	01		1			H3957	021	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	024	0	1	01	01	H3957_024_0	8	2		1		07/10/2017	2018.03	07/10/2017 10:37:51 AM Eastern Daylight Time	07/25/2017 11:20:39 AM Eastern Daylight Time				07/27/2017 08:30:44 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Basic (HMO)	01	01		1			H3957	024	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3957	025	0	1	01	01	H3957_025_0	8	2		1		07/10/2017	2018.03	07/10/2017 10:38:35 AM Eastern Daylight Time	07/25/2017 11:21:12 AM Eastern Daylight Time				07/27/2017 08:30:44 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO Basic (HMO)	01	01		1			H3957	025	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3957	031	0	1	01	01	H3957_031_0	9	1		1		07/10/2017	2018.03	07/10/2017 10:39:14 AM Eastern Daylight Time	08/01/2017 04:49:16 PM Eastern Daylight Time	08/02/2017 12:22:21 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO ValueRx (HMO)	01	01		1			H3957	031	0	2018	Southwestern PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	032	0	1	01	01	H3957_032_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:41:22 AM Eastern Daylight Time	08/01/2017 04:49:47 PM Eastern Daylight Time	08/02/2017 12:23:56 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO ValueRx (HMO)	01	01		1			H3957	032	0	2018	West Central PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	038	0	1	01	01	H3957_038_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:41:49 AM Eastern Daylight Time	08/01/2017 04:50:30 PM Eastern Daylight Time	08/02/2017 12:29:24 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO Signature (HMO)	01	01		1			H3957	038	0	2018	Western PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	039	0	1	01	01	H3957_039_0	9	2		1		07/10/2017	2018.03	07/10/2017 10:42:28 AM Eastern Daylight Time	08/01/2017 04:51:02 PM Eastern Daylight Time	08/02/2017 12:30:59 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO Prestige (HMO)	01	01		1			H3957	039	0	2018	Western PA		2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	042	1	1	01	01	H3957_042_1	9	2		1		07/10/2017	2018.03	07/10/2017 10:43:10 AM Eastern Daylight Time	08/01/2017 04:51:35 PM Eastern Daylight Time	08/02/2017 12:32:35 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO Signature (HMO)	01	01		1			H3957	042	1	2018	North Central	Lehigh Valley	2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	042	2	1	01	01	H3957_042_2	9	2		1		07/10/2017	2018.03	07/10/2017 10:43:52 AM Eastern Daylight Time	08/01/2017 04:52:07 PM Eastern Daylight Time	08/02/2017 12:33:56 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO Signature (HMO)	01	01		1			H3957	042	2	2018	North Central	Harrisburg	2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	042	4	1	01	01	H3957_042_4	9	2		1		07/10/2017	2018.03	07/10/2017 10:44:29 AM Eastern Daylight Time	08/01/2017 04:52:40 PM Eastern Daylight Time	08/02/2017 12:35:46 PM Eastern Daylight Time			08/03/2017 08:09:22 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO Signature (HMO)	01	01		1			H3957	042	4	2018	North Central	North Central	2		2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3957	805	0	1	01	01	H3957_805_0	7			1		07/10/2017	2018.03	07/10/2017 10:31:20 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO MA (HMO)	01	01		1			H3957	805	0	2018	Western PA		1	17878	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3957	806	0	1	01	01	H3957_806_0	7			1		07/10/2017	2018.03	07/10/2017 10:31:34 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO MA-PD (HMO)	01	01		1			H3957	806	0	2018	Western PA		1	126832	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3957	808	0	1	01	01	H3957_808_0	7			1		07/10/2017	2018.03	07/10/2017 10:31:48 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Security Blue HMO MA-PD Non-Calendar (HMO)	01	01		1			H3957	808	0	2018	Western PA		1	0	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(800)935-2583		(800)935-2583		(866)670-5844		(866)670-5844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3957	810	0	1	01	01	H3957_810_0	7			1		07/10/2017	2018.03	07/10/2017 10:32:03 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO MA (HMO)	01	01		1			H3957	810	0	2018	Pennsylvania (Western and North Central)		1	0	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3957	811	0	1	01	01	H3957_811_0	7			1		07/10/2017	2018.03	07/10/2017 10:32:16 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO MA-PD (HMO)	01	01		1			H3957	811	0	2018	Pennsylvania (Western and North Central)		1	1572	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3957	812	0	1	01	01	H3957_812_0	7			1		07/10/2017	2018.03	07/10/2017 10:32:28 AM Eastern Daylight Time					07/11/2017 07:27:53 AM Eastern Daylight Time	HIGHMARK CHOICE COMPANY	Highmark Choice Company	www.highmarkblueshield.com/medicare	Community Blue Medicare HMO MA-PD Non-Calendar (HMO)	01	01		1			H3957	812	0	2018	Pennsylvania (Western and North Central)		1	0	2			2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare	(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(888)234-5397		(888)234-5397		(866)687-3182		(866)687-3182		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					1				
H3959	001	0	1	01	01	H3959_001_0	5	2		1		07/13/2017	2018.03	07/13/2017 07:34:42 PM Eastern Daylight Time	08/03/2017 01:32:07 PM Eastern Daylight Time	07/31/2017 05:46:31 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Gold (HMO)	01	01		1			H3959	001	0	2018	Allegheny County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	002	0	1	01	01	H3959_002_0	5	1		1		07/13/2017	2018.03	07/13/2017 07:34:59 PM Eastern Daylight Time	08/02/2017 07:36:06 PM Eastern Daylight Time	07/31/2017 05:46:52 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Gold (HMO)	01	01		1			H3959	002	0	2018	Western Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	010	0	1	01	01	H3959_010_0	3	2		1		08/02/2017	2018.03	08/02/2017 03:40:46 PM Eastern Daylight Time	08/03/2017 01:33:17 PM Eastern Daylight Time	07/31/2017 05:47:13 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver (HMO)	01	01		1			H3959	010	0	2018	Allegheny County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	011	0	1	01	01	H3959_011_0	3	2		1		08/02/2017	2018.03	08/02/2017 09:05:27 AM Eastern Daylight Time	08/03/2017 01:34:34 PM Eastern Daylight Time	07/31/2017 05:47:35 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver (HMO)	01	01		1			H3959	011	0	2018	Western Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	031	0	1	01	01	H3959_031_0	3	2		1		06/27/2017	2018.03	06/27/2017 07:42:33 PM Eastern Daylight Time	08/03/2017 01:35:35 PM Eastern Daylight Time	07/31/2017 05:47:56 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver (HMO)	01	01		1			H3959	031	0	2018	Philadelphia and Delaware Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	032	0	1	01	01	H3959_032_0	3	2		1		06/27/2017	2018.03	06/27/2017 07:42:45 PM Eastern Daylight Time	08/03/2017 01:36:59 PM Eastern Daylight Time	07/31/2017 05:48:18 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver Plus (HMO)	01	01		1			H3959	032	0	2018	Northwestern Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	033	0	1	01	01	H3959_033_0	3	2		1		08/02/2017	2018.03	08/02/2017 03:42:22 PM Eastern Daylight Time	08/03/2017 01:38:13 PM Eastern Daylight Time	07/31/2017 05:48:40 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver (HMO)	01	01		1			H3959	033	0	2018	Bucks, Chester and Montgomery		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	035	0	1	01	01	H3959_035_0	4	2	1	1	2	07/14/2017	2018.03	07/14/2017 03:45:22 PM Eastern Daylight Time	08/03/2017 01:39:26 PM Eastern Daylight Time	07/31/2017 05:49:02 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Cares (HMO SNP)	01	01		1			H3959	035	0	2018	Southeastern Pennsylvania		2		2			1	3		2		2	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	036	0	1	01	01	H3959_036_0	5	2	1	1	2	07/19/2017	2018.03	07/19/2017 11:06:39 AM Eastern Daylight Time	08/03/2017 01:40:33 PM Eastern Daylight Time	07/31/2017 05:49:23 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Cares (HMO SNP)	01	01		1			H3959	036	0	2018	Central and Western Pennsylvania		2		2			1	3		2		2	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	037	0	1	01	01	H3959_037_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:36:53 PM Eastern Daylight Time	08/03/2017 01:41:59 PM Eastern Daylight Time	07/31/2017 05:49:45 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Northern Pennsylvania Gold (HMO)	01	01		1			H3959	037	0	2018	Northeastern Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	039	0	1	01	01	H3959_039_0	3	2		1		06/27/2017	2018.03	06/27/2017 07:43:45 PM Eastern Daylight Time	08/03/2017 01:43:02 PM Eastern Daylight Time	07/31/2017 05:50:06 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Silver Plus (HMO)	01	01		1			H3959	039	0	2018	Central Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	041	0	1	01	01	H3959_041_0	2	2		1		06/27/2017	2018.03	06/27/2017 07:43:56 PM Eastern Daylight Time	05/30/2017 01:50:55 PM Eastern Daylight Time				07/07/2017 10:24:19 AM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Basic Medical (HMO)	01	01		1			H3959	041	0	2018	Central and Western Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H3959	043	0	1	01	01	H3959_043_0	3	2		1		08/02/2017	2018.03	08/02/2017 03:05:03 PM Eastern Daylight Time	08/03/2017 01:44:11 PM Eastern Daylight Time	07/31/2017 05:50:29 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Choice Plan (HMO)	01	01		1			H3959	043	0	2018	Allegheny County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	044	0	1	01	01	H3959_044_0	4	2		1		08/02/2017	2018.03	08/02/2017 03:06:16 PM Eastern Daylight Time	08/03/2017 01:45:11 PM Eastern Daylight Time	07/31/2017 05:50:52 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Fayette Prime (HMO)	01	01		1			H3959	044	0	2018	Fayette County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	045	0	1	01	01	H3959_045_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:47:51 PM Eastern Daylight Time	08/03/2017 01:46:10 PM Eastern Daylight Time	07/31/2017 05:51:14 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Penn Highlands Prime (HMO)	01	01		1			H3959	045	0	2018	Clearfield, Elk and Jefferson Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	046	0	1	01	01	H3959_046_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:30:36 PM Eastern Daylight Time	08/03/2017 01:47:16 PM Eastern Daylight Time	07/31/2017 05:51:36 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Washington Prime (HMO)	01	01		1			H3959	046	0	2018	Greene and Washington Counties		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	047	0	1	01	01	H3959_047_0	4	2		1		08/02/2017	2018.03	08/02/2017 11:33:38 AM Eastern Daylight Time	08/03/2017 01:48:18 PM Eastern Daylight Time	07/31/2017 05:51:58 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Butler Prime (HMO)	01	01		1			H3959	047	0	2018	Butler County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	048	0	1	01	01	H3959_048_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:29:53 PM Eastern Daylight Time	08/03/2017 01:49:30 PM Eastern Daylight Time	07/31/2017 05:52:19 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Mt. Nittany Prime (HMO)	01	01		1			H3959	048	0	2018	Centre County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	049	0	1	01	01	H3959_049_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:45:05 PM Eastern Daylight Time	08/03/2017 01:50:43 PM Eastern Daylight Time	07/31/2017 05:52:42 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Excela Prime (HMO)	01	01		1			H3959	049	0	2018	Westmoreland County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	050	0	1	01	01	H3959_050_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:43:04 PM Eastern Daylight Time	08/03/2017 01:51:41 PM Eastern Daylight Time	07/31/2017 05:53:05 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Susquehanna Prime (HMO)	01	01		1			H3959	050	0	2018	Lycoming County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	051	0	1	01	01	H3959_051_0	4	2		1		08/02/2017	2018.03	08/02/2017 12:41:09 PM Eastern Daylight Time	08/03/2017 01:52:47 PM Eastern Daylight Time	07/31/2017 05:53:27 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	www.coventry-medicare.com	Advantra Beaver Valley Prime (HMO)	01	01		1			H3959	051	0	2018	Beaver County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3959	803	0	1	01	01	H3959_803_0	1			1		05/31/2017	2018.03	05/31/2017 08:04:38 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	http://www.pa.chcadvantra.com	Advantra MA Only (HMO)	01	01		1			H3959	803	0	2018	Pennsylvania		1	120	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3959	804	0	1	01	01	H3959_804_0	1			1		05/31/2017	2018.03	05/31/2017 08:04:59 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	HealthAmerica Pennsylvania	http://www.pa.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H3959	804	0	2018	Pennsylvania		1	30820	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(855)275-5888		(855)275-5888		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H3962	001	0	1	01	01	H3962_001_0	6			1		06/03/2017	2018.03	06/03/2017 03:57:48 PM Eastern Daylight Time	08/02/2017 10:19:28 AM Eastern Daylight Time	08/02/2017 10:30:24 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney Premier (HMO)	01	01		1			H3962	001	0	2018	21 Counties in Central PA		2	56016	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3962	004	0	1	01	01	H3962_004_0	6			1		06/03/2017	2018.03	06/03/2017 03:07:12 PM Eastern Daylight Time	08/02/2017 10:20:50 AM Eastern Daylight Time	08/02/2017 10:31:18 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney Value (HMO)	01	01		1			H3962	004	0	2018	21 Counties in Central PA		2	24758	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3962	007	0	1	01	01	H3962_007_0	8			1		08/03/2017	2018.03	08/03/2017 05:45:43 PM Eastern Daylight Time	08/03/2017 04:32:50 PM Eastern Daylight Time	08/02/2017 10:32:36 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney Essential (HMO)	01	01		1			H3962	007	0	2018	21 Counties in Central PA		2	74803	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3962	018	0	1	01	01	H3962_018_0	6		1	1		06/04/2017	2018.03	06/04/2017 11:21:38 PM Eastern Daylight Time	08/02/2017 10:23:36 AM Eastern Daylight Time	08/02/2017 10:33:26 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney Alliance Lung Care (HMO SNP)	01	01		1			H3962	018	0	2018	Lancaster County		2	534	2			1	4			00000000000100000000		www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3962	019	0	1	01	01	H3962_019_0	6		1	1		06/04/2017	2018.03	06/04/2017 10:47:29 PM Eastern Daylight Time	08/02/2017 10:24:46 AM Eastern Daylight Time	08/02/2017 10:34:30 AM Eastern Daylight Time			08/03/2017 06:50:41 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney Alliance Heart and Diabetes Care (HMO SNP)	01	01		1			H3962	019	0	2018	Lancaster County		2	534	2			1	4			00000000000000000010		www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3962	801	0	1	01	01	H3962_801_0	3			1		06/04/2017	2018.03	06/04/2017 11:02:30 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney ERH with Rx (HMO)	01	01		1			H3962	801	0	2018	National		1	15882	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					2				
H3962	802	0	1	01	01	H3962_802_0	3			1		06/04/2017	2018.03	06/04/2017 10:59:51 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney ERH without Rx (HMO)	01	01		1			H3962	802	0	2018	National		1	23235	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					2				
H3962	803	0	1	01	01	H3962_803_0	3			1		06/04/2017	2018.03	06/04/2017 11:05:03 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL, INC.	Keystone Health Plan Central, Inc.	www.capitalbluemedicare.com	BlueJourney ERH Non-Calendar with Rx (HMO)	01	01		1			H3962	803	0	2018	National		1	24	2			2						www.capitalbluemedicare.com	www.capitalbluemedicare.com	www.capitalbluemedicare.com	(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(800)779-6962		(800)779-6962		(800)990-4201		(800)990-4201		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1					2				
H3979	001	0	1	01	01	H3979_001_0	6			1		08/04/2017	2018.03	08/04/2017 12:27:39 PM Central Daylight Time	08/04/2017 05:49:20 PM Central Daylight Time	08/01/2017 03:54:40 PM Central Daylight Time			08/07/2017 04:33:04 PM Central Daylight Time	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Blue Cross Blue Shield of OK	www.getblueok.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H3979	001	0	2018	Oklahoma City Metro Area		2	65009	2			2						www.getblueok.com/mapd/pharmacies	www.getblueok.com/mapd/druglist	www.getblueok.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H3979	801	0	1	01	01	H3979_801_0	1			1		05/23/2017	2018.03	05/23/2017 11:53:34 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Blue Cross Blue Shield of OK	www.bcbsok.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3979	801	0	2018	State of Oklahoma		1	82	2			2						www.getblueok.com/mapd/pharmacies	www.getblueok.com/mapd/druglist	www.getblueok.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3979	803	0	1	01	01	H3979_803_0	1			1		05/23/2017	2018.03	05/23/2017 11:54:17 AM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Blue Cross Blue Shield of OK	www.bcbsok.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3979	803	0	2018	State of Oklahoma		1	10	2			2						www.getblueok.com/mapd/pharmacies	www.getblueok.com/mapd/druglist	www.getblueok.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H3979	805	0	1	01	01	H3979_805_0	1			1		05/23/2017	2018.03	05/23/2017 12:00:13 PM Central Daylight Time					05/30/2017 11:42:17 AM Central Daylight Time	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Blue Cross Blue Shield of OK	www.bcbsok.com	BlueCross Medicare Advantage (HMO)	01	01		1			H3979	805	0	2018	State of Oklahoma		1	5	2			2						www.getblueok.com/mapd/pharmacies	www.getblueok.com/mapd/druglist	www.getblueok.com/mapd/providers	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H4000	001	0	1	20	08	H4000_001_0	1			1		05/24/2017	2018.03	05/24/2017 11:07:18 AM Mountain Daylight Time		05/24/2017 10:44:05 AM Mountain Daylight Time			05/24/2017 11:13:32 AM Mountain Daylight Time	MEMORIAL HOSPITAL OF LARAMIE COUNTY	Wyoming PACE	www.crmcwy.org	001-Dual Eligible (PACE)	08	20		1			H4000	001	0	2018	001-Wyoming PACE		2		2			2						www.seniorscript.com	www.seniorscript.com										(307)773-8112		(307)773-8112		(307)773-8112		(307)773-8112										(800)877-9965		(800)877-9965		(800)877-9965		(800)877-9965																
H4000	002	0	1	20	08	H4000_002_0	1			1		05/24/2017	2018.03	05/24/2017 11:07:56 AM Mountain Daylight Time		05/24/2017 10:45:14 AM Mountain Daylight Time			05/24/2017 11:13:32 AM Mountain Daylight Time	MEMORIAL HOSPITAL OF LARAMIE COUNTY	Wyoming PACE	www.crmcwy.org	002-Medicare Only (PACE)	08	20		1			H4000	002	0	2018	002-Wyoming PACE		2		2			2						www.seniorscript.com	www.seniorscript.com										(307)773-8112		(307)773-8112		(307)773-8112		(307)773-8112										(800)877-9965		(800)877-9965		(800)877-9965		(800)877-9965																
H4003	009	0	1	01	01	H4003_009_0	12		1	1		08/07/2017	2018.03	08/07/2017 05:28:58 PM SA Western Standard Time	08/08/2017 01:06:26 PM SA Western Standard Time	08/08/2017 11:44:26 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Supremo (HMO SNP)	01	01		1			H4003	009	0	2018	Puerto Rico		2		2			1	4			00000000000000000010		www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	1	01	12;	
H4003	017	0	1	01	01	H4003_017_0	13		1	1	1	08/03/2017	2018.03	08/03/2017 05:57:52 PM SA Western Standard Time	08/07/2017 03:20:30 PM SA Western Standard Time	08/08/2017 11:46:04 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Diamante Choice Platino (HMO SNP)	01	01		1			H4003	017	0	2018	Puerto Rico		2		2		1	1	3		2		2	www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	2			
H4003	019	0	1	01	01	H4003_019_0	14			1		08/07/2017	2018.03	08/07/2017 01:46:42 PM SA Western Standard Time	08/08/2017 12:02:12 PM SA Western Standard Time	08/08/2017 11:50:58 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Unico (HMO)	01	01		1			H4003	019	0	2018	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	1	01	7d;12;	
H4003	027	0	1	02	01	H4003_027_0	13			1		08/07/2017	2018.03	08/07/2017 05:07:35 PM SA Western Standard Time	08/08/2017 12:04:32 PM SA Western Standard Time	08/08/2017 04:42:02 PM SA Western Standard Time			08/08/2017 05:02:54 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Elite Ultra (HMO-POS)	01	02		1			H4003	027	0	2018	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	1	01	7d;12;	
H4003	033	0	1	01	01	H4003_033_0	13		1	1	1	06/02/2017	2018.03	06/02/2017 10:18:05 AM SA Western Standard Time	08/07/2017 03:13:54 PM SA Western Standard Time	08/08/2017 11:53:48 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Diamante Excel Platino (HMO SNP)	01	01		1			H4003	033	0	2018	Puerto Rico		2		2		1	1	3		2		2	www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	2			
H4003	034	0	1	02	01	H4003_034_0	13			1		08/03/2017	2018.03	08/03/2017 05:41:22 PM SA Western Standard Time	08/07/2017 12:40:48 PM SA Western Standard Time	08/08/2017 11:54:46 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Elite Excel (HMO-POS)	01	02		1			H4003	034	0	2018	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	1	01	12;	
H4003	041	0	1	01	01	H4003_041_0	11		1	1	1	08/07/2017	2018.03	08/07/2017 03:11:47 PM SA Western Standard Time	08/08/2017 12:08:56 PM SA Western Standard Time	08/08/2017 11:55:54 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Diamante Choice Plus Platino (HMO SNP)	01	01		1			H4003	041	0	2018	Puerto Rico		2		2		1	1	3		2		2	www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	2			
H4003	806	0	1	02	01	H4003_806_0	9			1		06/13/2017	2018.03	06/13/2017 10:02:55 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Flex Group Calendar (HMO-POS)	01	02		1			H4003	806	0	2018	Puerto Rico		1	346027	2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	2				
H4003	807	0	1	02	01	H4003_807_0	9			1		06/13/2017	2018.03	06/13/2017 10:03:27 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Flex Group Non Calendar (HMO-POS)	01	02		1			H4003	807	0	2018	Puerto Rico		1	1495	2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	2				
H4003	820	0	1	01	01	H4003_820_0	9			1		06/13/2017	2018.03	06/13/2017 10:04:01 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Relax Group Calendar (HMO)	01	01		1			H4003	820	0	2018	Puerto Rico		1	0	2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1					2				
H4003	821	0	1	01	01	H4003_821_0	9			1		06/13/2017	2018.03	06/13/2017 10:04:31 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.mmm-pr.com	MMM - Relax Group Non Calendar (HMO)	01	01		1			H4003	821	0	2018	Puerto Rico		1	0	2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1					2				
H4004	048	0	1	01	01	H4004_048_0	13		1	1	1	08/07/2017	2018.03	08/07/2017 03:12:55 PM SA Western Standard Time	08/08/2017 12:16:02 PM SA Western Standard Time	08/08/2017 11:50:20 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Premier Preferred Platino (HMO SNP)	01	01		1			H4004	048	0	2018	PUERTO RICO		2		2		1	1	3		2		2	www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		2					2					2	2			
H4004	056	0	1	01	01	H4004_056_0	15			1		08/08/2017	2018.03	08/08/2017 04:27:43 PM SA Western Standard Time	08/07/2017 12:46:34 PM SA Western Standard Time	08/08/2017 11:56:36 AM SA Western Standard Time			08/08/2017 05:02:54 PM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Max Extra (HMO)	01	01		1			H4004	056	0	2018	PUERTO RICO		2		2			2						www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		2					2					2	1	01	7d;12;	
H4004	061	0	1	01	01	H4004_061_0	11		1	1	1	08/03/2017	2018.03	08/03/2017 05:59:56 PM SA Western Standard Time	08/08/2017 12:06:16 PM SA Western Standard Time	08/08/2017 11:57:42 AM SA Western Standard Time			08/08/2017 03:03:10 PM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	MMM - Diamante Excel Plus Platino (HMO SNP)	01	01		1			H4004	061	0	2018	Puerto Rico		2		2		1	1	3		2		2	www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5470		(787)620-2397		(866)333-5471		(787)620-2396		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		(866)333-5469		(866)333-5469		(877)522-0655		(877)522-0655		2					2					2	2			
H4004	817	0	1	02	01	H4004_817_0	9			1		06/13/2017	2018.03	06/13/2017 10:05:05 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Max Extra Group Non Calendar (HMO-POS)	01	02		1			H4004	817	0	2018	Puerto Rico		1	0	2			2						www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	2				
H4004	818	0	1	02	01	H4004_818_0	9			1		06/13/2017	2018.03	06/13/2017 10:05:21 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Max Extra Group Calendar (HMO-POS)	01	02		1			H4004	818	0	2018	Puerto Rico		1	0	2			2						www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	2				
H4004	819	0	1	01	01	H4004_819_0	9			1		06/13/2017	2018.03	06/13/2017 10:05:37 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Max Group Non Calendar (HMO)	01	01		1			H4004	819	0	2018	Puerto Rico		1	0	2			2						www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1					2				
H4004	820	0	1	01	01	H4004_820_0	9			1		06/13/2017	2018.03	06/13/2017 10:05:51 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	PMC Medicare Choice	www.pmcpr.org	PMC - Max Group Calendar (HMO)	01	01		1			H4004	820	0	2018	Puerto Rico		1	0	2			2						www.pmcpr.org	www.pmcpr.org	www.pmcpr.org	(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7700		(787)625-2126		(877)568-0808		(787)622-7510		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		(866)516-7701		(866)516-7701		(877)522-0656		(877)522-0656		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;16b;18a;	1					2				
H4005	001	0	1	04	01	H4005_001_0	5			1		07/12/2017	2018.03	07/12/2017 02:56:48 PM SA Western Standard Time	06/05/2017 01:45:49 PM SA Western Standard Time				07/13/2017 11:35:23 AM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo (PPO)	01	04		1			H4005	001	0	2018	Puerto Rico		2	11316	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777										(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520										2					2						1	11	7d;7f;8a1;8a2;8b1;8b2;8b3;	7f;
H4005	004	0	1	04	01	H4005_004_0	6			1		08/03/2017	2018.03	08/03/2017 09:44:35 AM SA Western Standard Time	08/04/2017 07:40:31 PM SA Western Standard Time	08/04/2017 07:40:33 PM SA Western Standard Time			08/04/2017 07:48:19 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo Plus (PPO)	01	04		1			H4005	004	0	2018	Puerto Rico		2	72552	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2						1	11	7d;7f;8a1;8a2;8b1;8b2;8b3;	7f;
H4005	801	0	1	04	01	H4005_801_0	5			1		06/13/2017	2018.03	06/13/2017 10:56:32 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo (PPO)	01	04		1			H4005	801	0	2018	Puerto Rico		1	5112	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777										(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520										1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1									
H4005	802	0	1	04	01	H4005_802_0	5			1		06/13/2017	2018.03	06/13/2017 10:56:11 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo Plus A (PPO)	01	04		1			H4005	802	0	2018	Puerto Rico		1	136932	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1									
H4005	804	0	1	04	01	H4005_804_0	5			1		06/13/2017	2018.03	06/13/2017 10:55:47 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo Plus B (PPO)	01	04		1			H4005	804	0	2018	Puerto Rico		1	1632	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1									
H4005	807	0	1	04	01	H4005_807_0	5			1		06/13/2017	2018.03	06/13/2017 10:50:45 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo Plus C (PPO)	01	04		1			H4005	807	0	2018	Puerto Rico		1	7704	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1									
H4005	808	0	1	04	01	H4005_808_0	5			1		06/13/2017	2018.03	06/13/2017 10:48:23 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple-S Advantage	www.sssadvantage.com	ptimo Plus D (PPO)	01	04		1			H4005	808	0	2018	Puerto Rico		1	104784	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;6;7c;7i;8a;8b1;8b2;9b;10a;11a;11b;15;16b;	2		1									
H4007	012	0	1	01	01	H4007_012_0	5			1		08/02/2017	2018.03	08/02/2017 03:07:55 PM Eastern Daylight Time	08/06/2017 01:13:51 PM Eastern Daylight Time	08/04/2017 09:52:47 AM Eastern Daylight Time			08/06/2017 01:32:19 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus H4007-012 (HMO)	01	01		1			H4007	012	0	2018	Puerto Rico Island Wide		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4007	013	0	1	01	01	H4007_013_0	4			1		08/02/2017	2018.03	08/02/2017 03:08:17 PM Eastern Daylight Time	08/06/2017 01:16:22 PM Eastern Daylight Time	08/04/2017 09:52:48 AM Eastern Daylight Time			08/06/2017 01:32:19 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus H4007-013 (HMO)	01	01		1			H4007	013	0	2018	Puerto Rico Island Wide		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4007	016	0	1	01	01	H4007_016_0	5		1	1	1	08/03/2017	2018.03	08/03/2017 09:56:06 AM Eastern Daylight Time	08/06/2017 01:24:40 PM Eastern Daylight Time	08/04/2017 09:52:48 AM Eastern Daylight Time			08/06/2017 01:32:19 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4007-016 (HMO SNP)	01	01		1			H4007	016	0	2018	Puerto Rico Island Wide		2		2		1	1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4007	018	0	1	01	01	H4007_018_0	5		1	1	1	08/03/2017	2018.03	08/03/2017 09:56:19 AM Eastern Daylight Time	08/06/2017 01:26:46 PM Eastern Daylight Time	08/04/2017 09:52:49 AM Eastern Daylight Time			08/06/2017 01:32:19 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4007-018 (HMO SNP)	01	01		1			H4007	018	0	2018	Puerto Rico Island Wide		2		2		1	1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4007	801	0	1	01	01	H4007_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:24:04 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4007	801	0	2018	Puerto Rico - Island Wide		1	45144	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4007	802	0	1	01	01	H4007_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:24:23 AM Eastern Daylight Time					06/13/2017 12:43:04 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4007	802	0	2018	Puerto Rico - Island Wide		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4036	008	0	1	04	01	H4036_008_0	5			1		06/03/2017	2018.03	06/03/2017 08:49:00 AM Eastern Daylight Time	08/07/2017 08:52:34 AM Eastern Daylight Time	08/06/2017 03:05:40 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H4036	008	0	2018	East and Southeast Wisconsin		2	23232	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7802		(855)690-7802		(800)797-5940		(800)797-5940		(855)690-7802		(855)690-7802		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	009	0	1	04	01	H4036_009_0	5			1		06/03/2017	2018.03	06/03/2017 08:48:46 AM Eastern Daylight Time	08/07/2017 08:52:34 AM Eastern Daylight Time	08/06/2017 03:05:40 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H4036	009	0	2018	Central Wisconsin		2	4392	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7802		(855)690-7802		(800)797-5940		(800)797-5940		(855)690-7802		(855)690-7802		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	010	1	1	04	01	H4036_010_1	5			1		06/03/2017	2018.03	06/03/2017 08:48:41 AM Eastern Daylight Time	08/07/2017 08:52:35 AM Eastern Daylight Time	08/06/2017 03:05:40 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H4036	010	1	2018	Select Counties in Ohio	Select Counties in Ohio	2	86868	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7801		(855)690-7801		(800)797-5940		(800)797-5940		(855)690-7801		(855)690-7801		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	010	2	1	04	01	H4036_010_2	5			1		06/03/2017	2018.03	06/03/2017 08:49:10 AM Eastern Daylight Time	08/07/2017 08:52:35 AM Eastern Daylight Time	08/06/2017 03:05:40 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H4036	010	2	2018	Select Counties in Ohio	Select Counties in Ohio	2	48744	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7801		(855)690-7801		(800)797-5940		(800)797-5940		(855)690-7801		(855)690-7801		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	012	1	1	04	01	H4036_012_1	5			1		06/03/2017	2018.03	06/03/2017 08:49:17 AM Eastern Daylight Time	08/07/2017 08:52:36 AM Eastern Daylight Time	08/06/2017 03:05:41 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Plus (PPO)	01	04		1			H4036	012	1	2018	Select Counties in Ohio	Select Counties in Ohio	2	5304	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7801		(855)690-7801		(800)797-5940		(800)797-5940		(855)690-7801		(855)690-7801		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	012	2	1	04	01	H4036_012_2	5			1		06/03/2017	2018.03	06/03/2017 08:49:25 AM Eastern Daylight Time	08/07/2017 08:52:36 AM Eastern Daylight Time	08/06/2017 03:05:41 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Plus (PPO)	01	04		1			H4036	012	2	2018	Select Counties in Ohio	Select Counties in Ohio	2	56244	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7801		(855)690-7801		(800)797-5940		(800)797-5940		(855)690-7801		(855)690-7801		(844)364-2118		(844)364-2118		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4036	016	0	1	04	01	H4036_016_0	4			1		06/03/2017	2018.03	06/03/2017 08:49:35 AM Eastern Daylight Time	07/17/2017 06:53:49 PM Eastern Daylight Time				07/18/2017 05:13:32 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Core (PPO)	01	04		1			H4036	016	0	2018	Select counties in WI		2	4236	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7802		(855)690-7802		(800)797-5940		(800)797-5940										(711)-		(711)-		(711)-		(711)-										2					2						2			
H4036	801	0	1	04	01	H4036_801_0	1			1		06/03/2017	2018.03	06/03/2017 11:44:02 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4036	801	0	2018	Wisconsin		1	31830	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4036	802	0	1	04	01	H4036_802_0	1			1		06/03/2017	2018.03	06/03/2017 11:46:59 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4036	802	0	2018	Wisconsin		1	6996	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;12;14d;14e1;14e2;14e3;15;18a;	2		1									
H4036	803	0	1	04	01	H4036_803_0	1			1		06/03/2017	2018.03	06/03/2017 11:46:09 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4036	803	0	2018	Wisconsin		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4036	805	0	1	04	01	H4036_805_0	1			1		06/03/2017	2018.03	06/03/2017 11:46:28 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4036	805	0	2018	National (ASO)		1	79056	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4036	806	0	2	04	01	H4036_806_0	1			1		06/03/2017	2018.03	06/03/2017 11:46:46 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		2	1		H4036	806	0	2018	National (Part B Only)		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4053	001	0	1	20	08	H4053_001_0	1			1		05/24/2017	2018.03	05/24/2017 09:28:46 AM Eastern Daylight Time		05/24/2017 09:21:01 AM Eastern Daylight Time			05/24/2017 09:33:10 AM Eastern Daylight Time	GREENVILLE HEALTH SYSTEM	GHS Senior Care	www.ghs.org	GHS Senior Care - Dual Eligible (PACE)	08	20		1			H4053	001	0	2018	Anderson, Greenville and Pickens counties		2		2			2						N/A	N/A												(864)522-1950				(864)522-1950												(711)-				(711)-																
H4053	002	0	1	20	08	H4053_002_0	1			1		05/24/2017	2018.03	05/24/2017 09:29:26 AM Eastern Daylight Time		05/24/2017 09:20:54 AM Eastern Daylight Time			05/24/2017 09:33:10 AM Eastern Daylight Time	GREENVILLE HEALTH SYSTEM	GHS Senior Care	www.ghs.org	GHS Senior Care - Medicare Only (PACE)	08	20		1			H4053	002	0	2018	Anderson, Greenville and Pickens counties		2		2			2						N/A	N/A												(864)522-1950				(864)522-1950												(711)-				(711)-																
H4069	001	0	1	04	01	H4069_001_0	8			1		06/05/2017	2018.03	06/05/2017 11:13:56 PM Pacific Daylight Time	08/07/2017 05:55:26 AM Pacific Daylight Time	08/06/2017 12:05:41 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H4069	001	0	2018	Broomfield County		2	37	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(888)346-0095		(888)346-0095		(800)797-1746		(800)797-1746		(888)346-0095		(888)346-0095		(800)261-8667		(800)261-8667		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4069	801	0	1	04	01	H4069_801_0	1			1		06/03/2017	2018.03	06/03/2017 11:59:36 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4069	801	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4069	802	0	1	04	01	H4069_802_0	1			1		06/03/2017	2018.03	06/03/2017 12:00:34 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4069	802	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4069	803	0	1	04	01	H4069_803_0	1			1		06/03/2017	2018.03	06/03/2017 11:59:44 AM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4069	803	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4069	804	0	2	04	01	H4069_804_0	3			1		06/04/2017	2018.03	06/04/2017 11:27:40 AM Pacific Daylight Time					06/04/2017 11:40:05 AM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		2	1		H4069	804	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4074	001	0	1	20	08	H4074_001_0	1			1		05/24/2017	2018.03	05/24/2017 12:07:20 PM Central Daylight Time		05/24/2017 08:14:32 AM Central Daylight Time			05/24/2017 12:12:55 PM Central Daylight Time	MERCY LIFE OF ALABAMA	Mercy LIFE of Alabama	mercylifeal.com	Mercy LIFE of Alabama (PACE)	08	20		1			H4074	001	0	2018	Mercy LIFE of Alabama Baldwin and Mobile counties		2		2			2						pharmastarpbm.com	www.mercylifeal.com	mercylifeal.com									(855)367-6562		(251)287-8420		(855)367-6562		(251)287-8420										(855)212-1552		(855)212-1552		(855)212-1552		(855)212-1552																
H4074	002	0	1	20	08	H4074_002_0	1			1		05/24/2017	2018.03	05/24/2017 12:07:47 PM Central Daylight Time		05/24/2017 08:14:16 AM Central Daylight Time			05/24/2017 12:12:55 PM Central Daylight Time	MERCY LIFE OF ALABAMA	Mercy LIFE of Alabama	mercylifeal.com	Mercy LIFE of Alabama (PACE)	08	20		1			H4074	002	0	2018	Mercy LIFE of Alabama Baldwin and Mobile counties		2		2			2						www.mercylifeal.com	www.mercylifeal.com										(855)367-6562		(251)287-8420		(855)367-6562		(251)287-8420										(855)212-1552		(855)212-1552		(855)212-1552		(855)212-1552																
H4089	001	0	1	01	01	H4089_001_0	6			1		08/02/2017	2018.03	08/02/2017 02:29:11 PM Central Daylight Time	08/03/2017 02:00:00 PM Central Daylight Time	08/01/2017 10:45:24 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF LOUISIANA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H4089	001	0	2018	New Orleans Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4089	002	0	1	01	01	H4089_002_0	6			1		06/28/2017	2018.03	06/28/2017 09:47:10 AM Central Daylight Time	08/03/2017 02:00:33 PM Central Daylight Time	08/01/2017 10:45:52 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE OF LOUISIANA, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H4089	002	0	2018	New Orleans Metro area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4091	001	0	1	04	01	H4091_001_0	11		1	1		08/05/2017	2018.03	08/05/2017 08:02:11 AM Eastern Daylight Time	08/02/2017 05:38:56 PM Eastern Daylight Time	08/02/2017 05:27:38 PM Eastern Daylight Time			08/05/2017 12:04:18 PM Eastern Daylight Time	SELECT HEALTH PLANS OF ALABAMA, INC.	SIMPRA Advantage	www.simpra-advantage.com	Select Health Plans of Alabama (PPO SNP)	01	04		1			H4091	001	0	2018	Alabama statewide		2		2			1	1	1				www.simpra-advantage.com	www.simpra-advantage.com	www.simpra-advantage.com			(999)999-9999				(999)999-9999		(888)888-8888		(999)999-9999		(888)888-8888		(999)999-9999		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		2					2						2			
H4091	002	0	1	04	01	H4091_002_0	11		1	1	2	08/05/2017	2018.03	08/05/2017 11:34:40 AM Eastern Daylight Time	08/03/2017 03:01:59 PM Eastern Daylight Time	08/02/2017 05:32:13 PM Eastern Daylight Time			08/05/2017 12:04:18 PM Eastern Daylight Time	SELECT HEALTH PLANS OF ALABAMA, INC.	SIMPRA Advantage	www.simpra-advantage.com	Select Health Plans of Alabama (PPO SNP)	01	04		1			H4091	002	0	2018	Alabama statewide		2	600	2			1	3		2		1	www.simpra-advantage.com	www.simpra-advantage.com	www.simpra-advantage.com			(999)999-9999				(999)999-9999		(888)888-8888		(999)999-9999		(888)888-8888		(999)999-9999		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		(771)-		2					2						2			
H4093	001	0	1	01	01	H4093_001_0	8		1	1		06/05/2017	2018.03	06/05/2017 01:27:29 PM Eastern Daylight Time	08/04/2017 01:01:34 PM Eastern Daylight Time	08/04/2017 01:01:34 PM Eastern Daylight Time			08/04/2017 01:02:47 PM Eastern Daylight Time	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Provider Partners Pennsylvania Advantage Plan	www.pphealthplanpa.com	Provider Partners Pennsylvania Advantage Plan (HMO SNP)	01	01		1			H4093	001	0	2018	PA East & West Borders		2		2			1	1	1				www.pphealthplanpa.com	www.pphealthplanpa.com	www.pphealthplanpa.com	(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H4105	001	0	1	20	08	H4105_001_0	1			1		05/30/2017	2018.03	05/30/2017 04:29:00 PM Eastern Daylight Time		05/30/2017 04:12:47 PM Eastern Daylight Time			05/30/2017 04:30:47 PM Eastern Daylight Time	PACE ORGANIZATION OF RHODE ISLAND	PACE Organization Of Rhode Island	www.pace-ri.org	PACE Organization of Rhode Island (PACE)	08	20		1			H4105	001	0	2018	PACE Organization of Rhode Island		2		2			2						www.pace-ri.org	www.pace-ri.org										(877)781-7223		(401)490-6566		(877)781-7223		(401)490-6566										(800)745-5555		(800)745-5555		(800)745-5555		(800)745-5555																
H4105	002	0	1	20	08	H4105_002_0	1			1		05/30/2017	2018.03	05/30/2017 04:29:30 PM Eastern Daylight Time		05/30/2017 04:13:30 PM Eastern Daylight Time			05/30/2017 04:30:47 PM Eastern Daylight Time	PACE ORGANIZATION OF RHODE ISLAND	PACE Organization Of Rhode Island	www.pace-ri.org	PACE Organization of Rhode Island (PACE)	08	20		1			H4105	002	0	2018	PACE Organization of Rhode Island		2		2			2						www.pace-ri.org	www.pace-ri.org										(877)781-7223		(401)490-6566		(877)781-7223		(401)490-6566										(800)745-5555		(800)745-5555		(800)745-5555		(800)745-5555																
H4118	001	0	1	20	08	H4118_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:07:48 PM Eastern Daylight Time		05/24/2017 08:26:39 AM Eastern Daylight Time			05/24/2017 01:12:53 PM Eastern Daylight Time	THE WASHTENAW PACE	Huron Valley PACE	www.huronvalleypace.org	Huron Valley PACE - Dual Eligible (PACE)	08	20		1			H4118	001	0	2018	Wash Co, Parts of Mon, Oak, Wayne & Livingston Co		2		2			2						http://www.hometownpharmacy.com/	http://huronvalleypace.org/										(855)483-7223		(734)572-5777		(855)483-7223		(734)572-5777										(800)649-3777		(800)649-3777		(800)649-3777		(800)649-3777																
H4118	002	0	1	20	08	H4118_002_0	1			1		05/24/2017	2018.03	05/24/2017 11:09:06 AM Eastern Daylight Time		05/24/2017 08:26:53 AM Eastern Daylight Time			05/24/2017 01:12:53 PM Eastern Daylight Time	THE WASHTENAW PACE	Huron Valley PACE	www.huronvalleypace.org	Huron Valley PACE - Medicare Only (PACE)	08	20		1			H4118	002	0	2018	Wash Co, Parts of Mon, Oak, Wayne & Livingston Co		2		2			2						http://www.hometownpharmacy.com/	http://huronvalleypace.org/										(855)483-7223		(734)572-5777		(855)483-7223		(734)572-5777										(800)649-3777		(800)649-3777		(800)649-3777		(800)649-3777																
H4141	003	0	1	01	01	H4141_003_0	3		1	1	2	05/30/2017	2018.03	05/30/2017 10:36:31 AM Eastern Daylight Time	08/04/2017 03:18:30 PM Eastern Daylight Time	08/04/2017 09:52:49 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H4141-003 (HMO SNP)	01	01		1			H4141	003	0	2018	Greater Georgia Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4141	004	0	1	01	01	H4141_004_0	2			1		08/03/2017	2018.03	08/03/2017 11:28:39 AM Eastern Daylight Time	08/04/2017 03:01:51 PM Eastern Daylight Time	08/04/2017 09:52:50 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Gold Plus H4141-004 (HMO)	01	01		1			H4141	004	0	2018	Greater Georgia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4141	015	0	1	01	01	H4141_015_0	3			1		08/03/2017	2018.03	08/03/2017 11:29:04 AM Eastern Daylight Time	08/04/2017 03:03:18 PM Eastern Daylight Time	08/04/2017 09:52:50 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Gold Plus H4141-015 (HMO)	01	01		1			H4141	015	0	2018	Atlanta Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;7a;7g;8a1;8b3;	
H4141	017	3	1	01	01	H4141_017_3	2			1		08/03/2017	2018.03	08/03/2017 11:29:37 AM Eastern Daylight Time	08/04/2017 03:08:42 PM Eastern Daylight Time	08/04/2017 09:52:51 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Gold Plus H4141-017 (HMO)	01	01		1			H4141	017	3	2018	Atlanta	Atlanta Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4700		(800)457-4700		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4141	017	4	1	01	01	H4141_017_4	3			1		05/31/2017	2018.03	05/31/2017 04:02:38 PM Eastern Daylight Time	08/04/2017 03:09:12 PM Eastern Daylight Time	08/04/2017 09:52:51 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Gold Plus H4141-017 (HMO)	01	01		1			H4141	017	4	2018	Atlanta	Atlanta	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4700		(800)457-4700		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4141	801	0	1	01	01	H4141_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:24:50 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4141	801	0	2018	Select counties in Georgia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4141	802	0	1	01	01	H4141_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:25:06 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4141	802	0	2018	Select counties in Georgia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4142	001	0	1	20	08	H4142_001_0	1			1		05/24/2017	2018.03	05/24/2017 08:03:58 AM Central Daylight Time		05/24/2017 07:57:41 AM Central Daylight Time			05/24/2017 08:18:10 AM Central Daylight Time	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	http://eldercare.cherokee.org	Cherokee Elder Care (PACE)	08	20		1			H4142	001	0	2018	Cherokee and surrounding counties		2		2			2						eldercare.cherokee.org	eldercare.cherokee.org										(800)256-0671	5554	(918)453-5554		(800)256-0671	5554	(918)453-5554										(800)256-0671	5554	(918)453-5554		(800)256-0671	5554	(918)453-5554																
H4142	002	0	1	20	08	H4142_002_0	1			1		05/24/2017	2018.03	05/24/2017 08:08:07 AM Central Daylight Time		05/24/2017 07:57:04 AM Central Daylight Time			05/24/2017 08:18:10 AM Central Daylight Time	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	http://eldercare.cherokee.org	Cherokee Elder Care (PACE)	08	20		1			H4142	002	0	2018	Cherokee and surrounding counties		2		2			2						eldercare.cherokee.org	eldercare.cherokee.org										(800)256-0671	5554	(918)453-5554		(800)256-0671	5554	(918)453-5554										(800)256-0671	5554	(918)453-5554		(800)256-0671	5554	(918)453-5554																
H4152	004	0	1	01	01	H4152_004_0	8			1		09/18/2017	2018.03	09/18/2017 04:02:28 PM Eastern Daylight Time	06/03/2017 07:34:50 PM Eastern Daylight Time				09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Core (HMO)	01	01		1			H4152	004	0	2018	State of Rhode Island		2	12658	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583										(711)-		(711)-		(711)-		(711)-										2					2					2	1	01	7a;	
H4152	005	0	1	01	01	H4152_005_0	11			1		09/18/2017	2018.03	09/18/2017 04:06:49 PM Eastern Daylight Time	08/01/2017 12:14:10 PM Eastern Daylight Time	08/01/2017 01:50:40 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Plus (HMO)	01	01		1			H4152	005	0	2018	State of Rhode Island		2	41856	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	007	0	1	02	01	H4152_007_0	12			1		09/18/2017	2018.03	09/18/2017 04:09:01 PM Eastern Daylight Time	08/01/2017 12:17:08 PM Eastern Daylight Time	08/01/2017 02:50:18 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Preferred (HMO-POS)	01	02		1			H4152	007	0	2018	State of Rhode Island		2	20664	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	013	0	1	01	01	H4152_013_0	11			1		09/18/2017	2018.03	09/18/2017 04:10:34 PM Eastern Daylight Time	08/01/2017 12:23:32 PM Eastern Daylight Time	08/01/2017 02:55:14 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Standard with Drugs (HMO)	01	01		1			H4152	013	0	2018	State of Rhode Island		2	79231	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	017	0	1	01	01	H4152_017_0	11			1		09/18/2017	2018.03	09/18/2017 04:15:13 PM Eastern Daylight Time	08/02/2017 11:49:20 AM Eastern Daylight Time	08/01/2017 02:59:12 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Advance (HMO)	01	01		1			H4152	017	0	2018	State of Rhode Island		2	103980	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4152	018	0	1	02	01	H4152_018_0	12			1		09/18/2017	2018.03	09/18/2017 04:17:17 PM Eastern Daylight Time	08/01/2017 12:29:20 PM Eastern Daylight Time	08/01/2017 03:07:40 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Extra (HMO-POS)	01	02		1			H4152	018	0	2018	State of Rhode Island		2	91376	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	019	1	1	02	01	H4152_019_1	12			1		09/18/2017	2018.03	09/18/2017 04:18:48 PM Eastern Daylight Time	08/01/2017 12:35:44 PM Eastern Daylight Time	08/01/2017 03:10:50 PM Eastern Daylight Time			09/20/2017 01:13:17 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Value (HMO-POS)	01	02		1			H4152	019	1	2018	State of Rhode Island	Bristol, Kent, Providence and Washington County	2	257426	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	019	2	1	02	01	H4152_019_2	11			1		09/18/2017	2018.03	09/18/2017 04:21:02 PM Eastern Daylight Time	08/01/2017 12:43:18 PM Eastern Daylight Time	08/01/2017 03:13:50 PM Eastern Daylight Time			09/20/2017 12:48:53 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Value (HMO-POS)	01	02		1			H4152	019	2	2018	State of Rhode Island	Newport County	2	18649	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H4152	815	0	1	02	01	H4152_815_0	5			1		06/01/2017	2018.03	06/01/2017 11:08:21 AM Eastern Daylight Time					06/05/2017 03:45:29 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Group Preferred (HMO-POS)	01	02		1			H4152	815	0	2018	RI, Bristol Cty MA, Partial New London Cty CT		1	35094	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;15;	2		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;15;	2		1				
H4152	817	0	1	01	01	H4152_817_0	5			1		06/01/2017	2018.03	06/01/2017 11:07:55 AM Eastern Daylight Time					06/05/2017 03:45:29 PM Eastern Daylight Time	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	www.BCBSRI.com/Medicare	BlueCHiP for Medicare Group Plus (HMO)	01	01		1			H4152	817	0	2018	RI, Bristol Cty MA, Partial New London Cty CT		1	7248	2			2						www.BCBSRI.com/Medicare	www.BCBSRI.com/Medicare	http://findadoctor.bcbsri.com/	(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(800)267-0439		(401)277-2958		(800)505-2583		(401)351-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14d;15;16b;17a;18a;	2		1					1				
H4172	001	0	1	01	01	H4172_001_0	4		1	1		08/07/2017	2018.03	08/07/2017 11:05:57 AM Central Daylight Time	08/07/2017 10:57:48 AM Central Daylight Time	08/07/2017 10:58:01 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	NHC ADVANTAGE, LLC	NHC Advantage (HMO SNP)	www.nhcadvantage-mo.com	NHC Advantage (HMO SNP)	01	01		1			H4172	001	0	2018	MO Counties: CAM, GRE, JAK, JAS, SCH & STL		2	1200	2			1	1	1				www.nhcadvantage-mo.com	www.nhcadvantage-mo.com	www.nhcadvantage-mo.com	(844)854-6886		(844)854-6886		(844)854-6886		(844)854-6886		(844)854-6886		(844)854-6886		(844)854-6886		(844)854-6886		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4198	001	0	1	01	01	H4198_001_0	5			1		07/20/2017	2018.03	07/20/2017 01:20:43 PM Central Daylight Time	06/05/2017 11:18:59 AM Central Daylight Time				07/20/2017 03:44:31 PM Central Daylight Time	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	CommunityCare Advantage Medicare Plan (HMO)	www.ccokadvantage.com	Advantage Choice (HMO)	01	01		1			H4198	001	0	2018	Tulsa Metro Area		2	6330	2			2						http://www.ccokadvantage.com	http://www.ccok.com/rxFormulary/?switch=7	www.ccokadvantage.com	(800)333-3275		(918)594-5202		(800)333-3275		(918)594-5202										(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353										2					2					2	2			
H4198	003	0	1	01	01	H4198_003_0	7			1		08/06/2017	2018.03	08/06/2017 02:54:17 PM Central Daylight Time	08/06/2017 02:52:04 PM Central Daylight Time	08/06/2017 02:52:05 PM Central Daylight Time			08/07/2017 11:09:05 AM Central Daylight Time	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	CommunityCare Advantage Medicare Plan (HMO)	www.ccokadvantage.com	Advantage Premier (HMO)	01	01		1			H4198	003	0	2018	Tulsa Metro Area		2	28379	2			2						http://www.ccokadvantage.com	http://www.ccok.com/rxFormulary/?switch=7	www.ccokadvantage.com	(800)333-3275		(918)594-5202		(800)333-3275		(918)594-5202		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5211		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H4198	005	0	1	01	01	H4198_005_0	5			1		08/06/2017	2018.03	08/06/2017 03:36:45 PM Central Daylight Time	08/06/2017 02:52:05 PM Central Daylight Time	08/06/2017 02:52:05 PM Central Daylight Time			08/07/2017 11:09:05 AM Central Daylight Time	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	CommunityCare Advantage Medicare Plan (HMO)	www.ccokadvantage.com	Advantage Choice Plus (HMO)	01	01		1			H4198	005	0	2018	Tulsa Metro Area		2	7081	2			2						http://www.ccokadvantage.com	http://www.ccok.com/rxFormulary/?switch=7	www.ccokadvantage.com	(800)333-3275		(918)594-5202		(800)333-3275		(918)594-5202		(877)293-8628		(918)594-5211		(877)293-8628		(918)594-5211		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		(800)722-0353		2					2					2	2			
H4203	001	0	1	20	08	H4203_001_0	1			1		05/24/2017	2018.03	05/24/2017 11:14:49 AM Eastern Daylight Time		05/24/2017 10:51:27 AM Eastern Daylight Time			05/24/2017 01:12:56 PM Eastern Daylight Time	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare PACE	Palmettohealth.org	Palmetto Health - Palmetto SeniorCare (PACE)	08	20		1			H4203	001	0	2018	Richland and  Lexington Counties		2	3386	2			2						N/A	n/a										(803)931-8175		(803)931-8175		(803)931-8175		(803)931-8175										(803)434-7000		(803)434-7000		(803)434-7000		(803)434-7000																
H4203	002	0	1	20	08	H4203_002_0	1			1		05/24/2017	2018.03	05/24/2017 11:02:34 AM Eastern Daylight Time		05/24/2017 10:51:45 AM Eastern Daylight Time			05/24/2017 01:12:56 PM Eastern Daylight Time	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare PACE	www.palmettohealth.org	Palmetto Health - Palmetto SeniorCare (PACE)	08	20		1			H4203	002	0	2018	Richland and Lexington Counties		2	78	2			2						N/A	n/a										(803)931-8175		(803)931-8175		(803)931-8175		(803)931-8175	245									(803)434-7000		(803)434-7000		(803)434-7000		(803)434-7000																
H4213	016	1	1	09	04	H4213_016_1	7			1		05/30/2017	2018.03	05/30/2017 11:27:20 AM Eastern Daylight Time	06/05/2017 05:14:33 PM Central Daylight Time				06/05/2017 06:18:04 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA (PFFS)	04	09	1	1			H4213	016	1	2018	State of Arkansas	Northern, Western and South Central AR counties	2	35066	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4213	016	3	1	09	04	H4213_016_3	5			1		05/30/2017	2018.03	05/30/2017 11:54:46 AM Eastern Daylight Time	06/05/2017 05:15:23 PM Central Daylight Time				06/05/2017 06:18:04 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA (PFFS)	04	09	1	1			H4213	016	3	2018	State of Arkansas	Northwest, Western and Central AR counties	2	12384	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4213	016	4	1	09	04	H4213_016_4	5			1		05/30/2017	2018.03	05/30/2017 11:53:59 AM Eastern Daylight Time	06/05/2017 05:16:13 PM Central Daylight Time				06/05/2017 06:18:04 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA (PFFS)	04	09	1	1			H4213	016	4	2018	State of Arkansas	East Central AR counties	2	18327	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4213	017	1	1	09	04	H4213_017_1	7			1		06/01/2017	2018.03	06/01/2017 02:18:33 PM Eastern Daylight Time	08/04/2017 07:46:57 AM Central Daylight Time	08/03/2017 03:10:54 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS)	04	09	1	1			H4213	017	1	2018	State of Arkansas	Northern, Western and South Central AR counties	2	66346	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4213	017	5	1	09	04	H4213_017_5	7			1		06/01/2017	2018.03	06/01/2017 02:19:17 PM Eastern Daylight Time	08/04/2017 07:47:40 AM Central Daylight Time	08/03/2017 03:11:23 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS)	04	09	1	1			H4213	017	5	2018	State of Arkansas	Northwest, Western and Central AR counties	2	31884	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4213	017	6	1	09	04	H4213_017_6	7			1		06/01/2017	2018.03	06/01/2017 02:19:46 PM Eastern Daylight Time	08/04/2017 07:48:23 AM Central Daylight Time	08/03/2017 03:11:52 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com/medicare	AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS)	04	09	1	1			H4213	017	6	2018	State of Arkansas	East Central AR counties	2	6777	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)233-7022		(877)233-7022		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4227	001	0	1	01	01	H4227_001_0	8		1	1	2	08/02/2017	2018.03	08/02/2017 09:02:33 AM Central Daylight Time	08/02/2017 11:06:21 AM Central Daylight Time	08/02/2017 11:03:49 AM Central Daylight Time			08/03/2017 01:36:25 PM Central Daylight Time	VISTA HEALTH PLAN, INC.	Vista Health Plan, Inc.	www.keystonevipchoice.com	Keystone VIP Choice (HMO SNP)	01	01		1			H4227	001	0	2018	Eastern Pennsylvania		2		2			1	3		1		1	www.keystonevipchoice.com	www.keystonevipchoice.com	www.keystonevipchoice.com	(800)450-1166		(800)450-1166		(855)241-3648		(855)241-3648		(800)450-1166		(800)450-1166		(855)241-3648		(855)241-3648		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4227	002	0	1	01	01	H4227_002_0	11		1	1	2	08/02/2017	2018.03	08/02/2017 09:03:06 AM Central Daylight Time	08/02/2017 12:39:29 PM Central Daylight Time	08/02/2017 11:04:26 AM Central Daylight Time			08/03/2017 01:36:25 PM Central Daylight Time	VISTA HEALTH PLAN, INC.	Vista Health Plan, Inc.	www.amerihealthvipcare.com	AmeriHealth VIP Care (HMO SNP)	01	01		1			H4227	002	0	2018	Eastern Pennsylvania		2		2			1	3		1		1	www.amerihealthvipcare.com	www.amerihealthvipcare.com	www.amerihealthvipcare.com	(866)533-5490		(866)533-5490		(855)241-3648		(855)241-3648		(866)533-5490		(866)533-5490		(855)241-3648		(855)241-3648		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4227	003	0	1	01	01	H4227_003_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 09:03:30 AM Central Daylight Time	08/02/2017 12:40:28 PM Central Daylight Time	08/02/2017 11:05:03 AM Central Daylight Time			08/03/2017 01:36:25 PM Central Daylight Time	VISTA HEALTH PLAN, INC.	Vista Health Plan, Inc.	www.amerihealthvipcare.com	AmeriHealth VIP Care (HMO SNP)	01	01		1			H4227	003	0	2018	Western Pennsylvania		2		2			1	3		1		1	www.amerihealthvipcare.com	www.amerihealthvipcare.com	www.amerihealthvipcare.com	(866)533-5490		(866)533-5490		(866)533-5490		(855)241-3648		(866)533-5490		(866)533-5490		(855)241-3648		(855)241-3648		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4235	001	0	1	20	08	H4235_001_0	5			1		06/02/2017	2018.03	06/02/2017 10:06:14 AM Eastern Daylight Time		06/05/2017 08:53:34 AM Eastern Daylight Time			06/05/2017 08:54:09 AM Eastern Daylight Time	SENIOR TOTAL LIFE CARE, INC.	Senior Total Life Care	www.seniorTLC.org	Senior Total Life Care Dual (PACE)	08	20		1			H4235	001	0	2018	Gaston County and Parts of Cleveland and Lincoln		2		2			2						www.seniortlc.org	www.seniorTLC.org	www.seniortlc.org									(855)327-7852		(704)874-0600		(855)327-7852		(704)874-0600										(704)874-3307		(704)874-3307		(704)874-3307		(704)874-3307																
H4235	002	0	1	20	08	H4235_002_0	5			1		06/02/2017	2018.03	06/02/2017 10:06:27 AM Eastern Daylight Time		06/05/2017 08:53:23 AM Eastern Daylight Time			06/05/2017 08:54:09 AM Eastern Daylight Time	SENIOR TOTAL LIFE CARE, INC.	Senior Total Life Care	www.seniorTLC.org	Senior Total Life Care Medicare (PACE)	08	20		1			H4235	002	0	2018	Gaston, Lincoln and Cleveland Counties in NC		2		2			2						www.seniortlc.org	www.seniorTLC.org	www.seniortlc.org									(855)327-7852		(704)874-0600		(855)327-7852		(704)874-0600										(704)874-3307		(704)874-3307		(704)874-3307		(704)874-3307																
H4236	001	0	1	01	01	H4236_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:06:03 AM Central Daylight Time	08/07/2017 10:57:48 AM Central Daylight Time	08/07/2017 10:58:01 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN PA, INC.	Spartan Plan PA, Inc.	www.sunriseadvantage.com	Spartan Plan PA I-SNP (HMO SNP)	01	01		1			H4236	001	0	2018	Pennsylvania (partial)		2	1008	2			1	1	3				www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4236	002	0	1	01	01	H4236_002_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:06:08 AM Central Daylight Time	08/07/2017 10:57:49 AM Central Daylight Time	08/07/2017 10:58:01 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN PA, INC.	Spartan Plan PA, Inc.	www.sunriseadvantage.com	Spartan Plan PA C-SNP (HMO SNP)	01	01		1			H4236	002	0	2018	Pennsylvania (partial)		2	2040	2			1	4			00000100000000000000		www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4236	003	0	1	01	01	H4236_003_0	4			1		08/07/2017	2018.03	08/07/2017 11:06:14 AM Central Daylight Time	08/07/2017 10:57:50 AM Central Daylight Time	08/07/2017 10:58:02 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN PA, INC.	Spartan Plan PA, Inc.	www.sunriseadvantage.com	Spartan Plan PA (HMO)	01	01		1			H4236	003	0	2018	Pennsylvania (partial)		2	2640	2			2						www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4262	001	1	1	09	04	H4262_001_1	4			2		05/31/2017	2018.03	05/31/2017 12:04:54 PM Eastern Daylight Time	06/05/2017 01:38:24 AM Eastern Daylight Time				06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service (PFFS)	04	09	1	1			H4262	001	1	2018	Michigan	Region 1	2	171	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4262	001	2	1	09	04	H4262_001_2	4			2		05/31/2017	2018.03	05/31/2017 12:05:12 PM Eastern Daylight Time	06/05/2017 01:39:28 AM Eastern Daylight Time				06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service (PFFS)	04	09	1	1			H4262	001	2	2018	Michigan	Region 2	2	245	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4262	001	3	1	09	04	H4262_001_3	4			2		05/31/2017	2018.03	05/31/2017 12:06:19 PM Eastern Daylight Time	06/05/2017 01:40:15 AM Eastern Daylight Time				06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service (PFFS)	04	09	1	1			H4262	001	3	2018	Michigan	Region 3	2	25	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4262	001	4	1	09	04	H4262_001_4	4			2		05/31/2017	2018.03	05/31/2017 12:05:47 PM Eastern Daylight Time	06/05/2017 01:41:01 AM Eastern Daylight Time				06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service (PFFS)	04	09	1	1			H4262	001	4	2018	Michigan	Region 4	2	122	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4262	001	6	1	09	04	H4262_001_6	4			2		05/31/2017	2018.03	05/31/2017 12:06:05 PM Eastern Daylight Time	06/05/2017 01:42:23 AM Eastern Daylight Time				06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service (PFFS)	04	09	1	1			H4262	001	6	2018	Michigan	Region 6	2	637	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4262	801	0	1	09	04	H4262_801_0	4			2		04/27/2017	2018.03	04/27/2017 01:47:15 PM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Blue Cross Medicare Private Fee for Service Emp CY (PFFS)	04	09	1	1			H4262	801	0	2018	State of Michigan		1	40	2			2								www.bcbsm.com/providersmedicare	(888)724-1373		(888)724-1373		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-										1					1					1				
H4279	001	0	1	01	01	H4279_001_0	6		1	1	2	08/03/2017	2018.03	08/03/2017 05:44:24 PM Eastern Daylight Time	08/02/2017 08:40:30 PM Eastern Daylight Time	08/01/2017 01:33:55 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC FOR YOU, INC	UPMC for You	www.upmchealthplan.com/snp	UPMC for Life Dual (HMO SNP)	01	01		1			H4279	001	0	2018	Pennsylvania		2	306388	2			1	3		1		1	http://www.upmchealthplan.com/snp/learn/plan-benefits/prescription-drug-coverage/	http://www.upmchealthplan.com/snp/learn/plan-benefits/prescription-drug-coverage/	http://www.upmchealthplan.com/snp	(800)606-8648		(800)606-8648		(866)405-8762		(866)405-8762		(800)606-8648		(800)606-8648		(866)405-8762		(866)405-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		(866)407-8762		2					2					2	2			
H4305	001	0	1	20	08	H4305_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:46:34 PM Central Daylight Time		05/24/2017 11:20:41 AM Central Daylight Time			05/24/2017 01:48:08 PM Central Daylight Time	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.stbernards.info/	Total Life Healthcare Dual (PACE)	08	20		1			H4305	001	0	2018	Counties: Craighead Cross Greene Law MS Poin Rand		2		2			2						n/a	n/a										(855)207-7500		(870)207-7500		(855)207-7500		(870)207-7500										(000)000-0000		(870)207-0527		(000)000-0000		(870)207-0527																
H4305	002	0	1	20	08	H4305_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:46:59 PM Central Daylight Time		05/24/2017 11:20:42 AM Central Daylight Time			05/24/2017 01:48:08 PM Central Daylight Time	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.stbernards.info/	Total Life Healthcare Medicare only (PACE)	08	20		1			H4305	002	0	2018	Counties:Craighead Cross Greene Law MS Poin Rand		2		2			2						n/a	n/a										(855)207-7500		(870)207-7500		(855)207-7500		(870)207-7500										(000)000-0000		(870)207-0527		(000)000-0000		(870)207-0527																
H4326	001	0	1	20	08	H4326_001_0	1			1		05/31/2017	2018.03	05/31/2017 04:01:10 PM Eastern Daylight Time		05/26/2017 10:18:32 AM Eastern Daylight Time			05/31/2017 04:03:26 PM Eastern Daylight Time	PACE @ HOME, INC.	PACE@Home	www.pace-at-home.org	PACE at Home - dual (PACE)	08	20		1			H4326	001	0	2018	Catawba Co. and Surrounding Select Zip Codes		2		2			2						www.holladaycare.com	www.pharmastarpbm.com										(828)468-3980		(828)468-3980		(828)468-3980		(828)468-3980										(828)468-3980		(828)468-3980		(828)468-3980		(828)468-3980																
H4326	002	0	1	20	08	H4326_002_0	1			1		05/31/2017	2018.03	05/31/2017 04:01:43 PM Eastern Daylight Time		05/26/2017 10:18:33 AM Eastern Daylight Time			05/31/2017 04:03:26 PM Eastern Daylight Time	PACE @ HOME, INC.	PACE@Home	www.pace-at-home.org	PACE at Home - medicare only (PACE)	08	20		1			H4326	002	0	2018	Catawba Co. and Surrounding Select Zip Codes		2		2			2						www.holladaycare.com	www.pharmastarpbm.com										(828)468-3980		(828)468-3980		(828)468-3980		(828)468-3980										(828)468-3980		(828)468-3980		(828)468-3980		(828)468-3980																
H4346	001	0	1	01	01	H4346_001_0	5			1		08/03/2017	2018.03	08/03/2017 01:49:08 PM Pacific Daylight Time	08/03/2017 03:13:32 PM Pacific Daylight Time	08/02/2017 12:35:25 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.caremore.com	Anthem Value Plus (HMO)	01	01		1			H4346	001	0	2018	Clark County		2	35036	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(800)822-6991		(800)822-6991		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	005	0	1	01	01	H4346_005_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:13:21 PM Pacific Daylight Time	08/03/2017 03:16:39 PM Pacific Daylight Time	08/02/2017 12:35:53 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.caremore.com	Anthem Breathe (HMO SNP)	01	01		1			H4346	005	0	2018	Clark County		2	7163	2			1	4			00000000000100000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(888)357-4166		(888)357-4166		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	006	0	1	01	01	H4346_006_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:13:43 PM Pacific Daylight Time	08/03/2017 03:15:53 PM Pacific Daylight Time	08/02/2017 12:36:20 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.caremore.com	Anthem Diabetes (HMO SNP)	01	01		1			H4346	006	0	2018	Clark County		2	23595	2			1	4			00000010000000000000		www.caremore.com	www.caremore.com	www.caremore.com	(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(888)357-4187		(888)357-4187		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	008	0	1	01	01	H4346_008_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:14:10 PM Pacific Daylight Time	08/03/2017 03:17:27 PM Pacific Daylight Time	08/02/2017 12:36:48 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem Heart (HMO SNP)	01	01		1			H4346	008	0	2018	Clark County		2	5845	2			1	4			00000000000000000010		www.caremore.com	www.caremore.com	www.caremore.com	(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(888)494-8280		(888)494-8280		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	009	0	1	01	01	H4346_009_0	5			1		08/03/2017	2018.03	08/03/2017 01:41:14 PM Pacific Daylight Time	08/03/2017 03:14:19 PM Pacific Daylight Time	08/02/2017 12:37:16 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.caremore.com	Anthem StartSmart Plus (HMO)	01	01		1			H4346	009	0	2018	Clark County		2	11242	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(800)822-8720		(800)822-8720		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	010	0	1	01	01	H4346_010_0	5		1	1		08/02/2017	2018.03	08/02/2017 05:15:00 PM Pacific Daylight Time	08/03/2017 03:15:06 PM Pacific Daylight Time	08/02/2017 12:37:43 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem Touch (HMO SNP)	01	01		1			H4346	010	0	2018	Clark County		2	8783	2			1	1	3				www.caremore.com	www.caremore.com	www.caremore.com	(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(800)589-3147		(800)589-3147		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	011	0	1	01	01	H4346_011_0	5			1		08/02/2017	2018.03	08/02/2017 05:15:12 PM Pacific Daylight Time	08/03/2017 03:06:30 PM Pacific Daylight Time	08/02/2017 12:38:10 PM Pacific Daylight Time			08/04/2017 04:30:09 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem Connect Plus (HMO)	01	01		1			H4346	011	0	2018	Anthem County		2	7128	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(888)426-5985		(888)426-5985		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	012	0	1	01	01	H4346_012_0	6			1		08/04/2017	2018.03	08/04/2017 02:10:17 PM Pacific Daylight Time	08/07/2017 05:55:26 AM Pacific Daylight Time	08/06/2017 12:05:41 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Plus (HMO)	01	01		1			H4346	012	0	2018	Denver Metro Area		2	17937	2			2						www.caremore.com	www.caremore.com	www.anthem.com/medicare	(888)346-0095		(888)346-0095		(800)797-1746		(800)797-1746		(888)346-0095		(888)346-0095		(800)261-8667		(800)261-8667		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	013	0	1	01	01	H4346_013_0	6			1		08/04/2017	2018.03	08/04/2017 02:17:27 PM Pacific Daylight Time	08/07/2017 05:55:27 AM Pacific Daylight Time	08/06/2017 12:05:42 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Plus (HMO)	01	01		1			H4346	013	0	2018	El Paso, Larimer, Pueblo and Weld Counties		2	6259	2			2						www.caremore.com	www.caremore.com	www.anthem.com/medicare	(888)346-0095		(888)346-0095		(800)797-1746		(800)797-1746		(888)346-0095		(888)346-0095		(800)261-8667		(800)261-8667		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	014	0	1	01	01	H4346_014_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 02:18:44 PM Pacific Daylight Time	08/07/2017 05:55:27 AM Pacific Daylight Time	08/06/2017 12:05:42 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H4346	014	0	2018	Greater Denver Area		2	7335	2			1	3		1			www.caremore.com	www.caremore.com	www.anthem.com/medicare	(888)346-0095		(888)346-0095		(800)797-1746		(800)797-1746		(888)346-0095		(888)346-0095		(800)261-8667		(800)261-8667		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	801	0	1	01	01	H4346_801_0	2			1		05/30/2017	2018.03	05/30/2017 10:34:03 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem EGWP (HMO)	01	01		1			H4346	801	0	2018	Nevada		1	65	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4346	802	0	1	01	01	H4346_802_0	2			1		05/30/2017	2018.03	05/30/2017 10:34:13 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem EGWP MAPD (HMO)	01	01		1			H4346	802	0	2018	Nevada		1	65	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	804	0	1	01	01	H4346_804_0	2			1		05/30/2017	2018.03	05/30/2017 10:34:31 AM Pacific Daylight Time					06/05/2017 06:32:31 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	caremore.com	Anthem EGWP MAPD (HMO)	01	01		1			H4346	804	0	2018	Nevada		1	40	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(855)295-7811		(855)295-7811		(866)622-2820		(866)622-2820		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4346	805	0	1	01	01	H4346_805_0	7			1		06/03/2017	2018.03	06/03/2017 01:08:14 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.anthem.com/co/medicare	Anthem MediBlue (HMO)	01	01		1			H4346	805	0	2018	Colorado - Select Counties		1	600	2			2						www.anthem.com/co/medicare	www.anthem.com/co/medicare	www.anthem.com/co/medicare	(866)362-4250		(866)362-4250		(877)826-1831		(877)826-1831		(866)362-4250		(866)362-4250		(877)826-1831		(877)826-1831		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H4346	806	0	1	02	01	H4346_806_0	7			1		06/03/2017	2018.03	06/03/2017 01:08:21 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	HMO of Colorado, Inc.	www.anthem.com/co/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H4346	806	0	2018	Colorado - Select Counties		1	600	2			2						www.anthem.com/co/medicare	www.anthem.com/co/medicare	www.anthem.com/co/medicare	(866)362-4250		(866)362-4250		(877)826-1831		(877)826-1831		(866)362-4250		(866)362-4250		(877)826-1831		(877)826-1831		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H4388	001	0	1	07	02	H4388_001_0	3			2		05/22/2017	2018.03	05/22/2017 09:55:52 AM Central Daylight Time			06/03/2017 12:42:38 PM Central Daylight Time		06/03/2017 05:33:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Secure Saver (MSA)	02	07	2	1			H4388	001	0	2018	Wisconsin statewide		2	68688	2			2						www.securityhealth.org/msapharmacies	www.securityhealth.org/securesaver	www.securityhealth.org/securesaver	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897										(711)-		(711)-		(711)-		(711)-																								
H4393	001	0	1	20	08	H4393_001_0	1			1		05/31/2017	2018.03	05/31/2017 12:58:45 PM Eastern Daylight Time		05/31/2017 12:40:17 PM Eastern Daylight Time			05/31/2017 01:13:43 PM Eastern Daylight Time	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	www.ArchCareSeniorLife.org	ArchCare Senior Life - Dual (PACE)	08	20		1			H4393	001	0	2018	New York, Bronx, and Richmond counties		2		2			2						www.archcare.org	www.archcare.org										(866)263-9083		(866)263-9083		(866)263-9083		(866)263-9083										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																
H4393	002	0	1	20	08	H4393_002_0	1			1		05/31/2017	2018.03	05/31/2017 12:58:55 PM Eastern Daylight Time		05/31/2017 12:40:41 PM Eastern Daylight Time			05/31/2017 01:13:43 PM Eastern Daylight Time	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	www.ArchCareSeniorLife.org	ArchCare Senior Life - Medicare only (PACE)	08	20		1			H4393	002	0	2018	New York, Bronx, and Richmond counties		2		2			2						www.archcare.org	www.archcare.org										(866)263-9083		(866)263-9083		(866)263-9083		(866)263-9083										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																
H4402	001	0	1	20	08	H4402_001_0	1			1		06/01/2017	2018.03	06/01/2017 11:45:04 AM Central Daylight Time		06/01/2017 10:23:38 AM Central Daylight Time			06/01/2017 11:48:14 AM Central Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	www.alexianpacetn.net	Alexian Brothers Community Services (PACE)	08	20		1			H4402	001	0	2018	Hamilton County Area		2		2			2						None	None										(800)441-8883		(423)698-0802		(800)441-8883		(423)698-0802										(800)848-0298		(800)848-0298		(800)848-0298		(800)848-0298																
H4402	002	0	1	20	08	H4402_002_0	1			1		06/01/2017	2018.03	06/01/2017 11:45:17 AM Central Daylight Time		06/01/2017 10:23:31 AM Central Daylight Time			06/01/2017 11:48:14 AM Central Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	www.alexianpacetn.net	Alexian Brothers Community Services (PACE)	08	20		1			H4402	002	0	2018	Hamilton County Area		2		2			2						None	None										(800)441-8883		(423)698-0802		(800)441-8883		(423)698-0802										(800)848-0298		(800)848-0298		(800)848-0298		(800)848-0298																
H4407	004	0	1	01	01	H4407_004_0	3		1	1	2	05/12/2017	2018.03	05/12/2017 03:36:14 PM Central Daylight Time	08/03/2017 10:27:20 AM Central Daylight Time	08/01/2017 02:07:52 PM Central Daylight Time			08/04/2017 03:29:28 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare SMS (HMO SNP)	01	01		1			H4407	004	0	2018	Select Mississippi Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4407	011	0	1	01	01	H4407_011_0	2			1		05/12/2017	2018.03	05/12/2017 03:36:50 PM Central Daylight Time	05/30/2017 02:33:18 PM Central Daylight Time				05/31/2017 10:14:22 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage SMS (HMO)	01	01		1			H4407	011	0	2018	Select Mississippi Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4407	025	1	1	01	01	H4407_025_1	3			1		08/02/2017	2018.03	08/02/2017 12:54:57 PM Central Daylight Time	08/03/2017 10:27:42 AM Central Daylight Time	08/01/2017 02:08:13 PM Central Daylight Time			08/04/2017 03:29:28 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred SMS (HMO)	01	01		1			H4407	025	1	2018	Select Mississippi Counties	Mississippi Preferred	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4407	025	2	1	01	01	H4407_025_2	3			1		08/02/2017	2018.03	08/02/2017 12:55:42 PM Central Daylight Time	08/03/2017 10:28:04 AM Central Daylight Time	08/01/2017 02:08:33 PM Central Daylight Time			08/04/2017 03:29:28 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred SMS (HMO)	01	01		1			H4407	025	2	2018	Select Mississippi Counties	Mississippi Preferred Select Counties	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	012	0	1	01	01	H4454_012_0	4			1		06/28/2017	2018.03	06/28/2017 09:12:43 PM Central Daylight Time	05/30/2017 08:58:39 AM Central Daylight Time				06/29/2017 05:24:38 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H4454	012	0	2018	Tennessee		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4454	020	0	1	01	01	H4454_020_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:12:54 PM Central Daylight Time	08/02/2017 01:25:01 PM Central Daylight Time	08/01/2017 02:09:10 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H4454	020	0	2018	Middle and West Tennessee		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	028	0	1	01	01	H4454_028_0	4			1		05/19/2017	2018.03	05/19/2017 03:40:22 PM Central Daylight Time	08/02/2017 01:25:22 PM Central Daylight Time	08/01/2017 02:09:32 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Primary (HMO)	01	01		1			H4454	028	0	2018	East Tennessee		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	030	0	1	02	01	H4454_030_0	4			1		08/02/2017	2018.03	08/02/2017 12:31:32 PM Central Daylight Time	08/02/2017 01:25:41 PM Central Daylight Time	08/01/2017 02:09:52 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier (HMO-POS)	01	02		1			H4454	030	0	2018	Tennessee		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	031	0	1	01	01	H4454_031_0	4			1		08/02/2017	2018.03	08/02/2017 12:32:18 PM Central Daylight Time	08/03/2017 11:56:27 AM Central Daylight Time	08/01/2017 02:10:12 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred KNX (HMO)	01	01		1			H4454	031	0	2018	Select Tennessee Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	033	0	1	01	01	H4454_033_0	4			1		08/02/2017	2018.03	08/02/2017 12:33:27 PM Central Daylight Time	08/02/2017 01:39:53 PM Central Daylight Time	08/01/2017 02:10:33 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred AR (HMO)	01	01		1			H4454	033	0	2018	Select Arkansas Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	034	0	1	01	01	H4454_034_0	5		1	1	2	08/02/2017	2018.03	08/02/2017 12:34:15 PM Central Daylight Time	08/02/2017 01:40:14 PM Central Daylight Time	08/01/2017 02:10:54 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare AR (HMO SNP)	01	01		1			H4454	034	0	2018	Select Arkansas Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	035	0	1	01	01	H4454_035_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:13:17 PM Central Daylight Time	08/02/2017 01:40:36 PM Central Daylight Time	08/01/2017 02:11:15 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare ETN (HMO SNP)	01	01		1			H4454	035	0	2018	East Tennessee		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	037	1	1	01	01	H4454_037_1	3			1		08/02/2017	2018.03	08/02/2017 12:36:31 PM Central Daylight Time	08/02/2017 01:40:58 PM Central Daylight Time	08/01/2017 02:11:35 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H4454	037	1	2018	Tennessee	Tennessee Preferred	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	037	2	1	01	01	H4454_037_2	3			1		08/04/2017	2018.03	08/04/2017 05:02:36 PM Central Daylight Time	08/03/2017 11:56:50 AM Central Daylight Time	08/01/2017 02:11:56 PM Central Daylight Time			08/04/2017 05:24:46 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H4454	037	2	2018	Tennessee	Tennessee Preferred Select Counties	2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(800)668-3813		(800)668-3813		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4454	805	0	1	01	01	H4454_805_0	2			1		05/22/2017	2018.03	05/22/2017 09:07:33 PM Central Daylight Time					06/02/2017 07:14:13 AM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H4454	805	0	2018	Tennessee, Mississippi, Illinois		1	14916	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H4454	809	0	1	02	01	H4454_809_0	2			1		05/23/2017	2018.03	05/23/2017 04:03:09 PM Central Daylight Time					06/02/2017 07:14:13 AM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier Rx CY (HMO-POS)	01	02		1			H4454	809	0	2018	Tennessee, Mississippi, Illinois		1	72	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1				
H4454	810	0	1	01	01	H4454_810_0	2			1		05/22/2017	2018.03	05/22/2017 09:11:32 PM Central Daylight Time					06/02/2017 07:14:13 AM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred FY (HMO)	01	01		1			H4454	810	0	2018	Tennessee, Mississippi, Illinois		1	948	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H4461	004	0	1	01	01	H4461_004_0	3			1		05/27/2017	2018.03	05/27/2017 01:53:04 PM Eastern Daylight Time	06/01/2017 06:15:56 PM Eastern Daylight Time				06/02/2017 08:36:33 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-004 (HMO)	01	01		1			H4461	004	0	2018	East Tennessee		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4461	022	0	1	01	01	H4461_022_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 04:19:21 PM Eastern Daylight Time	08/04/2017 02:01:07 PM Eastern Daylight Time	08/04/2017 09:52:52 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H4461-022 (HMO SNP)	01	01		1			H4461	022	0	2018	Greater Tennessee		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	025	0	1	01	01	H4461_025_0	3			1		06/01/2017	2018.03	06/01/2017 11:54:24 AM Eastern Daylight Time	08/04/2017 01:59:24 PM Eastern Daylight Time	08/04/2017 09:52:53 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-025 (HMO)	01	01		1			H4461	025	0	2018	Memphis Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	029	0	1	01	01	H4461_029_0	3			1		08/02/2017	2018.03	08/02/2017 02:27:24 PM Eastern Daylight Time	08/04/2017 02:02:58 PM Eastern Daylight Time	08/04/2017 09:52:53 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-029 (HMO)	01	01		1			H4461	029	0	2018	Nashville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	030	1	1	01	01	H4461_030_1	2			1		05/27/2017	2018.03	05/27/2017 01:55:35 PM Eastern Daylight Time	08/04/2017 02:05:22 PM Eastern Daylight Time	08/04/2017 09:52:54 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-030 (HMO)	01	01		1			H4461	030	1	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	030	2	1	01	01	H4461_030_2	2			1		05/27/2017	2018.03	05/27/2017 01:56:21 PM Eastern Daylight Time	08/04/2017 02:08:18 PM Eastern Daylight Time	08/04/2017 09:52:54 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-030 (HMO)	01	01		1			H4461	030	2	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	030	3	1	01	01	H4461_030_3	3			1		05/27/2017	2018.03	05/27/2017 01:57:12 PM Eastern Daylight Time	08/04/2017 02:10:27 PM Eastern Daylight Time	08/04/2017 09:52:55 AM Eastern Daylight Time			08/06/2017 10:16:27 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-030 (HMO)	01	01		1			H4461	030	3	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	031	1	1	01	01	H4461_031_1	4			1		05/27/2017	2018.03	05/27/2017 11:57:55 AM Eastern Daylight Time	08/04/2017 02:10:55 PM Eastern Daylight Time	08/04/2017 09:52:55 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-031 (HMO)	01	01		1			H4461	031	1	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	031	2	1	01	01	H4461_031_2	2			1		05/27/2017	2018.03	05/27/2017 11:58:50 AM Eastern Daylight Time	08/04/2017 02:11:22 PM Eastern Daylight Time	08/04/2017 09:52:56 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-031 (HMO)	01	01		1			H4461	031	2	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	031	3	1	01	01	H4461_031_3	3			1		05/27/2017	2018.03	05/27/2017 12:02:22 PM Eastern Daylight Time	08/04/2017 02:11:50 PM Eastern Daylight Time	08/04/2017 09:52:56 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-031 (HMO)	01	01		1			H4461	031	3	2018	East Tennessee	East Tennessee	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	034	0	1	01	01	H4461_034_0	2			1		08/02/2017	2018.03	08/02/2017 02:18:44 PM Eastern Daylight Time	08/04/2017 02:12:47 PM Eastern Daylight Time	08/04/2017 09:52:57 AM Eastern Daylight Time			08/06/2017 09:21:38 AM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Gold Plus H4461-034 (HMO)	01	01		1			H4461	034	0	2018	East Tennessee		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4461	806	0	1	01	01	H4461_806_0	3			1		06/13/2017	2018.03	06/13/2017 10:25:40 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4461	806	0	2018	Select counties in East Tennessee area		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4461	807	0	1	01	01	H4461_807_0	3			1		06/13/2017	2018.03	06/13/2017 10:26:50 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	CARITEN HEALTH PLAN INC.	Cariten Health Plan Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H4461	807	0	2018	Select counties in East Tennessee area		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4490	001	0	1	01	01	H4490_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 05:37:31 PM Central Daylight Time	08/07/2017 10:57:50 AM Central Daylight Time	08/07/2017 10:58:02 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	MISSOURI MEDICARE SELECT, LLC	Missouri Medicare Select (HMO SNP)	www.missourimedicareselect.com	Missouri Medicare Select (HMO SNP)	01	01		1			H4490	001	0	2018	MO Counties: CAS, JAK, LAF, SCH & STL		2	2280	2			1	1	1				www.missourimedicareselect.com	www.missourimedicareselect.com	www.missourimedicareselect.com	(844)228-7934		(844)228-7934		(844)228-7934		(844)228-7934		(844)228-7934		(844)228-7934		(844)228-7934		(844)228-7934		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4497	001	1	1	04	01	H4497_001_1	10			1		08/11/2017	2018.03	08/11/2017 08:08:19 AM Eastern Daylight Time	08/10/2017 11:46:30 AM Eastern Daylight Time	08/04/2017 01:39:06 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Select (PPO)	01	04		1			H4497	001	1	2018	Ohio Regions	Region 1	2	28812	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	001	2	1	04	01	H4497_001_2	9			1		08/11/2017	2018.03	08/11/2017 08:14:57 AM Eastern Daylight Time	08/10/2017 12:26:34 PM Eastern Daylight Time	08/04/2017 01:40:18 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Select (PPO)	01	04		1			H4497	001	2	2018	Ohio Regions	Region 2	2	5988	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	002	1	1	04	01	H4497_002_1	9			1		08/11/2017	2018.03	08/11/2017 08:13:55 AM Eastern Daylight Time	08/10/2017 12:28:08 PM Eastern Daylight Time	08/04/2017 01:41:34 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Preferred (PPO)	01	04		1			H4497	002	1	2018	Ohio Regions	Region 1	2	35340	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	002	2	1	04	01	H4497_002_2	9			1		08/11/2017	2018.03	08/11/2017 08:13:19 AM Eastern Daylight Time	08/10/2017 12:30:24 PM Eastern Daylight Time	08/04/2017 01:42:46 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Preferred (PPO)	01	04		1			H4497	002	2	2018	Ohio Regions	Region 2	2	6720	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	003	1	1	04	01	H4497_003_1	9			1		08/11/2017	2018.03	08/11/2017 08:12:43 AM Eastern Daylight Time	08/10/2017 12:32:02 PM Eastern Daylight Time	08/04/2017 01:43:58 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Premium (PPO)	01	04		1			H4497	003	1	2018	Ohio Regions	Region 1	2	36456	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	003	2	1	04	01	H4497_003_2	9			1		08/11/2017	2018.03	08/11/2017 08:12:21 AM Eastern Daylight Time	08/10/2017 12:33:34 PM Eastern Daylight Time	08/04/2017 01:45:10 PM Eastern Daylight Time			08/11/2017 09:05:36 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Premium (PPO)	01	04		1			H4497	003	2	2018	Ohio Regions	Region 2	2	5436	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4497	801	0	1	04	01	H4497_801_0	2			1		05/16/2017	2018.03	05/16/2017 10:05:11 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	medmutual.com/medicare	MedMutual Advantage EGWP (Calendar Year) (PPO)	01	04		1			H4497	801	0	2018	Ohio Regions		1	4800	2			2						medmutual.com/medicare	medmutual.com/medicare	medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1									
H4497	802	0	1	04	01	H4497_802_0	2			1		05/16/2017	2018.03	05/16/2017 10:05:23 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	medmutual.com/medicare	MedMutual Advantage EGWP (Non-Calendar Year) (PPO)	01	04		1			H4497	802	0	2018	Ohio Regions		1	1200	2			2						medmutual.com/medicare	medmutual.com/medicare	medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1									
H4497	803	0	1	04	01	H4497_803_0	2			1		05/16/2017	2018.03	05/16/2017 10:05:34 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	medmutual.com/medicare	MedMutual Advantage EGWP (MA-Only) (PPO)	01	04		1			H4497	803	0	2018	Ohio Regions		1	1200	2			2						medmutual.com/medicare	medmutual.com/medicare	medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1									
H4506	003	0	1	01	01	H4506_003_0	12			1		07/14/2017	2018.03	07/14/2017 04:59:40 PM Central Daylight Time	08/02/2017 11:22:42 AM Central Daylight Time	07/31/2017 03:29:16 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlus.com	TexanPlus Classic (HMO)	01	01		1			H4506	003	0	2018	Houston/Beaumont Area		2	792986	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4506	010	0	1	01	01	H4506_010_0	8			1		06/01/2017	2018.03	06/01/2017 02:14:44 PM Central Daylight Time	07/06/2017 02:45:32 PM Central Daylight Time				07/12/2017 09:40:19 AM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlus.com	TexanPlus Value (HMO)	01	01		1			H4506	010	0	2018	Houston/Beaumont Area		2	20059	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4506	029	0	1	02	01	H4506_029_0	11			1		08/02/2017	2018.03	08/02/2017 10:38:23 AM Central Daylight Time	08/02/2017 11:24:43 AM Central Daylight Time	07/31/2017 03:28:54 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlusPOS.com	TexanPlus Choice (HMO-POS)	01	02		1			H4506	029	0	2018	Houston/Beaumont Area		2	13804	2			2						www.TexanPlusPOS.com	www.TexanPlusPOS.com	www.TexanPlusPOS.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4506	801	0	1	01	01	H4506_801_0	1			1		05/28/2017	2018.03	05/28/2017 12:17:49 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlus.com	H4506 - Retiree - MA-PD non-CY (HMO)	01	01		1			H4506	801	0	2018	TexanPlus-Employer Group (MAPD nonCY)		1	300	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4506	806	0	1	01	01	H4506_806_0	1			1		05/28/2017	2018.03	05/28/2017 12:23:17 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlus.com	H4506 - Retiree - MA-PD CY (HMO)	01	01		1			H4506	806	0	2018	TexanPlus-Employer Group (MAPD CY)		1	8474	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4506	808	0	1	01	01	H4506_808_0	1			1		05/28/2017	2018.03	05/28/2017 12:18:26 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE OF TEXAS, INC.	Universal American Corp.	www.TexanPlus.com	H4506 - Retiree MA (HMO)	01	01		1			H4506	808	0	2018	TexanValue-Employer Group (MA Only)		1	300	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)230-2513		(866)230-2513		(866)556-4607		(866)556-4607										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4513	009	0	1	01	01	H4513_009_0	4			1		06/28/2017	2018.03	06/28/2017 09:20:35 PM Central Daylight Time	06/01/2017 11:06:59 AM Central Daylight Time				06/29/2017 05:24:38 PM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H4513	009	0	2018	Texas HealthSpring Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4513	010	0	1	01	01	H4513_010_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:20:27 PM Central Daylight Time	08/03/2017 09:10:57 AM Central Daylight Time	08/01/2017 02:12:35 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H4513	010	0	2018	Texas HealthSpring Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	025	0	1	01	01	H4513_025_0	4			1		08/05/2017	2018.03	08/05/2017 08:51:54 AM Central Daylight Time	08/05/2017 11:03:06 AM Central Daylight Time	08/01/2017 02:12:55 PM Central Daylight Time			08/06/2017 08:33:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H4513	025	0	2018	Texas HealthSpring Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	026	0	1	01	01	H4513_026_0	5			1		08/03/2017	2018.03	08/03/2017 08:03:49 AM Central Daylight Time	08/03/2017 09:11:40 AM Central Daylight Time	08/01/2017 02:13:14 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H4513	026	0	2018	North Texas		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	027	0	1	01	01	H4513_027_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 12:27:48 PM Central Daylight Time	08/03/2017 09:12:01 AM Central Daylight Time	08/01/2017 02:13:34 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H4513	027	0	2018	North Texas		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	028	0	1	01	01	H4513_028_0	4			1		08/02/2017	2018.03	08/02/2017 11:36:19 AM Central Daylight Time	08/03/2017 09:12:22 AM Central Daylight Time	08/01/2017 02:13:54 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H4513	028	0	2018	Select Texas Counties		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	029	0	1	01	01	H4513_029_0	4		1	1	2	05/27/2017	2018.03	05/27/2017 10:12:58 AM Central Daylight Time	08/03/2017 09:12:44 AM Central Daylight Time	08/01/2017 02:14:16 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H4513	029	0	2018	Select Texas Counties		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	030	0	1	01	01	H4513_030_0	3			1		06/01/2017	2018.03	06/01/2017 12:53:47 PM Central Daylight Time	08/02/2017 01:41:20 PM Central Daylight Time	08/01/2017 02:14:36 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred NGA (HMO)	01	01		1			H4513	030	0	2018	Northwest Georgia		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4513	804	0	1	01	01	H4513_804_0	3			1		05/22/2017	2018.03	05/22/2017 09:21:14 PM Central Daylight Time					06/02/2017 07:44:12 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H4513	804	0	2018	Texas		1	8484	2			2						www.cignahealthspring.com	www.cignahealthspring.com		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H4513	813	0	1	02	01	H4513_813_0	5			1		05/31/2017	2018.03	05/31/2017 11:08:14 AM Central Daylight Time					06/02/2017 07:44:12 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Premier Rx CY (HMO-POS)	01	02		1			H4513	813	0	2018	Texas		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;14e1;15;16b;17a;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1				
H4513	814	0	1	01	01	H4513_814_0	2			1		05/27/2017	2018.03	05/27/2017 10:22:23 AM Central Daylight Time					06/02/2017 07:44:12 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H4513	814	0	2018	Nationwide		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(888)281-7867		(888)281-7867		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H4514	001	0	1	01	01	H4514_001_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 12:59:30 PM Central Daylight Time	08/03/2017 01:53:08 PM Central Daylight Time	08/01/2017 10:46:18 AM Central Daylight Time			08/04/2017 01:02:46 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4514	001	0	2018	Houston and Austin Metro areas		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4514	007	0	1	01	01	H4514_007_0	3			1		08/02/2017	2018.03	08/02/2017 02:17:28 PM Central Daylight Time	08/03/2017 01:53:45 PM Central Daylight Time	08/01/2017 10:46:45 AM Central Daylight Time			08/04/2017 01:04:12 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H4514	007	0	2018	Houston area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4514	801	0	1	01	01	H4514_801_0	1			1		05/30/2017	2018.03	05/30/2017 11:50:52 AM Central Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	801	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H4514	803	0	1	01	01	H4514_803_0	1			1		05/24/2017	2018.03	05/24/2017 01:18:34 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	803	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H4514	806	0	1	01	01	H4514_806_0	1			1		05/24/2017	2018.03	05/24/2017 01:18:40 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	806	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H4517	001	0	1	20	08	H4517_001_0	3			1		05/22/2017	2018.03	05/22/2017 02:55:15 PM Central Daylight Time		05/23/2017 02:35:27 PM Central Daylight Time			05/23/2017 02:37:57 PM Central Daylight Time	AMARILLO MULTISVC CTR FR THE AGING INC	The Basics at Jan Werner	www.janwerneradultdaycare.org	DUAL ELIGIBLE (PACE)	08	20		1			H4517	001	0	2018	Potter, TX and Randall, TX Counties		2		2			2						N/A	N/A										(888)299-6401		(806)374-8400		(888)299-6401		(806)374-5516										(800)735-2989		(806)374-8400		(800)735-2989		(806)374-5516																
H4517	002	0	1	20	08	H4517_002_0	7			1		05/22/2017	2018.03	05/22/2017 02:55:29 PM Central Daylight Time		05/24/2017 07:58:22 AM Central Daylight Time			05/24/2017 08:00:28 AM Central Daylight Time	AMARILLO MULTISVC CTR FR THE AGING INC	The Basics at Jan Werner	www.janwerneradultdaycare.org	MEDICARE ONLY (PACE)	08	20		1			H4517	002	0	2018	Potter, TX and Randall, TX Counties		2		2			2						N/A	N/A										(888)299-6401		(806)374-8400		(888)299-6401		(806)374-5516										(800)735-2989		(806)374-8400		(800)735-2989		(806)374-5516																
H4518	001	0	1	20	08	H4518_001_0	1			1		05/24/2017	2018.03	05/24/2017 11:09:14 AM Mountain Daylight Time		05/24/2017 10:37:59 AM Mountain Daylight Time			05/24/2017 11:12:57 AM Mountain Daylight Time	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	BSHS Part D, Dual Eligibles (PACE)	08	20		1			H4518	001	0	2018	El Paso, Texas and El Paso County		2		2			2						www.bienvivir.org	www.bienvivir.org										(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801									(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801															
H4518	002	0	1	20	08	H4518_002_0	1			1		05/24/2017	2018.03	05/24/2017 11:09:29 AM Mountain Daylight Time		05/24/2017 10:36:20 AM Mountain Daylight Time			05/24/2017 11:12:57 AM Mountain Daylight Time	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	BSHS Part D, Medicare Only (PACE)	08	20		1			H4518	002	0	2018	El Paso, Texas and El Paso County		2		2			2						www.bienvivir.org	www.bienvivir.org										(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801									(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801	(915)562-3444	1801															
H4523	001	0	1	01	01	H4523_001_0	6			1		08/03/2017	2018.03	08/03/2017 03:57:43 PM Central Daylight Time	08/03/2017 04:40:06 PM Central Daylight Time	07/31/2017 04:44:30 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H4523	001	0	2018	South Central Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4523	015	0	1	01	01	H4523_015_0	4			1		08/02/2017	2018.03	08/02/2017 04:09:56 PM Central Daylight Time	08/03/2017 04:41:01 PM Central Daylight Time	07/31/2017 04:44:56 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H4523	015	0	2018	Southeast Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4523	020	0	1	01	01	H4523_020_0	4			1		08/02/2017	2018.03	08/02/2017 04:10:40 PM Central Daylight Time	08/03/2017 04:42:16 PM Central Daylight Time	07/31/2017 04:45:22 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H4523	020	0	2018	Bexar and Comal counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4523	021	0	1	01	01	H4523_021_0	5			1		08/02/2017	2018.03	08/02/2017 08:49:04 PM Central Daylight Time	08/03/2017 05:43:30 PM Eastern Daylight Time	08/08/2017 03:34:33 PM Eastern Daylight Time			08/10/2017 11:06:07 AM Eastern Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H4523	021	0	2018	Collin, Dallas, Denton, Parker,  Tarrant Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4523	024	0	1	01	01	H4523_024_0	4			1		08/03/2017	2018.03	08/03/2017 09:20:24 AM Central Daylight Time	08/03/2017 04:44:46 PM Central Daylight Time	07/31/2017 05:01:53 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (HMO)	01	01		1			H4523	024	0	2018	Harris, Montgomery, Fort Bend, Jefferson		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4523	801	0	1	01	01	H4523_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:31:40 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H4523	801	0	2018	Texas		1	720	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H4523	802	0	1	01	01	H4523_802_0	2			1		05/30/2017	2018.03	05/30/2017 11:31:55 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (TX)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H4523	802	0	2018	Texas		1	5840	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H4527	001	0	1	01	01	H4527_001_0	4			1		08/03/2017	2018.03	08/03/2017 10:42:00 AM Central Daylight Time	08/03/2017 01:32:47 PM Central Daylight Time	08/01/2017 10:47:11 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (HMO)	01	01		1			H4527	001	0	2018	Aransas, Kleberg, Nueces, San Patricio counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	002	0	1	01	01	H4527_002_0	4			1		08/03/2017	2018.03	08/03/2017 10:42:17 AM Central Daylight Time	08/03/2017 01:33:25 PM Central Daylight Time	08/01/2017 10:47:37 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (HMO)	01	01		1			H4527	002	0	2018	Hays, Travis, and Williamson counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	003	0	1	01	01	H4527_003_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 11:47:22 AM Central Daylight Time	08/03/2017 01:34:02 PM Central Daylight Time	08/01/2017 10:48:04 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete Focus (HMO SNP)	01	01		1			H4527	003	0	2018	Hays, Travis, and Williamson counties		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	004	0	1	01	01	H4527_004_0	3		1	1	2	05/25/2017	2018.03	05/25/2017 10:11:58 AM Central Daylight Time	08/03/2017 01:34:42 PM Central Daylight Time	08/01/2017 10:48:30 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete Focus (HMO SNP)	01	01		1			H4527	004	0	2018	Aransas, Kleberg, Nueces, San Patricio counties		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	005	0	1	01	01	H4527_005_0	4			1		08/03/2017	2018.03	08/03/2017 10:43:02 AM Central Daylight Time	08/03/2017 01:35:20 PM Central Daylight Time	08/01/2017 10:48:57 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (HMO)	01	01		1			H4527	005	0	2018	El Paso County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	006	0	1	01	01	H4527_006_0	3		1	1	2	05/25/2017	2018.03	05/25/2017 01:10:02 PM Central Daylight Time	08/03/2017 01:35:59 PM Central Daylight Time	08/01/2017 10:49:23 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete Focus (HMO SNP)	01	01		1			H4527	006	0	2018	El Paso County		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	013	0	1	01	01	H4527_013_0	4			1		08/03/2017	2018.03	08/03/2017 10:43:18 AM Central Daylight Time	08/03/2017 01:36:36 PM Central Daylight Time	08/01/2017 10:49:50 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus (HMO)	01	01		1			H4527	013	0	2018	Cameron, Hidalgo, and Willacy counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	015	0	1	01	01	H4527_015_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 11:47:33 AM Central Daylight Time	08/03/2017 01:37:14 PM Central Daylight Time	08/01/2017 10:50:16 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete Focus (HMO SNP)	01	01		1			H4527	015	0	2018	Cameron, Hidalgo, and Willacy counties		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(866)550-4736		(866)550-4736		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	024	0	1	01	01	H4527_024_0	2			1		05/05/2017	2018.03	05/05/2017 10:46:44 AM Central Daylight Time	06/01/2017 01:18:32 PM Central Daylight Time				07/06/2017 03:17:39 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Focus Essential (HMO)	01	01		1			H4527	024	0	2018	Select counties in Texas		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4527	037	0	1	01	01	H4527_037_0	5			1		08/03/2017	2018.03	08/03/2017 10:43:45 AM Central Daylight Time	08/03/2017 01:37:53 PM Central Daylight Time	08/01/2017 10:50:42 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H4527	037	0	2018	Houston Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(866)550-4736		(866)550-4736		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4527	801	0	1	01	01	H4527_801_0	1			1		05/25/2017	2018.03	05/25/2017 12:43:06 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4527	801	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4527	802	0	1	01	01	H4527_802_0	1			1		05/25/2017	2018.03	05/25/2017 12:43:20 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4527	802	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4527	803	0	1	01	01	H4527_803_0	1			1		05/25/2017	2018.03	05/25/2017 12:43:33 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4527	803	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4564	001	0	1	18	06	H4564_001_0	7			1		06/27/2017	2018.03	06/27/2017 11:13:35 AM Central Daylight Time		08/01/2017 07:48:08 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Premium - Basic Rx (Cost)	06	18		1			H4564	001	0	2018	Central Texas		2	81523	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	002	0	1	18	06	H4564_002_0	7			1		06/27/2017	2018.03	06/27/2017 11:15:20 AM Central Daylight Time		08/01/2017 08:11:50 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Preferred - Basic Rx (Cost)	06	18		1			H4564	002	0	2018	Central Texas		2	74247	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	004	0	1	18	06	H4564_004_0	7			1		06/27/2017	2018.03	06/27/2017 11:17:42 AM Central Daylight Time		08/01/2017 08:26:32 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	http://seniorcare.swhp.org	SeniorCare Sr Premium - Enhanced Rx (Cost)	06	18		1			H4564	004	0	2018	Central Texas		2	24957	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	005	0	1	18	06	H4564_005_0	7			1		06/27/2017	2018.03	06/27/2017 11:18:54 AM Central Daylight Time		08/01/2017 08:28:10 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Preferred - Enhanced Rx (Cost)	06	18		1			H4564	005	0	2018	Central Texas		2	3642	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	010	0	1	18	06	H4564_010_0	6			1		06/27/2017	2018.03	06/27/2017 11:20:26 AM Central Daylight Time					06/27/2017 12:35:16 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Premium (Cost)	06	18		1			H4564	010	0	2018	Central Texas		2	27956	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356										(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989										2					2					2	2			
H4564	011	0	1	18	06	H4564_011_0	6			1		06/27/2017	2018.03	06/27/2017 11:21:41 AM Central Daylight Time					06/27/2017 12:35:16 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Preferred (Cost)	06	18		1			H4564	011	0	2018	Central Texas		2	53467	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356										(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989										2					2					2	2			
H4564	012	0	1	18	06	H4564_012_0	6			1		06/02/2017	2018.03	06/02/2017 11:19:47 AM Central Daylight Time					06/27/2017 12:35:16 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Select (Cost)	06	18		1			H4564	012	0	2018	Central Texas		2	67090	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356										(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989										2					2					2	2			
H4564	015	0	1	18	06	H4564_015_0	7			1		06/02/2017	2018.03	06/02/2017 01:04:12 PM Central Daylight Time		08/01/2017 08:35:42 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr Select - Value Rx (Cost)	06	18		1			H4564	015	0	2018	Central Texas		2	13587	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	016	0	1	18	06	H4564_016_0	6			1		06/27/2017	2018.03	06/27/2017 11:22:47 AM Central Daylight Time					06/27/2017 12:35:16 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr VIP (Cost)	06	18		1			H4564	016	0	2018	Central Texas		2	4375	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356										(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989										2					2					2	2			
H4564	017	0	1	18	06	H4564_017_0	7			1		06/27/2017	2018.03	06/27/2017 11:23:49 AM Central Daylight Time		08/01/2017 08:33:56 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr VIP - Basic Rx (Cost)	06	18		1			H4564	017	0	2018	Central Texas		2	7140	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	018	0	1	18	06	H4564_018_0	7			1		06/27/2017	2018.03	06/27/2017 11:24:51 AM Central Daylight Time		08/01/2017 08:31:52 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare Sr VIP - Enhanced Rx (Cost)	06	18		1			H4564	018	0	2018	Central Texas		2	564	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H4564	801	0	1	18	06	H4564_801_0	5			1		05/22/2017	2018.03	05/22/2017 03:11:00 PM Central Daylight Time					06/05/2017 06:17:26 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	seniorcare.swhp.org	SeniorCare EGWP (Cost)	06	18		1			H4564	801	0	2018	Central Texas		1	0	2			2						www.swhp.org	www.swhp.org		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989																
H4590	010	0	1	01	01	H4590_010_0	4			1		08/02/2017	2018.03	08/02/2017 02:26:02 PM Central Daylight Time	08/03/2017 02:01:46 PM Central Daylight Time	08/01/2017 10:51:08 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H4590	010	0	2018	San Antonio Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	012	0	1	01	01	H4590_012_0	4			1		08/02/2017	2018.03	08/02/2017 02:26:19 PM Central Daylight Time	08/03/2017 02:02:26 PM Central Daylight Time	08/01/2017 10:51:34 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H4590	012	0	2018	Dallas/Fort Worth Metroplex		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	020	0	1	01	01	H4590_020_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:41:22 AM Central Daylight Time	08/03/2017 02:03:15 PM Central Daylight Time	08/01/2017 10:52:01 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	020	0	2018	Dallas/Ft Worth Metroplex		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	022	0	1	01	01	H4590_022_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:41:48 AM Central Daylight Time	08/03/2017 02:03:58 PM Central Daylight Time	08/01/2017 10:52:28 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	022	0	2018	San Antonio metro area		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	025	0	1	01	01	H4590_025_0	4			1		08/02/2017	2018.03	08/02/2017 02:26:52 PM Central Daylight Time	08/03/2017 02:04:41 PM Central Daylight Time	08/01/2017 10:52:54 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H4590	025	0	2018	Nueces and San Patricio counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	027	0	1	01	01	H4590_027_0	2			1		05/25/2017	2018.03	05/25/2017 08:54:22 AM Central Daylight Time	06/01/2017 01:19:55 PM Central Daylight Time				07/06/2017 03:17:39 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H4590	027	0	2018	Dallas/Ft Worth Metroplex		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4590	029	0	1	01	01	H4590_029_0	2			1		05/07/2017	2018.03	05/07/2017 07:39:16 PM Central Daylight Time	06/01/2017 01:20:29 PM Central Daylight Time				07/06/2017 03:17:39 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H4590	029	0	2018	San Antonio area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4590	033	0	1	01	01	H4590_033_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:42:22 AM Central Daylight Time	08/03/2017 02:05:17 PM Central Daylight Time	08/01/2017 10:53:21 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	033	0	2018	Corpus Christi metro area		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(866)846-2762		(866)846-2762		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	037	0	1	01	01	H4590_037_0	4		1	1		08/02/2017	2018.03	08/02/2017 02:27:17 PM Central Daylight Time	08/03/2017 02:05:55 PM Central Daylight Time	08/01/2017 10:53:47 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Chronic Complete (HMO SNP)	01	01		1			H4590	037	0	2018	San Antonio Metro Area		2		2			1	4			00011010000000000000		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)846-2762		(866)846-2762		(800)555-5757		(800)555-5757		(866)846-2762		(866)846-2762		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	041	0	1	01	01	H4590_041_0	5			1		06/28/2017	2018.03	06/28/2017 10:16:33 AM Central Daylight Time	08/03/2017 02:06:33 PM Central Daylight Time	08/01/2017 10:54:13 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H4590	041	0	2018	Dallas/Ft Worth Metroplex		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	042	0	1	01	01	H4590_042_0	5			1		08/02/2017	2018.03	08/02/2017 02:28:06 PM Central Daylight Time	08/03/2017 02:07:13 PM Central Daylight Time	08/01/2017 10:54:39 AM Central Daylight Time			08/04/2017 02:48:24 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete (HMO)	01	01		1			H4590	042	0	2018	Select Counties in Texas		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(800)950-9355		(800)950-9355		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4590	801	0	1	01	01	H4590_801_0	1			1		05/25/2017	2018.03	05/25/2017 12:44:01 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	801	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4590	803	0	1	01	01	H4590_803_0	2			1		06/08/2017	2018.03	06/08/2017 11:36:56 AM Central Daylight Time					06/13/2017 05:00:01 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	803	0	2018	TX Employer Sponsored Plan Service Area		1	21996	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4590	804	0	1	01	01	H4590_804_0	1			1		05/25/2017	2018.03	05/25/2017 12:44:47 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	804	0	2018	TX Employer Sponsored Plan Service Area		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H4604	003	0	1	01	01	H4604_003_0	3			1		05/26/2017	2018.03	05/26/2017 01:56:47 PM Central Daylight Time	08/03/2017 02:08:07 PM Central Daylight Time	08/01/2017 10:55:05 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H4604	003	0	2018	Select Counties in Utah		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4604	005	0	1	01	01	H4604_005_0	2			1		05/05/2017	2018.03	05/05/2017 01:25:41 PM Central Daylight Time	06/01/2017 12:28:54 PM Central Daylight Time				07/06/2017 03:17:29 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H4604	005	0	2018	Select Counties in Utah		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H4604	011	0	1	01	01	H4604_011_0	3			1		08/02/2017	2018.03	08/02/2017 03:03:07 PM Central Daylight Time	08/03/2017 02:08:46 PM Central Daylight Time	08/01/2017 10:55:31 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H4604	011	0	2018	Select Counties in Utah		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4604	012	0	1	01	01	H4604_012_0	4			1		05/25/2017	2018.03	05/25/2017 11:22:33 AM Central Daylight Time	08/03/2017 02:09:22 PM Central Daylight Time	08/01/2017 10:55:57 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H4604	012	0	2018	Ada, Canyon, Gem, and Payette Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4604	013	0	1	01	01	H4604_013_0	4			1		05/25/2017	2018.03	05/25/2017 11:22:43 AM Central Daylight Time	08/03/2017 02:10:00 PM Central Daylight Time	08/01/2017 10:56:23 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H4604	013	0	2018	Bonner and Kootenai Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4604	014	0	1	01	01	H4604_014_0	4			1		05/25/2017	2018.03	05/25/2017 03:31:55 PM Central Daylight Time	08/03/2017 02:10:38 PM Central Daylight Time	08/01/2017 10:56:50 AM Central Daylight Time			08/04/2017 01:19:32 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H4604	014	0	2018	Bannock, Bonneville, and Twin Falls Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4604	801	0	1	01	01	H4604_801_0	2			1		06/08/2017	2018.03	06/08/2017 11:45:53 AM Central Daylight Time					06/13/2017 05:01:21 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	801	0	2018	Salt Lake and Surrounding Counties		1	2616	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H4604	803	0	1	01	01	H4604_803_0	1			1		05/24/2017	2018.03	05/24/2017 01:34:57 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	803	0	2018	Select Counties In UT		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H4604	805	0	1	01	01	H4604_805_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:03 PM Pacific Daylight Time					06/01/2017 04:29:50 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	805	0	2018	Select counties in UT		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H4605	001	0	1	04	01	H4605_001_0	8			1		07/07/2017	2018.03	07/07/2017 01:13:13 PM Mountain Daylight Time	06/04/2017 08:21:21 PM Mountain Daylight Time				07/10/2017 11:30:50 AM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UTAH	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H4605	001	0	2018	Davis, Salt Lake, Utah, and Weber counties		2	5759	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H4605	002	0	1	04	01	H4605_002_0	9			1		07/07/2017	2018.03	07/07/2017 01:13:50 PM Mountain Daylight Time	08/04/2017 05:01:25 PM Mountain Daylight Time	08/01/2017 06:51:46 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UTAH	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H4605	002	0	2018	Davis, Salt Lake, Utah, and Weber counties		2	66077	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4605	004	0	1	04	01	H4605_004_0	8			1		05/11/2017	2018.03	05/11/2017 02:25:47 PM Mountain Daylight Time	08/04/2017 05:02:58 PM Mountain Daylight Time	08/01/2017 06:52:44 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UTAH	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H4605	004	0	2018	Davis, Salt Lake, Utah, and Weber counties		2	22998	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4605	801	0	1	04	01	H4605_801_0	3			1		05/15/2017	2018.03	05/15/2017 03:17:07 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UTAH	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H4605	801	0	2018	Nationwide except territories		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H4605	802	0	1	04	01	H4605_802_0	3			1		05/15/2017	2018.03	05/15/2017 03:17:27 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UTAH	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H4605	802	0	2018	Nationwide except territories		1	2561	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H4714	001	0	1	20	08	H4714_001_0	1			1		06/01/2017	2018.03	06/01/2017 02:30:22 PM Eastern Daylight Time		06/01/2017 02:20:28 PM Eastern Daylight Time			06/01/2017 02:50:45 PM Eastern Daylight Time	PACE OF THE SOUTHERN PIEDMONT, INC.	PACE of the Southern Piedmont, Inc.	www.pacesp.com	PACE of  the Southern Piedmont - Dual (PACE)	08	20		1			H4714	001	0	2018	PACE of  the Southern Piedmont - Dual		2		2			2						www.seniorscript.com	Not applicable										(704)887-3840		(704)887-3840		(704)887-3840		(704)887-3840										(704)887-3840		(704)887-3840		(704)887-3840		(704)887-3840																
H4714	002	0	1	20	08	H4714_002_0	1			1		06/01/2017	2018.03	06/01/2017 02:30:52 PM Eastern Daylight Time		06/01/2017 02:21:35 PM Eastern Daylight Time			06/01/2017 02:50:45 PM Eastern Daylight Time	PACE OF THE SOUTHERN PIEDMONT, INC.	PACE of the Southern Piedmont, Inc.	www.pacesp.com	PACE of  the Southern Piedmont - Medicare only (PACE)	08	20		1			H4714	002	0	2018	PACE of  the Southern Piedmont - Medicare only		2		2			2						www.seniorscript.com	Not applicable										(704)887-3840		(704)887-3840		(704)887-3840		(704)887-3840										(704)887-3840		(704)887-3840		(704)887-3840		(704)887-3840																
H4754	004	0	1	04	01	H4754_004_0	8			1		07/18/2017	2018.03	07/18/2017 05:22:24 PM Pacific Daylight Time	08/04/2017 08:42:36 AM Pacific Daylight Time	08/01/2017 01:31:48 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 4 (PPO)	01	04		1			H4754	004	0	2018	Lane County		2	7144	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2						2			
H4754	006	0	1	04	01	H4754_006_0	4			1		07/18/2017	2018.03	07/18/2017 05:22:46 PM Pacific Daylight Time	07/10/2017 11:17:11 AM Pacific Daylight Time				07/19/2017 03:45:00 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 6 (PPO)	01	04		1			H4754	006	0	2018	Southwestern Idaho		2	13689	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2						2			
H4754	007	0	1	04	01	H4754_007_0	7			1		07/18/2017	2018.03	07/18/2017 05:23:07 PM Pacific Daylight Time	08/04/2017 08:42:37 AM Pacific Daylight Time	08/01/2017 01:32:16 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 7 (PPO)	01	04		1			H4754	007	0	2018	Coos and Curry Counties		2	6030	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2						2			
H4754	008	0	1	04	01	H4754_008_0	4			1		07/18/2017	2018.03	07/18/2017 05:23:28 PM Pacific Daylight Time	07/10/2017 11:17:11 AM Pacific Daylight Time				07/19/2017 03:45:00 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 8 (PPO)	01	04		1			H4754	008	0	2018	Coos, Curry and Lane Counties		2	2987	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)225-3771		(888)863-3637		(541)225-3771										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2						2			
H4754	009	0	1	04	01	H4754_009_0	7			1		07/18/2017	2018.03	07/18/2017 05:23:49 PM Pacific Daylight Time	08/04/2017 08:42:38 AM Pacific Daylight Time	08/01/2017 01:32:44 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 9 (PPO)	01	04		1			H4754	009	0	2018	Eastern Idaho		2	43120	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2						2			
H4754	011	0	1	04	01	H4754_011_0	7			1		07/18/2017	2018.03	07/18/2017 05:24:10 PM Pacific Daylight Time	08/04/2017 08:42:24 AM Pacific Daylight Time	08/01/2017 01:33:14 PM Pacific Daylight Time			08/04/2017 08:48:01 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 11 (PPO)	01	04		1			H4754	011	0	2018	Northern Idaho		2	71016	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2						2			
H4754	012	0	1	04	01	H4754_012_0	4			1		07/18/2017	2018.03	07/18/2017 05:24:39 PM Pacific Daylight Time	07/10/2017 11:17:10 AM Pacific Daylight Time				07/19/2017 03:45:00 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 12 (PPO)	01	04		1			H4754	012	0	2018	Northern and Eastern Idaho		2	11090	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(208)433-4612		(888)863-3637		(208)433-4612										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										2					2						2			
H4754	801	0	1	04	01	H4754_801_0	2			1		06/14/2017	2018.03	06/14/2017 08:10:32 AM Pacific Daylight Time					06/14/2017 02:07:24 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 801 (PPO)	01	04		1			H4754	801	0	2018	Statewide - Oregon, Idaho, Montana and Washington		1	1200	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315										(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900										1	1	1a;1b;2;5;6;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1									
H4754	802	0	1	04	01	H4754_802_0	2			1		06/14/2017	2018.03	06/14/2017 08:10:47 AM Pacific Daylight Time					06/14/2017 02:07:24 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 802 (PPO)	01	04		1			H4754	802	0	2018	Statewide - Oregon, Idaho, Montana and Washington		1	1200	2			2						https://medicare.pacificsource.com/Search/Pharmacy	https://medicare.pacificsource.com/Search/Drug	https://medicare.pacificsource.com/Search/Provider	(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(888)863-3637		(541)385-5315		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		1	1	1a;1b;2;5;6;7c;7d;7g;7i;8a;8b1;8b2;8b3;9a;9b;10a;11a;11b;15;	2		1									
H4778	001	0	1	01	01	H4778_001_0	3		1	1		08/04/2017	2018.03	08/04/2017 05:48:15 PM Central Daylight Time	08/07/2017 10:57:51 AM Central Daylight Time	08/07/2017 10:58:02 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN IL, INC.	Spartan Plan IL, Inc.	www.sunriseadvantage.com	Spartan Plan IL I-SNP (HMO SNP)	01	01		1			H4778	001	0	2018	Illinois (partial)		2	1320	2			1	1	3				www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4778	002	0	1	01	01	H4778_002_0	3		1	1		08/04/2017	2018.03	08/04/2017 05:48:39 PM Central Daylight Time	08/07/2017 10:57:52 AM Central Daylight Time	08/07/2017 10:58:03 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN IL, INC.	Spartan Plan IL, Inc.	www.sunriseadvantage.com	Spartan Plan IL C-SNP (HMO SNP)	01	01		1			H4778	002	0	2018	Illinois (partial)		2	3240	2			1	4			00000100000000000000		www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4778	003	0	1	01	01	H4778_003_0	4			1		08/04/2017	2018.03	08/04/2017 05:48:56 PM Central Daylight Time	08/07/2017 10:57:53 AM Central Daylight Time	08/07/2017 10:58:03 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN IL, INC.	Spartan Plan IL, Inc.	www.sunriseadvantage.com	Spartan Plan IL (HMO)	01	01		1			H4778	003	0	2018	Illinois (partial)		2	1560	2			2						www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4853	001	0	1	01	01	H4853_001_0	7			1		08/04/2017	2018.03	08/04/2017 02:19:22 PM Central Daylight Time	08/03/2017 11:54:47 AM Central Daylight Time	08/03/2017 11:32:06 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH COMPANY OF ARIZONA	Bright Health	http://www.brighthealthplan.com/	Bright Advantage (HMO)	01	01		1			H4853	001	0	2018	Maricopa County		2	55680	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		2					2					2	2			
H4853	002	0	1	01	01	H4853_002_0	6			1		08/04/2017	2018.03	08/04/2017 02:20:50 PM Central Daylight Time	08/03/2017 11:54:51 AM Central Daylight Time	08/03/2017 11:32:10 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH COMPANY OF ARIZONA	Bright Health	http://www.brighthealthplan.com/	Bright Advantage Plus (HMO)	01	01		1			H4853	002	0	2018	Maricopa County		2	13920	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		(844)202-4463		(844)202-4463		(844)679-2028		(844)679-2028		2					2					2	2			
H4868	001	0	1	01	01	H4868_001_0	4			1		08/02/2017	2018.03	08/02/2017 03:36:35 PM Central Daylight Time	08/04/2017 08:36:25 AM Central Daylight Time	07/31/2017 03:28:18 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	HERITAGE HEALTH SYSTEMS OF NEW YORK, INC.	Today's Options of New York	www.TodaysOptionsNY.com	Today's Options Classic (HMO)	01	01		1			H4868	001	0	2018	Select counties in NY		2	4196	2			2						http://www.TodaysOptionsNY.com	http://www.TodaysOptionsNY.com	www.TodaysOptionsNY.com	(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(866)422-5009		(866)422-5009		(866)422-1967		(866)422-1967		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4875	016	1	1	04	01	H4875_016_1	4			1		08/04/2017	2018.03	08/04/2017 11:23:34 AM Eastern Daylight Time	08/04/2017 12:02:24 PM Eastern Daylight Time	08/01/2017 11:09:12 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Merit (PPO)	01	04		1			H4875	016	1	2018	68 lower peninsula Michigan counties	Region 3	2	44285	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	016	2	1	04	01	H4875_016_2	4			1		08/04/2017	2018.03	08/04/2017 11:04:30 AM Eastern Daylight Time	08/04/2017 12:03:08 PM Eastern Daylight Time	08/01/2017 11:09:40 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Merit (PPO)	01	04		1			H4875	016	2	2018	68 lower peninsula Michigan counties	Region 4	2	21808	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	016	3	1	04	01	H4875_016_3	4			1		08/04/2017	2018.03	08/04/2017 11:04:55 AM Eastern Daylight Time	08/04/2017 12:03:54 PM Eastern Daylight Time	08/01/2017 11:10:10 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Merit (PPO)	01	04		1			H4875	016	3	2018	68 lower peninsula Michigan counties	Region 5	2	48433	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	016	4	1	04	01	H4875_016_4	4			1		08/04/2017	2018.03	08/04/2017 11:05:21 AM Eastern Daylight Time	08/04/2017 12:04:38 PM Eastern Daylight Time	08/01/2017 11:10:36 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Merit (PPO)	01	04		1			H4875	016	4	2018	68 lower peninsula Michigan counties	Region 1	2	135903	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	016	5	1	04	01	H4875_016_5	4			1		08/04/2017	2018.03	08/04/2017 11:05:51 AM Eastern Daylight Time	08/04/2017 12:05:24 PM Eastern Daylight Time	08/01/2017 11:11:04 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Merit (PPO)	01	04		1			H4875	016	5	2018	68 lower peninsula Michigan counties	Region 2	2	76377	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	017	1	1	04	01	H4875_017_1	4			1		07/20/2017	2018.03	07/20/2017 11:25:01 AM Eastern Daylight Time	08/04/2017 12:06:08 PM Eastern Daylight Time	08/01/2017 11:11:32 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	017	1	2018	68 lower peninsula Michigan counties	Region 1	2	28647	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	017	2	1	04	01	H4875_017_2	4			1		07/20/2017	2018.03	07/20/2017 01:00:35 PM Eastern Daylight Time	08/04/2017 12:06:56 PM Eastern Daylight Time	08/01/2017 11:12:00 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	017	2	2018	68 lower peninsula Michigan counties	Region 2	2	14013	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	017	3	1	04	01	H4875_017_3	4			1		07/20/2017	2018.03	07/20/2017 01:01:40 PM Eastern Daylight Time	08/04/2017 12:07:42 PM Eastern Daylight Time	08/01/2017 11:12:28 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	017	3	2018	68 lower peninsula Michigan counties	Region 3	2	9434	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	017	4	1	04	01	H4875_017_4	4			1		07/20/2017	2018.03	07/20/2017 01:02:38 PM Eastern Daylight Time	08/04/2017 12:08:28 PM Eastern Daylight Time	08/01/2017 11:12:56 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	017	4	2018	68 lower peninsula Michigan counties	Region 4	2	4244	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	017	5	1	04	01	H4875_017_5	4			1		07/20/2017	2018.03	07/20/2017 01:03:43 PM Eastern Daylight Time	08/04/2017 12:09:12 PM Eastern Daylight Time	08/01/2017 11:13:24 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	017	5	2018	68 lower peninsula Michigan counties	Region 5	2	7245	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	018	1	1	04	01	H4875_018_1	6			1		08/04/2017	2018.03	08/04/2017 11:15:00 AM Eastern Daylight Time	08/04/2017 12:09:58 PM Eastern Daylight Time	08/01/2017 11:13:52 AM Eastern Daylight Time			08/07/2017 04:18:09 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Ideal (PPO)	01	04		1			H4875	018	1	2018	68 lower peninsula Michigan counties	Region 1	2	4203	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	018	2	1	04	01	H4875_018_2	4			1		08/04/2017	2018.03	08/04/2017 11:20:55 AM Eastern Daylight Time	08/04/2017 12:10:46 PM Eastern Daylight Time	08/01/2017 11:14:18 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Ideal (PPO)	01	04		1			H4875	018	2	2018	68 lower peninsula Michigan counties	Region 2	2	12008	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	018	3	1	04	01	H4875_018_3	4			1		08/04/2017	2018.03	08/04/2017 11:21:42 AM Eastern Daylight Time	08/04/2017 12:11:32 PM Eastern Daylight Time	08/01/2017 11:14:46 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Ideal (PPO)	01	04		1			H4875	018	3	2018	68 lower peninsula Michigan counties	Region 3	2	11454	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	018	4	1	04	01	H4875_018_4	4			1		08/04/2017	2018.03	08/04/2017 11:22:19 AM Eastern Daylight Time	08/04/2017 12:12:18 PM Eastern Daylight Time	08/01/2017 11:15:14 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Ideal (PPO)	01	04		1			H4875	018	4	2018	68 lower peninsula Michigan counties	Region 4	2	11677	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	018	5	1	04	01	H4875_018_5	4			1		08/04/2017	2018.03	08/04/2017 11:22:58 AM Eastern Daylight Time	08/04/2017 12:13:04 PM Eastern Daylight Time	08/01/2017 11:15:42 AM Eastern Daylight Time			08/07/2017 12:47:38 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Ideal (PPO)	01	04		1			H4875	018	5	2018	68 lower peninsula Michigan counties	Region 5	2	35267	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(888)389-6648		(616)464-8820		(866)249-4188		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	803	0	1	04	01	H4875_803_0	4			1		07/20/2017	2018.03	07/20/2017 09:34:41 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select EG Non-Calendar Year (PPO)	01	04		1			H4875	803	0	2018	National		1	36	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4875	804	0	1	04	01	H4875_804_0	3			1		07/20/2017	2018.03	07/20/2017 09:42:55 AM Eastern Daylight Time					07/20/2017 01:45:40 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select EG Calendar Year (PPO)	01	04		1			H4875	804	0	2018	National		1	649	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4876	001	0	1	04	01	H4876_001_0	8			1		08/08/2017	2018.03	08/08/2017 05:03:39 PM SA Western Standard Time	08/04/2017 08:26:14 AM SA Western Standard Time	08/03/2017 05:35:48 PM SA Western Standard Time			08/08/2017 05:12:52 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Olympus - Constellation Health (PPO)	01	04		1			H4876	001	0	2018	Puerto Rico		2	7523	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2						2			
H4876	003	0	1	04	01	H4876_003_0	9			1		08/08/2017	2018.03	08/08/2017 05:03:45 PM SA Western Standard Time	08/04/2017 08:27:58 AM SA Western Standard Time	08/03/2017 05:37:39 PM SA Western Standard Time			08/08/2017 05:12:52 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Olympus Prime - Constellation Health (PPO)	01	04		1			H4876	003	0	2018	Puerto Rico		2	40840	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2						2			
H4876	801	0	1	04	01	H4876_801_0	5			1		06/03/2017	2018.03	06/03/2017 05:34:39 PM SA Western Standard Time					06/05/2017 05:07:33 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Geminis 1 - Constellation Health (PPO)	01	04		1			H4876	801	0	2018	Puerto Rico		1	6448	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2						2			
H4876	802	0	1	04	01	H4876_802_0	3			1		06/03/2017	2018.03	06/03/2017 05:36:15 PM SA Western Standard Time					06/05/2017 05:07:33 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Geminis 2 - Constellation Health (PPO)	01	04		1			H4876	802	0	2018	Puerto Rico		1	6448	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2						2			
H4882	001	0	1	04	01	H4882_001_0	10			1		07/10/2017	2018.03	07/10/2017 02:31:37 PM Central Daylight Time	08/04/2017 12:32:26 PM Central Daylight Time	08/04/2017 12:34:26 PM Central Daylight Time			08/04/2017 04:04:33 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Journey Stride (PPO)	01	04		1			H4882	001	0	2018	Metro MN Counties		2	4380	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx	healthpartners.com/medicare	(866)233-8734		(952)883-6655		(844)363-8979		(952)883-5090		(866)233-8734		(952)883-6655		(844)363-8979		(952)883-5090		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4882	801	0	1	04	01	H4882_801_0	3			1		07/10/2017	2018.03	07/10/2017 02:38:11 PM Central Daylight Time					07/10/2017 02:46:27 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Journey MA-PD Calendar Year (PPO)	01	04		1			H4882	801	0	2018	Nationwide		1	600	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx	healthpartners.com/medicare	(866)233-8734		(952)883-6655		(844)363-8979		(952)883-5090		(866)233-8734		(952)883-6655		(844)363-8979		(952)883-5090		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4882	803	0	1	04	01	H4882_803_0	3			1		07/10/2017	2018.03	07/10/2017 02:38:38 PM Central Daylight Time					07/10/2017 02:46:27 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Journey MA (PPO)	01	04		1			H4882	803	0	2018	Nationwide		1	0	2			2						healthpartners.com/medicare	healthpartners.com/medicarerx	healthpartners.com/medicare	(866)233-8734		(952)883-6655		(844)363-8979		(952)883-5090										(711)-		(711)-		(711)-		(711)-										2					2						2			
H4909	014	0	1	04	01	H4909_014_0	4			1		06/02/2017	2018.03	06/02/2017 09:24:29 PM Eastern Daylight Time	08/07/2017 08:55:29 AM Eastern Daylight Time	08/06/2017 03:05:34 PM Eastern Daylight Time			08/07/2017 02:54:04 PM Eastern Daylight Time	ANTHEM HEALTH INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	Anthem MediBlue Access (PPO)	01	04		1			H4909	014	0	2018	Mathews County		2	1225	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)827-9866		(866)827-9866		(800)797-5937		(800)797-5937		(866)827-9866		(866)827-9866		(844)364-2119		(844)364-2119		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4909	015	0	1	04	01	H4909_015_0	5			1		08/02/2017	2018.03	08/02/2017 06:01:11 PM Eastern Daylight Time	08/07/2017 08:55:29 AM Eastern Daylight Time	08/06/2017 03:05:34 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM HEALTH INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	Anthem MediBlue Access (PPO)	01	04		1			H4909	015	0	2018	Select counties in MO		2	30996	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)690-7798		(855)690-7798		(800)797-5937		(800)797-5937		(855)690-7798		(855)690-7798		(844)364-2119		(844)364-2119		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H4909	804	0	1	04	01	H4909_804_0	1			1		06/03/2017	2018.03	06/03/2017 02:28:22 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4909	804	0	2018	Virginia		1	9966	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4909	805	0	1	04	01	H4909_805_0	1			1		06/03/2017	2018.03	06/03/2017 02:39:03 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4909	805	0	2018	Virginia		1	96000	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4909	806	0	1	04	01	H4909_806_0	1			1		06/03/2017	2018.03	06/03/2017 02:28:31 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4909	806	0	2018	Virginia		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4909	810	0	2	04	01	H4909_810_0	1			1		06/03/2017	2018.03	06/03/2017 02:28:33 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		2	1		H4909	810	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4909	811	0	1	04	01	H4909_811_0	1			1		06/03/2017	2018.03	06/03/2017 02:28:35 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H4909	811	0	2018	National		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(866)845-8609		(866)845-8609		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H4922	002	0	1	01	01	H4922_002_0	11		1	1	2	08/04/2017	2018.03	08/04/2017 04:54:51 PM Eastern Daylight Time	08/04/2017 10:23:27 AM Eastern Daylight Time	08/04/2017 10:41:11 AM Eastern Daylight Time			08/04/2017 04:58:30 PM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York BeWell (HMO SNP)	01	01		1			H4922	002	0	2018	New York City Metro Area, Long Island, Westchester		2	4104	2			1	3		2		2	www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4922	003	0	1	01	01	H4922_003_0	12		1	1	2	08/04/2017	2018.03	08/04/2017 04:55:35 PM Eastern Daylight Time	08/04/2017 10:24:32 AM Eastern Daylight Time	08/04/2017 10:35:50 AM Eastern Daylight Time			08/04/2017 04:58:30 PM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York FeelWell (HMO SNP)	01	01		1			H4922	003	0	2018	New York City Metro Area, Long Island, Westchester		2	6932	2			1	3		1		1	www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4922	004	0	1	01	01	H4922_004_0	12		1	1		08/11/2017	2018.03	08/11/2017 11:37:14 AM Eastern Daylight Time	08/10/2017 05:28:44 PM Eastern Daylight Time	08/04/2017 10:36:38 AM Eastern Daylight Time			08/11/2017 11:38:27 AM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York CareWell (HMO SNP)	01	01		1			H4922	004	0	2018	New York City Metro Area, Long Island, Westchester		2	7343	2			1	1	1				www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4922	005	1	1	01	01	H4922_005_1	10			1		08/04/2017	2018.03	08/04/2017 04:44:49 PM Eastern Daylight Time	08/04/2017 10:26:50 AM Eastern Daylight Time	08/04/2017 10:37:37 AM Eastern Daylight Time			08/04/2017 04:58:30 PM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York LiveWell (HMO)	01	01		1			H4922	005	1	2018	New York City Metro Area, Long Island, Westchester	NYC Metro Area, Nassau, Westchester Counties	2	13414	2			2						www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4922	005	2	1	01	01	H4922_005_2	12			1		08/04/2017	2018.03	08/04/2017 04:45:31 PM Eastern Daylight Time	08/04/2017 10:27:55 AM Eastern Daylight Time	08/04/2017 10:38:26 AM Eastern Daylight Time			08/04/2017 04:58:30 PM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York LiveWell (HMO)	01	01		1			H4922	005	2	2018	New York City Metro Area, Long Island, Westchester	Suffolk County	2	27582	2			2						www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4922	006	0	1	01	01	H4922_006_0	10			1		08/04/2017	2018.03	08/04/2017 04:47:35 PM Eastern Daylight Time	08/04/2017 10:53:01 AM Eastern Daylight Time	08/04/2017 10:39:15 AM Eastern Daylight Time			08/04/2017 04:58:30 PM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York	www.agewellnewyork.com	AgeWell New York StayWell (HMO)	01	01		1			H4922	006	0	2018	New York City Metro Area, Long Island, Westchester		2	5790	2			2						www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(844)782-7670		(844)782-7670		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2					2	2			
H4931	001	0	1	01	01	H4931_001_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 12:46:00 PM US Mountain Standard Time	08/04/2017 04:09:17 PM US Mountain Standard Time	08/04/2017 04:09:18 PM US Mountain Standard Time			08/04/2017 04:16:01 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	001	0	2018	Cochise, Gila, Graham, Greenlee, La Paz		2	14748	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	006	0	1	01	01	H4931_006_0	9		1	1	2	08/09/2017	2018.03	08/09/2017 10:20:42 AM US Mountain Standard Time	08/04/2017 04:09:19 PM US Mountain Standard Time	08/04/2017 04:09:19 PM US Mountain Standard Time			08/09/2017 12:31:34 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	006	0	2018	Pima County		2	39359	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	007	0	1	01	01	H4931_007_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 12:33:54 PM US Mountain Standard Time	08/04/2017 04:09:20 PM US Mountain Standard Time	08/04/2017 04:09:21 PM US Mountain Standard Time			08/04/2017 04:16:01 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage  (HMO SNP)	01	01		1			H4931	007	0	2018	Pinal County		2	18500	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	008	0	1	01	01	H4931_008_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 12:20:13 PM US Mountain Standard Time	08/04/2017 04:09:22 PM US Mountain Standard Time	08/04/2017 04:09:23 PM US Mountain Standard Time			08/04/2017 04:16:01 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	008	0	2018	Santa Cruz, Yavapai, Yuma		2	24000	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	013	0	1	01	01	H4931_013_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 12:46:44 PM US Mountain Standard Time	08/04/2017 04:09:24 PM US Mountain Standard Time	08/04/2017 04:09:25 PM US Mountain Standard Time			08/04/2017 04:16:01 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	013	0	2018	ALTCS: Cochise, Gila, Graham, Greenlee, La Paz		2	1075	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	014	0	1	01	01	H4931_014_0	9		1	1	2	08/09/2017	2018.03	08/09/2017 10:21:32 AM US Mountain Standard Time	08/04/2017 04:09:26 PM US Mountain Standard Time	08/04/2017 04:09:27 PM US Mountain Standard Time			08/09/2017 12:31:34 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	014	0	2018	ALTCS: Pima		2	2217	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	015	0	1	01	01	H4931_015_0	8		1	1	2	08/09/2017	2018.03	08/09/2017 10:22:26 AM US Mountain Standard Time	08/04/2017 04:09:28 PM US Mountain Standard Time	08/04/2017 04:09:14 PM US Mountain Standard Time			08/09/2017 12:31:34 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	015	0	2018	ALTCS: Maricopa, Pinal		2	2434	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4931	016	0	1	01	01	H4931_016_0	9		1	1	2	08/09/2017	2018.03	08/09/2017 10:23:41 AM US Mountain Standard Time	08/04/2017 04:09:15 PM US Mountain Standard Time	08/04/2017 04:09:16 PM US Mountain Standard Time			08/09/2017 12:31:34 PM US Mountain Standard Time	UNIVERSITY CARE ADVANTAGE, INC.	University Care Advantage	http://www.UAHealthPlans.com	University Care Advantage (HMO SNP)	01	01		1			H4931	016	0	2018	ALTCS: Santa Cruz, Yuma		2	3312	2			1	3		2		2	http://www.UAHealthPlans.com/UCA/PharmacyLookup	http://www.UAHealthPlans.com/UCA/PartD	http://www.UAHealthPlans.com/UCA/ProviderSearch	(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(877)874-3930		(520)874-3930		(877)874-3938		(520)874-3938		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H4999	001	0	1	20	08	H4999_001_0	1			1		05/31/2017	2018.03	05/31/2017 10:04:53 AM Eastern Daylight Time		05/31/2017 10:01:07 AM Eastern Daylight Time			05/31/2017 10:10:18 AM Eastern Daylight Time	THE LUTHERAN HOME FOR THE AGED	LIFE Northwestern Pennsylvania	www.lifenwpa.org	LIFE Northwestern Pennsylvania (PACE)	08	20		1			H4999	001	0	2018	Counties: Erie, War, Craw, Mer, Ven, McK, For, Cla		2		2			2						www.lifenwpa.org	www.lifenwpa.org										(844)456-5433		(814)456-5433		(844)456-5433		(814)456-5433										(814)456-5433		(814)456-5433		(814)456-5433		(814)456-5433																
H4999	002	0	1	20	08	H4999_002_0	1			1		05/31/2017	2018.03	05/31/2017 10:05:30 AM Eastern Daylight Time		05/31/2017 10:00:30 AM Eastern Daylight Time			05/31/2017 10:10:18 AM Eastern Daylight Time	THE LUTHERAN HOME FOR THE AGED	LIFE Northwestern Pennsylvania	www.lifenwpa.org	LIFE Northwestern Pennsylvania (PACE)	08	20		1			H4999	002	0	2018	Counties: Erie, War, Craw, Mer, Ven, McK, For, Cla		2		2			2						www.lifenwpa.org	www.lifenwpa.org										(844)456-5433		(814)456-5433		(844)456-5433		(814)456-5433										(814)456-5433		(814)456-5433		(814)456-5433		(814)456-5433																
H5007	001	0	1	20	08	H5007_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:40:22 AM Pacific Daylight Time		05/24/2017 01:25:00 PM Pacific Daylight Time			05/25/2017 11:43:08 AM Pacific Daylight Time	PROVIDENCE HEALTH SYSTEM	Providence Health System	washington.providence.org/senior-care/elderplace	Providence ElderPlace - Seattle (PACE)	08	20		1			H5007	001	0	2018	Seattle - King County Washington		2		2			2						www.providence.org/longtermcare/elderplace	www.providence.org/longtermcare/elderplace										(206)320-5325		(206)320-5325		(206)320-5325		(206)320-5325										(206)320-5325		(206)320-5325		(206)320-5325		(206)320-5325																
H5007	002	0	1	20	08	H5007_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:41:05 AM Pacific Daylight Time		05/24/2017 01:24:32 PM Pacific Daylight Time			05/25/2017 11:43:08 AM Pacific Daylight Time	PROVIDENCE HEALTH SYSTEM	Providence Health System	washington.providence.org/senior-care/elderplace	Providence ElderPlace - Seattle (PACE)	08	20		1			H5007	002	0	2018	Seattle - King County Washington		2		2			2						www.providence.org/longtermcare/elderplace	www.providence.org/longtermcare/elderplace										(206)320-5325		(206)320-5325		(206)320-5325		(206)320-5325										(206)320-5325		(206)320-5325		(206)320-5325		(206)320-5325																
H5008	001	0	1	01	01	H5008_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 08:25:14 AM Central Daylight Time	08/03/2017 02:21:11 PM Central Daylight Time	08/01/2017 10:57:17 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H5008	001	0	2018	Select Counties in Washington		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5008	002	0	1	01	01	H5008_002_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 12:59:37 PM Central Daylight Time	08/03/2017 02:21:48 PM Central Daylight Time	08/01/2017 10:57:43 AM Central Daylight Time			08/04/2017 01:02:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5008	002	0	2018	Select Counties in Washington		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5008	009	0	1	02	01	H5008_009_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:35:42 PM Central Daylight Time	08/03/2017 02:22:26 PM Central Daylight Time	08/01/2017 10:58:10 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H5008	009	0	2018	Select counties in New Mexico		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(866)393-0208		(866)393-0208		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5008	010	0	1	01	01	H5008_010_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:44:01 AM Central Daylight Time	08/03/2017 02:23:04 PM Central Daylight Time	08/01/2017 10:58:36 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5008	010	0	2018	New Orleans Metro area		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)263-0627		(866)263-0627		(888)834-3721		(888)834-3721		(866)263-0627		(866)263-0627		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5008	011	0	1	01	01	H5008_011_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:36:09 PM Central Daylight Time	08/03/2017 02:23:43 PM Central Daylight Time	08/01/2017 10:59:03 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5008	011	0	2018	DeSoto and Hinds Counties		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)263-1164		(866)263-1164		(888)834-3721		(888)834-3721		(866)263-1164		(866)263-1164		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5008	012	0	1	01	01	H5008_012_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:45:22 AM Central Daylight Time	08/03/2017 02:24:21 PM Central Daylight Time	08/01/2017 10:59:29 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5008	012	0	2018	Gila county		2		2			1	3		2		2	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)263-1164		(866)263-1164		(888)834-3721		(888)834-3721		(866)263-1164		(866)263-1164		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5009	001	0	1	04	01	H5009_001_0	8			1		07/07/2017	2018.03	07/07/2017 01:19:47 PM Mountain Daylight Time	06/04/2017 08:25:04 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H5009	001	0	2018	Select Counties in Washington		2	8156	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5009	002	0	1	04	01	H5009_002_0	9			1		07/07/2017	2018.03	07/07/2017 01:20:07 PM Mountain Daylight Time	08/04/2017 05:04:31 PM Mountain Daylight Time	08/01/2017 06:53:43 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H5009	002	0	2018	Select Counties in Washington		2	212685	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5009	008	0	1	04	01	H5009_008_0	8			1		05/22/2017	2018.03	05/22/2017 11:37:07 AM Mountain Daylight Time	08/04/2017 05:06:20 PM Mountain Daylight Time	08/01/2017 06:54:41 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx Primary (PPO)	01	04		1			H5009	008	0	2018	Select Counties in Washington		2	2832	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5009	801	0	1	04	01	H5009_801_0	3			1		05/22/2017	2018.03	05/22/2017 03:22:54 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H5009	801	0	2018	Nationwide except territories		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H5009	802	0	1	04	01	H5009_802_0	3			1		05/22/2017	2018.03	05/22/2017 03:23:26 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H5009	802	0	2018	Nationwide except territories		1	13833	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H5010	001	0	1	04	01	H5010_001_0	8			1		07/07/2017	2018.03	07/07/2017 01:21:04 PM Mountain Daylight Time	06/04/2017 08:28:47 PM Mountain Daylight Time				07/10/2017 10:34:34 AM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris TruAdvantage Basic (PPO)	01	04		1			H5010	001	0	2018	Spokane county		2	394	2			2						www.asuris.com/medicare	www.asuris.com/medicare	www.asuris.com/medicare	(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5010	002	0	1	04	01	H5010_002_0	10			1		07/07/2017	2018.03	07/07/2017 01:21:26 PM Mountain Daylight Time	08/04/2017 05:07:52 PM Mountain Daylight Time	08/01/2017 06:55:40 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris TruAdvantage + Rx Classic (PPO)	01	04		1			H5010	002	0	2018	Spokane county		2	9440	2			2						www.asuris.com/medicare	www.asuris.com/medicare	www.asuris.com/medicare	(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172		(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5010	004	0	1	04	01	H5010_004_0	8			1		05/16/2017	2018.03	05/16/2017 04:16:25 PM Mountain Daylight Time	08/04/2017 05:09:24 PM Mountain Daylight Time	08/01/2017 06:56:39 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris TruAdvantage + Rx Enhanced (PPO)	01	04		1			H5010	004	0	2018	Spokane county		2	3037	2			2						www.asuris.com/medicare	www.asuris.com/medicare	www.asuris.com/medicare	(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172		(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5037	001	0	1	20	08	H5037_001_0	1			1		05/24/2017	2018.03	05/24/2017 12:07:10 PM Eastern Daylight Time		05/24/2017 11:51:00 AM Eastern Daylight Time			05/24/2017 12:09:10 PM Eastern Daylight Time	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	Mountain Empire PACE	www.meoc.org	Mountain Empire PACE - Dual (PACE)	08	20		1			H5037	001	0	2018	Lee, Scott, Wise Counties and Norton City		2		2			2						www.meoc.org	www.meoc.org										(866)793-7223		(276)523-0599		(866)793-7223		(276)523-0599										(866)793-7223		(276)523-0599		(866)793-7223		(276)523-0599																
H5037	002	0	1	20	08	H5037_002_0	1			1		05/24/2017	2018.03	05/24/2017 12:07:32 PM Eastern Daylight Time		05/24/2017 11:51:00 AM Eastern Daylight Time			05/24/2017 12:09:10 PM Eastern Daylight Time	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	Mountain Empire PACE	www.meoc.org	Mountain Empire PACE  - Medicare only (PACE)	08	20		1			H5037	002	0	2018	Lee, Scott, Wise Counties and Norton City		2		2			2						www.meoc.org	www.meoc.org										(866)793-7223		(276)523-0599		(866)793-7223		(276)523-0599										(866)793-7223		(276)523-0599		(866)793-7223		(276)523-0599																
H5042	801	0	1	04	01	H5042_801_0	4			1		06/08/2017	2018.03	06/08/2017 01:45:38 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices		CDPHP Group Medicare Rx (PPO)	01	04		1			H5042	801	0	2018	Greater Capital Region of New York State		1	840	2			2									(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(888)831-3039		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;6;8a;8b1;8b2;8b3;11a;	1	1a;1b;2;5;6;8b1;8b2;8b3;14d;	1									
H5042	802	0	1	04	01	H5042_802_0	4			1		06/08/2017	2018.03	06/08/2017 01:45:59 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices		CDPHP Group Medicare Rx (PPO)	01	04		1			H5042	802	0	2018	Greater Capital Region of New York State		1	39058	2			2									(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400		(888)831-3039		(518)641-3950		(888)519-4455		(518)641-3400		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1b;2;6;8b1;8b2;8b3;11a;	1	1a;1b;2;5;6;8b1;8b2;8b3;14d;	1									
H5042	803	0	1	04	01	H5042_803_0	4			1		06/08/2017	2018.03	06/08/2017 01:46:15 PM Eastern Daylight Time					06/13/2017 10:01:31 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices		CDPHP Group Medicare (PPO)	01	04		1			H5042	803	0	2018	Greater Capital Region of New York State		1	5398	2			2									(888)248-6522		(518)641-3950		(888)519-4455		(518)641-3400										(711)-		(711)-		(711)-		(711)-										1	1	1b;2;6;8b1;8b2;8b3;11a;	1	1a;1b;2;5;6;8b1;8b2;8b3;14d;	1									
H5050	001	0	1	01	01	H5050_001_0	6			1		07/07/2017	2018.03	07/07/2017 07:41:37 AM Pacific Daylight Time	07/11/2017 04:03:44 PM Pacific Daylight Time				07/19/2017 06:12:17 AM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Basic (HMO)	01	01		1			H5050	001	0	2018	Puget Sound Area and Counties: GY, TH, LE, SP		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5050	004	0	1	01	01	H5050_004_0	8			1		07/07/2017	2018.03	07/07/2017 07:42:23 AM Pacific Daylight Time	08/02/2017 02:05:55 PM Pacific Daylight Time	08/02/2017 02:43:25 PM Pacific Daylight Time			08/04/2017 02:50:06 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Optimal (HMO)	01	01		1			H5050	004	0	2018	Counties: KI, PI, KP, SN, GY, LE, MA, TH		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	009	0	1	01	01	H5050_009_0	8			1		08/04/2017	2018.03	08/04/2017 08:32:20 AM Pacific Daylight Time	08/02/2017 02:07:23 PM Pacific Daylight Time	08/02/2017 02:44:58 PM Pacific Daylight Time			08/04/2017 02:50:06 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Essential (HMO)	01	01		1			H5050	009	0	2018	Counties: KI, PI, KP, SN, GY, LE, MA, TH		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	013	0	1	01	01	H5050_013_0	8			1		08/03/2017	2018.03	08/03/2017 09:40:43 AM Pacific Daylight Time	08/02/2017 02:08:52 PM Pacific Daylight Time	08/02/2017 02:46:42 PM Pacific Daylight Time			08/04/2017 02:50:06 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Vital (HMO)	01	01		1			H5050	013	0	2018	Counties: KI, PI, KP, SN, GY, LE, MA, TH		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	017	0	1	01	01	H5050_017_0	7			1		08/04/2017	2018.03	08/04/2017 08:33:56 AM Pacific Daylight Time	08/02/2017 02:10:22 PM Pacific Daylight Time	08/02/2017 02:48:09 PM Pacific Daylight Time			08/04/2017 02:50:06 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Harbor (HMO)	01	01		1			H5050	017	0	2018	Counties: SK, SJ, IS, WM		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	019	0	1	01	01	H5050_019_0	8			1		08/04/2017	2018.03	08/04/2017 08:35:02 AM Pacific Daylight Time	08/02/2017 02:11:50 PM Pacific Daylight Time	08/02/2017 02:49:43 PM Pacific Daylight Time			08/04/2017 02:50:06 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Columbia (HMO)	01	01		1			H5050	019	0	2018	Spokane		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	021	0	1	01	01	H5050_021_0	8			1		08/11/2017	2018.03	08/11/2017 11:06:26 AM Pacific Daylight Time	08/02/2017 02:13:20 PM Pacific Daylight Time	08/02/2017 02:51:23 PM Pacific Daylight Time			08/11/2017 11:18:04 AM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Centennial (HMO)	01	01		1			H5050	021	0	2018	Spokane		2		2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5050	801	0	1	01	01	H5050_801_0	3			1		06/03/2017	2018.03	06/03/2017 02:03:51 PM Pacific Daylight Time					06/03/2017 02:19:24 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Group [AB] (HMO)	01	01		1			H5050	801	0	2018	Puget Sound Area and Counties: GY, TH, LE, SP		1	316295	2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7f;7g;7h;7i;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;12;14a;14d;14e1;14e2;14e3;16b;18a;	1					2				
H5050	802	0	1	01	01	H5050_802_0	3			1		06/03/2017	2018.03	06/03/2017 02:04:14 PM Pacific Daylight Time					06/03/2017 02:19:24 PM Pacific Daylight Time	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Kaiser Foundation Health Plan of Washington	kp.org/wa/medicare	Kaiser Permanente Medicare Advantage Group [ABD] (HMO)	01	01		1			H5050	802	0	2018	Puget Sound Area and Counties: GY, TH, LE, SP		1	47137	2			2						kp.org/wa/medicare/providers	kp.org/wa/medicare/formulary	kp.org/wa/medicare/providers	(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(888)901-4600		(206)630-4600		(800)446-8882		(800)446-8882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7f;7g;7h;7i;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;12;14a;14d;14e1;14e2;14e3;16b;18a;	1					2				
H5085	003	0	1	20	08	H5085_003_0	1			1		09/20/2017	2018.03	09/20/2017 11:48:32 AM Eastern Daylight Time		09/14/2017 02:06:48 PM Eastern Daylight Time			09/20/2017 11:50:06 AM Eastern Daylight Time	COMMUNITY PACE AT HOME, INC.	Community PACE at Home, Inc,	N/A	Community PACE at Home, Inc. - Dual Eligible (PACE)	08	20		1			H5085	003	0	2018	Lake, Newaygo, Oceana, Osceola, Mason, Mecosta		2		2			2						N/A	N/A												(231)689-6675				(231)689-6675												(231)689-6675				(231)689-6675																
H5085	004	0	1	20	08	H5085_004_0	1			1		09/20/2017	2018.03	09/20/2017 11:48:44 AM Eastern Daylight Time		09/14/2017 02:06:57 PM Eastern Daylight Time			09/20/2017 11:50:06 AM Eastern Daylight Time	COMMUNITY PACE AT HOME, INC.	Community PACE at Home, Inc,	N/A	Community PACE at Home, Inc - Medicare Only (PACE)	08	20		1			H5085	004	0	2018	Lake, Newaygo, Oceana, Osceola, Mason, Mecosta		2		2			2						N/A	N/A												(231)689-6675				(231)689-6675												(231)689-6675				(231)689-6675																
H5087	001	0	1	01	01	H5087_001_0	3		1	1	2	06/29/2017	2018.03	06/29/2017 01:35:33 PM Eastern Daylight Time	08/03/2017 04:44:12 PM Eastern Daylight Time	07/31/2017 07:15:16 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Freedom Plan (HMO SNP)	01	01		1			H5087	001	0	2018	Los Angeles County		2	52657	2			1	3		1		1	www.easychoicehealthplan.com	www.easychoicehealthplan.com	www.easychoicehealthplan.com	(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H5087	002	0	1	01	01	H5087_002_0	2			1		06/01/2017	2018.03	06/01/2017 05:05:41 PM Eastern Daylight Time	08/04/2017 03:16:44 PM Eastern Daylight Time	07/31/2017 07:15:39 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Plus Plan (HMO)	01	01		1			H5087	002	0	2018	Select Counties in CA		2	39154	2			2						www.easychoicehealthplan.com	www.easychoicehealthplan.com	www.easychoicehealthplan.com	(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H5087	005	0	1	01	01	H5087_005_0	4			1		08/03/2017	2018.03	08/03/2017 10:34:52 AM Eastern Daylight Time	08/03/2017 04:46:27 PM Eastern Daylight Time	07/31/2017 07:16:01 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Best Plan (HMO)	01	01		1			H5087	005	0	2018	Los Angeles, Orange Counties		2	108220	2			2						www.easychoicehealthplan.com	www.easychoicehealthplan.com	www.easychoicehealthplan.com	(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H5087	016	0	1	01	01	H5087_016_0	4			1		08/03/2017	2018.03	08/03/2017 10:35:24 AM Eastern Daylight Time	08/03/2017 04:47:34 PM Eastern Daylight Time	07/31/2017 07:16:23 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Best Plan (HMO)	01	01		1			H5087	016	0	2018	Riverside, San Bernardino Counties		2	7420	2			2						www.easychoicehealthplan.com	www.easychoicehealthplan.com	www.easychoicehealthplan.com	(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H5087	017	0	1	01	01	H5087_017_0	3			1		06/29/2017	2018.03	06/29/2017 01:36:14 PM Eastern Daylight Time	08/04/2017 03:17:51 PM Eastern Daylight Time	07/31/2017 07:16:46 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Plus Plan (HMO)	01	01		1			H5087	017	0	2018	Los Angeles County		2	128163	2			2						www.easychoicehealthplan.com	www.easychoicehealthplan.com	www.easychoicehealthplan.com	(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(866)999-3945		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H5106	013	0	1	04	01	H5106_013_0	10			1		07/19/2017	2018.03	07/19/2017 10:45:09 AM Eastern Daylight Time	08/01/2017 04:53:12 PM Eastern Daylight Time	08/02/2017 12:37:43 PM Eastern Daylight Time			08/03/2017 08:29:36 AM Eastern Daylight Time	HIGHMARK SENIOR SOLUTIONS COMPANY	Highmark Senior Solutions Company	www.highmarkbcbswv.com/medicare	Freedom Blue PPO Standard (PPO)	01	04		1			H5106	013	0	2018	West Virginia Region 1 counties		2		2			2						www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5106	806	0	1	04	01	H5106_806_0	8			1		07/12/2017	2018.03	07/12/2017 11:49:15 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR SOLUTIONS COMPANY	Highmark Senior Solutions Company	www.highmarkbcbswv.com/medicare	Freedom Blue PPO MAPD WV NON-CALENDAR (PPO)	01	04		1			H5106	806	0	2018	ALL WV COUNTIES		1	1	2			2						www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H5106	807	0	1	04	01	H5106_807_0	8			1		07/12/2017	2018.03	07/12/2017 11:49:27 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR SOLUTIONS COMPANY	Highmark Senior Solutions Company	www.highmarkbcbswv.com/medicare	Freedom Blue PPO MA WV (PPO)	01	04		1			H5106	807	0	2018	ALL WV COUNTIES		1	0	2			2						www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H5106	808	0	1	04	01	H5106_808_0	8			1		07/12/2017	2018.03	07/12/2017 11:49:41 AM Eastern Daylight Time					07/13/2017 08:20:35 AM Eastern Daylight Time	HIGHMARK SENIOR SOLUTIONS COMPANY	Highmark Senior Solutions Company	www.highmarkbcbswv.com/medicare	Freedom Blue PPO MAPD WV CALENDAR (PPO)	01	04		1			H5106	808	0	2018	ALL WV COUNTIES		1	3630	2			2						www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	www.highmarkbcbswv.com/medicare	(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(888)459-4020		(888)459-4020		(866)739-1899		(866)739-1899		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H5117	001	0	1	01	01	H5117_001_0	2			1		08/01/2017	2018.03	08/01/2017 11:36:44 AM Pacific Daylight Time	08/04/2017 04:35:01 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Allwell	www.allwell.louisianahealthconnect.com	Allwell Medicare (HMO)	01	01		1			H5117	001	0	2018	Ascen, E Baton Rouge, W Baton Rouge, Living, Tang		2		2			2						www.centene.com	www.centene.com	www.allwell.louisianahealthconnect.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5117	002	0	1	01	01	H5117_002_0	2			1		08/03/2017	2018.03	08/03/2017 11:23:08 AM Pacific Daylight Time	08/04/2017 04:35:01 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Allwell	www.allwell.louisianahealthconnect.com	Allwell Medicare (HMO)	01	01		1			H5117	002	0	2018	St. Tammany		2		2			2						www.centene.com	www.centene.com	www.allwell.louisianahealthconnect.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5124	001	0	1	20	08	H5124_001_0	2			1		06/05/2017	2018.03	06/05/2017 08:49:09 AM Eastern Daylight Time		06/05/2017 08:45:25 AM Eastern Daylight Time			06/05/2017 08:52:56 AM Eastern Daylight Time	FRANCISCAN ACO, INC.	Franciscan  Senior Health & Wellness	FranciscanStFrancis.org	Franciscan Senior Health and Wellness (PACE)	08	20		1			H5124	001	0	2018	Central and Northern Indiana		2		2			2						carekinesis.org	franciscanalliance.org										(844)817-7223		(317)528-7223		(800)743-3333		(317)782-8012										(800)743-3333		(317)528-6395		(800)743-3333		(800)743-3333																
H5124	002	0	1	20	08	H5124_002_0	2			1		06/05/2017	2018.03	06/05/2017 08:49:23 AM Eastern Daylight Time		06/05/2017 08:45:49 AM Eastern Daylight Time			06/05/2017 08:52:56 AM Eastern Daylight Time	FRANCISCAN ACO, INC.	Franciscan  Senior Health & Wellness	FranciscanStFrancis.org	Franciscan Senior Health and Wellness (PACE)	08	20		1			H5124	002	0	2018	Central and Northern Indiana		2		2			2						carekinesis.org	franciscanalliance.org										(844)817-7223		(317)528-7223		(844)817-7223		(317)528-7223										(800)743-3333		(317)528-6395		(800)743-3333		(800)743-3333																
H5141	001	0	1	04	01	H5141_001_0	8			1		08/04/2017	2018.03	08/04/2017 11:20:25 AM Pacific Daylight Time	08/04/2017 10:17:00 AM Pacific Daylight Time	08/04/2017 10:16:58 AM Pacific Daylight Time			08/04/2017 02:47:49 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health NJ CarePoint Green (PPO)	01	04		1			H5141	001	0	2018	Hudson County		2	57990	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	004	0	1	04	01	H5141_004_0	8			1		08/04/2017	2018.03	08/04/2017 11:15:41 AM Pacific Daylight Time	08/04/2017 10:17:04 AM Pacific Daylight Time	08/04/2017 10:16:58 AM Pacific Daylight Time			08/04/2017 02:47:49 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health NJ Classic Aqua (PPO)	01	04		1			H5141	004	0	2018	Central NJ Counties (excluding Hudson)		2	164635	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(855)593-5757		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	007	0	1	04	01	H5141_007_0	10			1		08/06/2017	2018.03	08/06/2017 01:36:05 PM Pacific Daylight Time	08/04/2017 11:11:20 AM Pacific Daylight Time	08/04/2017 11:11:18 AM Pacific Daylight Time			08/06/2017 01:36:55 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health NJ Premier Orange (PPO)	01	04		1			H5141	007	0	2018	Central NJ Counties		2	219088	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(855)593-5757		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	025	0	1	04	01	H5141_025_0	8			1		08/04/2017	2018.03	08/04/2017 10:17:38 AM Pacific Daylight Time	08/04/2017 10:17:10 AM Pacific Daylight Time	08/04/2017 10:17:02 AM Pacific Daylight Time			08/04/2017 02:47:49 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health TX Green (PPO)	01	04		1			H5141	025	0	2018	Bexar County		2	35872	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	026	0	1	04	01	H5141_026_0	8			1		08/04/2017	2018.03	08/04/2017 10:19:25 AM Pacific Daylight Time	08/04/2017 10:17:14 AM Pacific Daylight Time	08/04/2017 10:17:02 AM Pacific Daylight Time			08/04/2017 02:47:49 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health GA Green (PPO)	01	04		1			H5141	026	0	2018	Chatham County		2	27234	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	028	0	1	04	01	H5141_028_0	9			1		08/04/2017	2018.03	08/04/2017 10:22:50 AM Pacific Daylight Time	08/04/2017 10:17:18 AM Pacific Daylight Time	08/04/2017 10:17:02 AM Pacific Daylight Time			08/04/2017 02:47:49 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health PA Green (PPO)	01	04		1			H5141	028	0	2018	Bucks County		2	4888	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(855)593-5757		(201)432-2133		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5141	032	0	1	04	01	H5141_032_0	9			1		08/06/2017	2018.03	08/06/2017 01:36:12 PM Pacific Daylight Time	08/04/2017 11:11:06 AM Pacific Daylight Time	08/04/2017 11:11:04 AM Pacific Daylight Time			08/06/2017 01:36:55 PM Pacific Daylight Time	CLOVER INSURANCE COMPANY	CLOVER HEALTH	www.cloverhealth.com	Clover Health NJ Purple (PPO)	01	04		1			H5141	032	0	2018	Southern NJ Counties		2	27832	2			2						www.cloverhealth.com	www.cloverhealth.com	www.cloverhealth.com	(888)657-1207		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(855)479-3657		(201)432-2133	100	(888)657-1207		(201)432-2133	100	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5167	001	0	1	20	08	H5167_001_0	1			1		05/24/2017	2018.03	05/24/2017 11:49:24 AM Mountain Daylight Time		05/24/2017 11:34:15 AM Mountain Daylight Time			05/24/2017 11:52:56 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	rmhcare.org	Rocky Mountain PACE (PACE)	08	20		1			H5167	001	0	2018	Colorado Springs Metro Area		2		2			2						www.rmhcare.org	www.rmhcare.org										(855)207-0702	300	(719)314-2327	300	(855)207-0702	300	(719)314-2327	300									(855)207-0702	300	(719)314-2327	300	(855)207-0702	300	(719)314-2327	300															
H5167	002	0	1	20	08	H5167_002_0	1			1		05/24/2017	2018.03	05/24/2017 11:50:17 AM Mountain Daylight Time		05/24/2017 11:34:16 AM Mountain Daylight Time			05/24/2017 11:52:56 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	rmhcare.org	Rocky Mountain PACE (PACE)	08	20		1			H5167	002	0	2018	Colorado Springs Metro Area		2		2			2						www.rmhcare.org	www.rmhcare.org										(855)207-0702	300	(719)314-2327	300	(855)207-0702	300	(719)314-2327	300									(855)207-0702	300	(719)314-2327	300	(855)207-0702	300	(719)314-2327	300															
H5172	002	0	1	48	05	H5172_002_0	7			1		09/19/2017	2018.03	09/19/2017 10:55:13 AM Pacific Daylight Time					09/19/2017 10:59:07 AM Pacific Daylight Time	COMMUNITY HEALTH GROUP	Community Health Group	www.chgsd.com	CommuniCare Advantage Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H5172	002	0	2018	San Diego, California		2	74376	2			2						http://www.chgsd.com/	www.chgsd.com	www.chgsd.com	(888)244-4430		(619)422-0422		(888)244-4430		(619)422-0422		(888)244-4430		(619)422-0422		(888)244-4430		(619)422-0422		(855)266-4584		(855)266-4584		(855)266-4584		(855)266-4584		(855)266-4584		(855)266-4584		(855)266-4584		(855)266-4584																
H5190	001	0	1	01	01	H5190_001_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 02:30:32 PM Eastern Daylight Time	08/04/2017 04:35:16 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE STATE HEALTH PLAN, INC.	Allwell	https://advantage.sunshinehealth.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5190	001	0	2018	9 Counties in Central and North Florida		2		2			1	3		2		2	https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5190	002	0	1	01	01	H5190_002_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 09:39:00 AM Eastern Daylight Time	08/04/2017 04:35:16 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE STATE HEALTH PLAN, INC.	Allwell	https://allwell.sunshinehealth.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5190	002	0	2018	8 Counties in Central and North Florida		2		2			1	3		2		2	https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5190	003	0	1	01	01	H5190_003_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 09:39:23 AM Eastern Daylight Time	08/04/2017 04:35:17 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE STATE HEALTH PLAN, INC.	Allwell	https://allwell.sunshinehealth.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5190	003	0	2018	Broward and Palm Beach Counties		2		2			1	3		2		2	https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5190	004	0	1	01	01	H5190_004_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 04:22:44 PM Eastern Daylight Time	08/04/2017 04:35:16 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE STATE HEALTH PLAN, INC.	Allwell	https://allwell.sunshinehealth.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5190	004	0	2018	Miami-Dade County		2		2			1	3		2		2	https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(877)935-8022		(877)935-8022		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5199	001	0	1	04	01	H5199_001_0	3			1		08/03/2017	2018.03	08/03/2017 11:44:08 AM Eastern Daylight Time	08/03/2017 04:49:52 PM Eastern Daylight Time	07/31/2017 07:17:08 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H5199	001	0	2018	Selected FL Counties		2	2011	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H5199	002	0	1	04	01	H5199_002_0	4			1		08/03/2017	2018.03	08/03/2017 11:47:55 AM Eastern Daylight Time	08/03/2017 04:50:59 PM Eastern Daylight Time	07/31/2017 07:17:31 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H5199	002	0	2018	Selected FL Counties		2	70	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H5199	003	0	1	04	01	H5199_003_0	4			1		08/04/2017	2018.03	08/04/2017 04:51:52 PM Eastern Daylight Time	08/03/2017 04:52:08 PM Eastern Daylight Time	07/31/2017 07:17:53 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H5199	003	0	2018	Selected FL Counties		2	6320	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H5199	004	0	1	04	01	H5199_004_0	4			1		08/04/2017	2018.03	08/04/2017 04:55:13 PM Eastern Daylight Time	08/03/2017 04:53:18 PM Eastern Daylight Time	07/31/2017 07:18:16 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H5199	004	0	2018	Selected FL Counties		2	2339	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(888)888-9355		(888)888-9355		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H5209	002	0	1	01	01	H5209_002_0	9		1	1	2	06/05/2017	2018.03	06/05/2017 04:41:24 PM Central Daylight Time	08/01/2017 06:24:14 PM Central Daylight Time	08/01/2017 06:16:22 PM Central Daylight Time			08/07/2017 03:19:47 PM Central Daylight Time	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewisc.org/partnership	Partnership (HMO SNP)	01	01		1			H5209	002	0	2018	Southcentral and Eastern Wisconsin		2	15792	2			1	3		1		1	www.carewisc.org/partnership	www.carewisc.org/partnership	www.carewisc.org/partnership	(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7g;7h;7i;8a;8b1;8b2;9a;9b;9c;11a;11b;15;17b;	2		1					1				
H5209	004	0	1	01	01	H5209_004_0	9		1	1	2	06/05/2017	2018.03	06/05/2017 04:43:01 PM Central Daylight Time	08/01/2017 10:05:30 AM Central Daylight Time	08/01/2017 10:00:30 AM Central Daylight Time			08/07/2017 03:19:47 PM Central Daylight Time	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewisc.org	Care Wisconsin Medicare Dual Advantage (HMO SNP)	01	01		1			H5209	004	0	2018	Southern, Central and Northeastern Wisconsin		2	8036	2			1	3		1		1	www.carewisc.org	www.carewisc.org	www.carewisc.org	(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)963-0035		(608)240-0035		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7g;7h;7i;8a;8b1;8b2;9a;9b;9c;11a;11b;15;17b;	2		1					1				
H5211	001	0	1	02	01	H5211_001_0	5			1		07/20/2017	2018.03	07/20/2017 10:58:48 AM Central Daylight Time	06/03/2017 02:47:38 PM Central Daylight Time				07/20/2017 02:47:41 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Spirit (HMO-POS)	01	02		1			H5211	001	0	2018	Central, Northern, Western and South Central WI		2	47178	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5211	002	0	1	02	01	H5211_002_0	6			1		07/20/2017	2018.03	07/20/2017 11:00:10 AM Central Daylight Time	08/04/2017 10:40:49 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Essence Rx (HMO-POS)	01	02		1			H5211	002	0	2018	Central, Northern, Western WI		2	190800	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	003	0	1	02	01	H5211_003_0	5			1		07/20/2017	2018.03	07/20/2017 10:59:36 AM Central Daylight Time	06/03/2017 02:51:30 PM Central Daylight Time				07/20/2017 02:47:41 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Essence (HMO-POS)	01	02		1			H5211	003	0	2018	Central, Northern, Western  WI		2	146208	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5211	004	0	1	02	01	H5211_004_0	6			1		07/20/2017	2018.03	07/20/2017 11:00:01 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Spirit Rx (HMO-POS)	01	02		1			H5211	004	0	2018	Central, Northern, Western and South Central WI		2	104232	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	007	0	1	02	01	H5211_007_0	7			1		08/02/2017	2018.03	08/02/2017 08:49:07 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Assurance Rx (HMO-POS)	01	02		1			H5211	007	0	2018	Southern Wisconsin		2	14388	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	008	0	1	02	01	H5211_008_0	5			1		08/02/2017	2018.03	08/02/2017 08:49:27 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time	08/04/2017 10:40:50 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Surety Rx (HMO-POS)	01	02		1			H5211	008	0	2018	Eastern Wisconsin		2	1482	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/providersmedicare	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	009	0	1	02	01	H5211_009_0	5			1		07/06/2017	2018.03	07/06/2017 11:21:06 AM Central Daylight Time	08/04/2017 10:40:51 AM Central Daylight Time	08/04/2017 10:40:51 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Promise Rx (HMO-POS)	01	02		1			H5211	009	0	2018	Eastern Wisconsin		2	900	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/providersmedicare	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	010	0	1	01	01	H5211_010_0	5		1	1	2	07/06/2017	2018.03	07/06/2017 08:51:38 AM Central Daylight Time	08/04/2017 12:08:37 PM Central Daylight Time	08/04/2017 12:08:37 PM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Ally Rx (HMO SNP)	01	01		1			H5211	010	0	2018	Central Wisconsin		2	4344	2			1	3		1		1	www.securityhealth.org/allypharmacies	www.securityhealth.org/allyformulary	www.securityhealth.org/allyproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5211	012	0	1	02	01	H5211_012_0	5			1		08/02/2017	2018.03	08/02/2017 08:49:43 AM Central Daylight Time	08/04/2017 10:40:51 AM Central Daylight Time	08/04/2017 10:40:51 AM Central Daylight Time			08/04/2017 12:16:26 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Security Health Plan of Wisconsin, Inc.	www.securityhealth.org/medicareadvantage	Esteem Rx (HMO-POS)	01	02		1			H5211	012	0	2018	Central, Northern, Western WI		2	52860	2			2						www.securityhealth.org/medicarepharmacies	www.securityhealth.org/medicareformulary	www.securityhealth.org/medicareproviders	(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(877)998-0998		(715)221-9897		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5212	001	0	1	20	08	H5212_001_0	1			1		05/11/2017	2018.03	05/11/2017 08:43:57 AM Central Daylight Time		05/24/2017 02:13:53 PM Central Daylight Time			05/24/2017 02:15:46 PM Central Daylight Time	COMMUNITY CARE, INC.	Community Care	www.communitycareinc.org	Community Care's PACE Program (PACE)	08	20		1			H5212	001	0	2018	Milwaukee County, Waukesha County		2	6804	2			2						www.communitycareinc.org	www.communitycareinc.org	www.communitycareinc.org									(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000										(711)-		(711)-		(711)-		(711)-																
H5212	002	0	1	20	08	H5212_002_0	1			1		05/11/2017	2018.03	05/11/2017 08:44:42 AM Central Daylight Time		05/24/2017 02:13:40 PM Central Daylight Time			05/24/2017 02:15:46 PM Central Daylight Time	COMMUNITY CARE, INC.	Community Care	www.communitycareinc.org	Community Care's PACE Program (PACE)	08	20		1			H5212	002	0	2018	Milwaukee County, Waukesha County		2	12	2			2						www.communitycareinc.org	www.communitycareinc.org	www.communitycareinc.org									(866)992-6600		(414)231-4000		(866)992-6600		(414)231-4000										(711)-		(711)-		(711)-		(711)-																
H5213	001	0	1	20	08	H5213_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:45:38 PM Mountain Daylight Time		05/24/2017 01:32:40 PM Mountain Daylight Time			05/24/2017 01:47:59 PM Mountain Daylight Time	TOTAL COMMUNITY CARE, L.L.C.	InnovAge Greater New Mexico PACE	www.PACEmyinnovage.org	Total Community Care (PACE)	08	20		1			H5213	001	0	2018	Albuquerque Metro Area		2		2			2						www.pharmerica.com	www.TotalCommunityCare.org										(844)326-2973		(505)924-2650		(844)326-2973		(505)924-2608										(855)487-6768		(855)487-6768		(855)487-6768		(855)487-6768																
H5213	002	0	1	20	08	H5213_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:45:54 PM Mountain Daylight Time		05/24/2017 01:32:11 PM Mountain Daylight Time			05/24/2017 01:47:59 PM Mountain Daylight Time	TOTAL COMMUNITY CARE, L.L.C.	InnovAge Greater New Mexico PACE	www.PACEmyinnovage.org	Total Community Care (PACE)	08	20		1			H5213	002	0	2018	Albuquerque Metro Area		2		2			2						www.pharmerica.com	www.TotalCommunityCare.org										(844)326-2973		(505)924-2650		(505)924-2608		(505)924-2608										(844)326-2973		(844)326-2973		(505)924-2608		(505)924-2608																
H5215	001	0	1	04	01	H5215_001_0	6			1		07/07/2017	2018.03	07/07/2017 09:41:56 AM Central Daylight Time	06/04/2017 01:33:13 PM Central Daylight Time				07/07/2017 10:02:20 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPlus (PPO)	01	04		1			H5215	001	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280										(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529										2					2						2			
H5215	002	0	1	04	01	H5215_002_0	8			1		07/07/2017	2018.03	07/07/2017 09:42:04 AM Central Daylight Time	08/04/2017 08:19:00 AM Central Daylight Time	08/04/2017 08:19:02 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPlus Pharmacy (PPO)	01	04		1			H5215	002	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	005	0	1	04	01	H5215_005_0	7			1		07/07/2017	2018.03	07/07/2017 09:37:19 AM Central Daylight Time	08/04/2017 08:19:03 AM Central Daylight Time	08/04/2017 08:19:05 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPremier Pharmacy (PPO)	01	04		1			H5215	005	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	006	0	1	04	01	H5215_006_0	6			1		07/07/2017	2018.03	07/07/2017 09:37:27 AM Central Daylight Time	06/04/2017 01:33:13 PM Central Daylight Time				07/07/2017 10:02:20 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPremier (PPO)	01	04		1			H5215	006	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280										(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529										2					2						2			
H5215	007	0	1	04	01	H5215_007_0	7		1	1	2	08/03/2017	2018.03	08/03/2017 03:31:49 PM Central Daylight Time	08/04/2017 08:19:06 AM Central Daylight Time	08/04/2017 08:19:08 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	NetworkCares (PPO SNP)	01	04		1			H5215	007	0	2018	East Central Wisconsin		2		2			1	3		2		2	www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	008	0	1	04	01	H5215_008_0	7			1		08/03/2017	2018.03	08/03/2017 03:14:29 PM Central Daylight Time	08/04/2017 08:19:09 AM Central Daylight Time	08/04/2017 08:19:11 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumSelect (PPO)	01	04		1			H5215	008	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	009	0	1	04	01	H5215_009_0	7			1		08/03/2017	2018.03	08/03/2017 03:24:17 PM Central Daylight Time	08/04/2017 08:19:12 AM Central Daylight Time	08/04/2017 08:19:14 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network Health Medicare Go (PPO)	01	04		1			H5215	009	0	2018	Southeast Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	010	0	1	04	01	H5215_010_0	7			1		07/07/2017	2018.03	07/07/2017 09:38:10 AM Central Daylight Time	08/04/2017 08:19:15 AM Central Daylight Time	08/04/2017 08:19:17 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network Health Medicare Anywhere (PPO)	01	04		1			H5215	010	0	2018	Southeast Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	011	0	1	04	01	H5215_011_0	7			1		07/07/2017	2018.03	07/07/2017 09:38:05 AM Central Daylight Time	08/04/2017 08:19:18 AM Central Daylight Time	08/04/2017 08:18:59 AM Central Daylight Time			08/04/2017 08:27:46 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumChoice (PPO)	01	04		1			H5215	011	0	2018	East Central Wisconsin		2		2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		2					2						2			
H5215	806	0	1	04	01	H5215_806_0	1			1		04/13/2017	2018.03	04/13/2017 10:26:21 AM Central Daylight Time					05/23/2017 04:33:03 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPlus Pharmacy EGP (PPO)	01	04		1			H5215	806	0	2018	East Central WI		1	3600	2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;12;15;16b;	2		1									
H5215	807	0	1	04	01	H5215_807_0	1			1		04/13/2017	2018.03	04/13/2017 10:45:43 AM Central Daylight Time					05/23/2017 04:33:03 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPremier EGP (PPO)	01	04		1			H5215	807	0	2018	East Central WI		1	3600	2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280										(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;12;15;16b;	2		1									
H5215	808	0	1	04	01	H5215_808_0	1			1		04/13/2017	2018.03	04/13/2017 10:43:19 AM Central Daylight Time					05/23/2017 04:33:03 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Health Medicare Advantage Plans	www.networkhealthmedicare.com	Network PlatinumPremier Pharmacy EGP (PPO)	01	04		1			H5215	808	0	2018	East Central WI		1	3600	2			2						www.networkhealthmedicare.com	www.networkhealthmedicare.com/search/formulary/index.php	www.networkhealthmedicare.com/search/providers/index.php	(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)378-5234		(920)720-1345		(800)983-7587		(920)720-1280		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		(800)947-3529		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8b1;8b2;8b3;9a;9b;9c;11a;11b;11c;12;15;16b;	2		1									
H5216	001	0	1	04	01	H5216_001_0	2			1		05/27/2017	2018.03	05/27/2017 12:56:54 PM Eastern Daylight Time	08/04/2017 02:46:14 PM Eastern Daylight Time	08/04/2017 09:52:57 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-001 (PPO)	01	04		1			H5216	001	0	2018	Select Counties in Eastern Wisconsin		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	006	0	1	04	01	H5216_006_0	3			1		06/28/2017	2018.03	06/28/2017 10:46:55 AM Eastern Daylight Time	08/04/2017 02:40:35 PM Eastern Daylight Time	08/04/2017 09:52:58 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-006 (PPO)	01	04		1			H5216	006	0	2018	Madison area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	009	0	1	04	01	H5216_009_0	2			1		05/27/2017	2018.03	05/27/2017 01:00:25 PM Eastern Daylight Time	08/04/2017 02:39:38 PM Eastern Daylight Time	08/04/2017 09:52:58 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-009 (PPO)	01	04		1			H5216	009	0	2018	Select Counties in Western Michigan		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	011	0	1	04	01	H5216_011_0	3			1		06/28/2017	2018.03	06/28/2017 10:47:21 AM Eastern Daylight Time	08/04/2017 02:48:07 PM Eastern Daylight Time	08/04/2017 09:52:59 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-011 (PPO)	01	04		1			H5216	011	0	2018	Oakland, Macomb, and Wayne counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	012	0	1	04	01	H5216_012_0	3			1		06/28/2017	2018.03	06/28/2017 10:47:48 AM Eastern Daylight Time	06/01/2017 07:20:52 PM Eastern Daylight Time				06/29/2017 11:26:38 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-012 (PPO)	01	04		1			H5216	012	0	2018	Select Counties in WI, MI and IL		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	013	0	1	04	01	H5216_013_0	2			1		05/27/2017	2018.03	05/27/2017 01:09:07 PM Eastern Daylight Time	08/04/2017 02:47:39 PM Eastern Daylight Time	08/04/2017 09:53:00 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-013 (PPO)	01	04		1			H5216	013	0	2018	Select Counties in Illinois		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	014	0	1	04	01	H5216_014_0	2			1		05/31/2017	2018.03	05/31/2017 01:12:23 PM Eastern Daylight Time	08/04/2017 04:31:55 PM Eastern Daylight Time	08/04/2017 09:53:00 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-014 (PPO)	01	04		1			H5216	014	0	2018	Select Counties in Iowa		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	015	1	1	04	01	H5216_015_1	2			1		06/01/2017	2018.03	06/01/2017 11:03:11 AM Eastern Daylight Time	08/04/2017 03:15:36 PM Eastern Daylight Time	08/04/2017 09:53:01 AM Eastern Daylight Time			08/06/2017 09:18:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-015 (PPO)	01	04		1			H5216	015	1	2018	Greater North Carolina Area	Western North Carolina	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	015	2	1	04	01	H5216_015_2	2			1		05/27/2017	2018.03	05/27/2017 01:52:14 PM Eastern Daylight Time	08/04/2017 03:15:06 PM Eastern Daylight Time	08/04/2017 09:53:01 AM Eastern Daylight Time			08/06/2017 09:18:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-015 (PPO)	01	04		1			H5216	015	2	2018	Greater North Carolina Area	Central North Carolina	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	017	0	1	04	01	H5216_017_0	2			1		05/30/2017	2018.03	05/30/2017 03:52:19 PM Eastern Daylight Time	08/04/2017 03:17:03 PM Eastern Daylight Time	08/04/2017 09:53:02 AM Eastern Daylight Time			08/06/2017 09:18:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-017 (PPO)	01	04		1			H5216	017	0	2018	Greensboro		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	018	0	1	04	01	H5216_018_0	2			1		06/01/2017	2018.03	06/01/2017 10:52:42 AM Eastern Daylight Time	08/04/2017 05:30:38 PM Eastern Daylight Time	08/04/2017 09:53:02 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-018 (PPO)	01	04		1			H5216	018	0	2018	Louisville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	019	0	1	04	01	H5216_019_0	2			1		05/27/2017	2018.03	05/27/2017 01:31:18 PM Eastern Daylight Time	08/04/2017 05:31:05 PM Eastern Daylight Time	08/04/2017 09:53:03 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-019 (PPO)	01	04		1			H5216	019	0	2018	Lexington Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	020	0	1	04	01	H5216_020_0	2			1		05/27/2017	2018.03	05/27/2017 01:31:22 PM Eastern Daylight Time	08/04/2017 05:26:08 PM Eastern Daylight Time	08/04/2017 09:53:03 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-020 (PPO)	01	04		1			H5216	020	0	2018	Barren, Metcalfe and Warren counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	021	0	1	04	01	H5216_021_0	2			1		05/27/2017	2018.03	05/27/2017 01:31:27 PM Eastern Daylight Time	08/04/2017 05:24:19 PM Eastern Daylight Time	08/04/2017 09:53:04 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-021 (PPO)	01	04		1			H5216	021	0	2018	Charleston-Huntington Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	022	0	1	04	01	H5216_022_0	2			1		05/27/2017	2018.03	05/27/2017 01:31:33 PM Eastern Daylight Time	08/04/2017 05:26:34 PM Eastern Daylight Time	08/04/2017 09:53:04 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-022 (PPO)	01	04		1			H5216	022	0	2018	Martinsburg Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	023	0	1	04	01	H5216_023_0	4			1		06/28/2017	2018.03	06/28/2017 12:21:29 PM Eastern Daylight Time	08/04/2017 01:42:14 PM Eastern Daylight Time	08/04/2017 09:53:05 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-023 (PPO)	01	04		1			H5216	023	0	2018	Cincinnati and Dayton Metro Areas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	024	0	1	04	01	H5216_024_0	3			1		06/28/2017	2018.03	06/28/2017 12:23:08 PM Eastern Daylight Time	08/04/2017 01:58:05 PM Eastern Daylight Time	08/04/2017 09:53:05 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-024 (PPO)	01	04		1			H5216	024	0	2018	Cleveland-Akron Metro Areas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	025	0	1	04	01	H5216_025_0	2			1		05/27/2017	2018.03	05/27/2017 11:47:09 AM Eastern Daylight Time	08/04/2017 05:24:07 PM Eastern Daylight Time	08/04/2017 09:53:06 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-025 (PPO)	01	04		1			H5216	025	0	2018	Northeast Virginia area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	026	0	1	04	01	H5216_026_0	2			1		05/27/2017	2018.03	05/27/2017 11:43:25 AM Eastern Daylight Time	08/04/2017 05:23:04 PM Eastern Daylight Time	08/04/2017 09:53:07 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-026 (PPO)	01	04		1			H5216	026	0	2018	Northern Virginia area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	027	0	1	04	01	H5216_027_0	2			1		08/03/2017	2018.03	08/03/2017 12:25:22 PM Eastern Daylight Time	08/04/2017 05:40:17 PM Eastern Daylight Time	08/04/2017 09:53:07 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-027 (PPO)	01	04		1			H5216	027	0	2018	Roanoke Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	028	0	1	04	01	H5216_028_0	2			1		05/29/2017	2018.03	05/29/2017 10:28:30 AM Eastern Daylight Time	08/04/2017 05:26:08 PM Eastern Daylight Time	08/04/2017 09:53:08 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-028 (PPO)	01	04		1			H5216	028	0	2018	Kent, New Castle and Sussex Counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	029	0	1	04	01	H5216_029_0	2			1		05/27/2017	2018.03	05/27/2017 11:37:28 AM Eastern Daylight Time	08/04/2017 05:27:08 PM Eastern Daylight Time	08/04/2017 09:53:08 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-029 (PPO)	01	04		1			H5216	029	0	2018	Select Counties in Western Maryland		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	030	1	1	04	01	H5216_030_1	2			1		08/03/2017	2018.03	08/03/2017 12:26:13 PM Eastern Daylight Time	08/04/2017 05:33:10 PM Eastern Daylight Time	08/04/2017 09:53:09 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-030 (PPO)	01	04		1			H5216	030	1	2018	Tidewater area	Tidewater area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	030	2	1	04	01	H5216_030_2	2			1		08/03/2017	2018.03	08/03/2017 12:26:51 PM Eastern Daylight Time	08/04/2017 05:34:09 PM Eastern Daylight Time	08/04/2017 09:53:09 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-030 (PPO)	01	04		1			H5216	030	2	2018	Tidewater area	Tidewater area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	031	1	1	04	01	H5216_031_1	2			1		05/27/2017	2018.03	05/27/2017 11:32:09 AM Eastern Daylight Time	08/04/2017 05:35:08 PM Eastern Daylight Time	08/04/2017 09:53:10 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-031 (PPO)	01	04		1			H5216	031	1	2018	Richmond Metro Area	Richmond Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	031	2	1	04	01	H5216_031_2	2			1		05/29/2017	2018.03	05/29/2017 04:17:12 PM Eastern Daylight Time	08/04/2017 05:36:08 PM Eastern Daylight Time	08/04/2017 09:53:10 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-031 (PPO)	01	04		1			H5216	031	2	2018	Richmond Metro Area	Richmond Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	032	0	1	04	01	H5216_032_0	4			1		06/26/2017	2018.03	06/26/2017 11:44:01 AM Eastern Daylight Time	08/04/2017 02:59:50 PM Eastern Daylight Time	08/04/2017 09:53:11 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-032 (PPO)	01	04		1			H5216	032	0	2018	Select counties in Illinois, Kansas and Missouri		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	033	1	1	04	01	H5216_033_1	3			1		05/27/2017	2018.03	05/27/2017 02:17:59 PM Eastern Daylight Time	08/04/2017 03:00:28 PM Eastern Daylight Time	08/04/2017 09:53:12 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-033 (PPO)	01	04		1			H5216	033	1	2018	Select counties in Illinois, Kansas, and Missouri	Select counties in Kansas and Missouri	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	033	2	1	04	01	H5216_033_2	3			1		08/04/2017	2018.03	08/04/2017 08:03:02 AM Eastern Daylight Time	08/04/2017 03:51:45 PM Eastern Daylight Time	08/04/2017 09:53:12 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-033 (PPO)	01	04		1			H5216	033	2	2018	Select counties in Illinois, Kansas, and Missouri	Select counties in Illinois and Missouri	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	034	0	1	04	01	H5216_034_0	2			1		05/30/2017	2018.03	05/30/2017 04:23:21 PM Eastern Daylight Time	08/04/2017 01:25:39 PM Eastern Daylight Time	08/04/2017 09:53:13 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-034 (PPO)	01	04		1			H5216	034	0	2018	Maricopa, Pima, Pinal and Santa Cruz counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	035	0	1	04	01	H5216_035_0	3			1		06/28/2017	2018.03	06/28/2017 10:35:17 AM Eastern Daylight Time	08/04/2017 01:20:11 PM Eastern Daylight Time	08/04/2017 09:53:13 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-035 (PPO)	01	04		1			H5216	035	0	2018	La Paz, Mohave and Yavapai counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	036	0	1	04	01	H5216_036_0	3			1		06/28/2017	2018.03	06/28/2017 10:35:47 AM Eastern Daylight Time	08/04/2017 12:57:29 PM Eastern Daylight Time	08/04/2017 09:53:14 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-036 (PPO)	01	04		1			H5216	036	0	2018	Clark and Nye (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	037	0	1	04	01	H5216_037_0	2			1		05/30/2017	2018.03	05/30/2017 04:23:43 PM Eastern Daylight Time	08/04/2017 01:13:00 PM Eastern Daylight Time	08/04/2017 09:53:14 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-037 (PPO)	01	04		1			H5216	037	0	2018	Clark and Nye (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	038	0	1	04	01	H5216_038_0	2			1		05/30/2017	2018.03	05/30/2017 04:23:50 PM Eastern Daylight Time	08/04/2017 01:06:04 PM Eastern Daylight Time	08/04/2017 09:53:15 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-038 (PPO)	01	04		1			H5216	038	0	2018	Washoe County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	039	0	1	04	01	H5216_039_0	2			1		05/30/2017	2018.03	05/30/2017 04:23:55 PM Eastern Daylight Time	08/04/2017 01:09:54 PM Eastern Daylight Time	08/04/2017 09:53:15 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-039 (PPO)	01	04		1			H5216	039	0	2018	Washoe County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	040	0	1	04	01	H5216_040_0	4			1		08/02/2017	2018.03	08/02/2017 03:21:58 PM Eastern Daylight Time	08/05/2017 10:37:06 AM Eastern Daylight Time	08/04/2017 09:53:16 AM Eastern Daylight Time			08/06/2017 08:53:33 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-040 (PPO)	01	04		1			H5216	040	0	2018	Honolulu, Kauai and Maui counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	041	0	1	04	01	H5216_041_0	2			1		08/02/2017	2018.03	08/02/2017 03:23:19 PM Eastern Daylight Time	08/05/2017 10:38:00 AM Eastern Daylight Time	08/04/2017 09:53:16 AM Eastern Daylight Time			08/06/2017 08:53:33 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-041 (PPO)	01	04		1			H5216	041	0	2018	Honolulu, Kauai and Maui counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	042	0	1	04	01	H5216_042_0	3			1		06/28/2017	2018.03	06/28/2017 12:23:08 PM Eastern Daylight Time	08/04/2017 04:11:55 PM Eastern Daylight Time	08/04/2017 09:53:17 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-042 (PPO)	01	04		1			H5216	042	0	2018	Select Counties in Texas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	043	1	1	04	01	H5216_043_1	2			1		05/27/2017	2018.03	05/27/2017 11:34:39 AM Eastern Daylight Time	08/04/2017 04:10:52 PM Eastern Daylight Time	08/04/2017 09:53:18 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-043 (PPO)	01	04		1			H5216	043	1	2018	Select Counties in Texas	Select Counties in Texas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	043	2	1	04	01	H5216_043_2	2			1		05/27/2017	2018.03	05/27/2017 11:37:01 AM Eastern Daylight Time	08/04/2017 04:09:52 PM Eastern Daylight Time	08/04/2017 09:53:18 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-043 (PPO)	01	04		1			H5216	043	2	2018	Select Counties in Texas	Select Counties in Texas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	044	0	1	04	01	H5216_044_0	4			1		06/28/2017	2018.03	06/28/2017 10:32:17 AM Eastern Daylight Time	08/04/2017 05:11:33 PM Eastern Daylight Time	08/04/2017 09:53:19 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-044 (PPO)	01	04		1			H5216	044	0	2018	Select Counties in Idaho and Malheur County Oregon		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	045	0	1	04	01	H5216_045_0	3			1		06/28/2017	2018.03	06/28/2017 12:24:00 PM Eastern Daylight Time	08/04/2017 01:43:40 PM Eastern Daylight Time	08/04/2017 09:53:19 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-045 (PPO)	01	04		1			H5216	045	0	2018	Columbus Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	046	0	1	04	01	H5216_046_0	3			1		06/28/2017	2018.03	06/28/2017 10:33:12 AM Eastern Daylight Time	06/01/2017 06:55:24 PM Eastern Daylight Time				06/29/2017 11:07:50 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-046 (PPO)	01	04		1			H5216	046	0	2018	Select Counties in ID, OR, WA and UT		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	047	0	1	04	01	H5216_047_0	4			1		06/28/2017	2018.03	06/28/2017 10:33:59 AM Eastern Daylight Time	08/04/2017 05:17:02 PM Eastern Daylight Time	08/04/2017 09:53:20 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-047 (PPO)	01	04		1			H5216	047	0	2018	Select Counties in Washington and Oregon		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	048	0	1	04	01	H5216_048_0	4			1		06/28/2017	2018.03	06/28/2017 10:35:04 AM Eastern Daylight Time	08/04/2017 05:20:41 PM Eastern Daylight Time	08/04/2017 09:53:20 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-048 (PPO)	01	04		1			H5216	048	0	2018	Select Counties in ID, OR and WA		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	050	0	1	04	01	H5216_050_0	3			1		06/28/2017	2018.03	06/28/2017 12:24:53 PM Eastern Daylight Time	08/04/2017 01:45:08 PM Eastern Daylight Time	08/04/2017 09:53:21 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-050 (PPO)	01	04		1			H5216	050	0	2018	Northwest Ohio Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	051	0	1	04	01	H5216_051_0	3			1		06/28/2017	2018.03	06/28/2017 12:25:46 PM Eastern Daylight Time	08/04/2017 01:44:39 PM Eastern Daylight Time	08/04/2017 09:53:22 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-051 (PPO)	01	04		1			H5216	051	0	2018	Canton-Youngstown Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	052	1	1	04	01	H5216_052_1	3			1		06/28/2017	2018.03	06/28/2017 12:26:42 PM Eastern Daylight Time	08/04/2017 01:59:34 PM Eastern Daylight Time	08/04/2017 09:53:22 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-052 (PPO)	01	04		1			H5216	052	1	2018	Select counties in northwest West Virginia	Select counties in Ohio	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	052	2	1	04	01	H5216_052_2	3			1		06/28/2017	2018.03	06/28/2017 12:27:34 PM Eastern Daylight Time	08/04/2017 01:58:37 PM Eastern Daylight Time	08/04/2017 09:53:23 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-052 (PPO)	01	04		1			H5216	052	2	2018	Select counties in northwest West Virginia	Select counties in northwest West Virginia	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	053	0	1	04	01	H5216_053_0	3			1		06/28/2017	2018.03	06/28/2017 12:28:23 PM Eastern Daylight Time	08/04/2017 01:45:35 PM Eastern Daylight Time	08/04/2017 09:53:23 AM Eastern Daylight Time			08/06/2017 11:29:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-053 (PPO)	01	04		1			H5216	053	0	2018	Central Indiana Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	054	0	1	04	01	H5216_054_0	2			1		05/27/2017	2018.03	05/27/2017 04:39:14 PM Eastern Daylight Time	08/04/2017 01:42:42 PM Eastern Daylight Time	08/04/2017 09:53:24 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-054 (PPO)	01	04		1			H5216	054	0	2018	Southern Indiana Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	055	0	1	04	01	H5216_055_0	3			1		06/28/2017	2018.03	06/28/2017 12:29:13 PM Eastern Daylight Time	08/04/2017 01:43:11 PM Eastern Daylight Time	08/04/2017 09:53:24 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-055 (PPO)	01	04		1			H5216	055	0	2018	Northern Indiana Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	056	0	1	04	01	H5216_056_0	2			1		05/27/2017	2018.03	05/27/2017 03:05:06 PM Eastern Daylight Time	08/04/2017 03:07:13 PM Eastern Daylight Time	08/04/2017 09:53:25 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-056 (PPO)	01	04		1			H5216	056	0	2018	Greater Georgia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	057	0	1	04	01	H5216_057_0	3			1		06/28/2017	2018.03	06/28/2017 10:18:25 AM Eastern Daylight Time	08/05/2017 10:11:08 AM Eastern Daylight Time	08/04/2017 09:53:25 AM Eastern Daylight Time			08/06/2017 09:08:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-057 (PPO)	01	04		1			H5216	057	0	2018	Select Counties in New Hampshire		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	058	0	1	04	01	H5216_058_0	3			1		08/02/2017	2018.03	08/02/2017 01:58:54 PM Eastern Daylight Time	08/05/2017 10:14:25 AM Eastern Daylight Time	08/04/2017 09:53:26 AM Eastern Daylight Time			08/06/2017 09:08:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-058 (PPO)	01	04		1			H5216	058	0	2018	Select Counties in New Hampshire		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	059	0	1	04	01	H5216_059_0	3			1		06/28/2017	2018.03	06/28/2017 10:18:52 AM Eastern Daylight Time	06/01/2017 07:48:26 PM Eastern Daylight Time				06/29/2017 11:05:45 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-059 (PPO)	01	04		1			H5216	059	0	2018	Select Counties in New Hampshire		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	060	0	1	04	01	H5216_060_0	4			1		06/28/2017	2018.03	06/28/2017 11:35:15 AM Eastern Daylight Time	08/04/2017 07:13:14 PM Eastern Daylight Time	08/04/2017 09:53:26 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-060 (PPO)	01	04		1			H5216	060	0	2018	Martin and St. Lucie counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	061	0	1	04	01	H5216_061_0	3			1		08/03/2017	2018.03	08/03/2017 09:55:05 AM Eastern Daylight Time	08/04/2017 09:19:19 PM Eastern Daylight Time	08/04/2017 09:53:27 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-061 (PPO)	01	04		1			H5216	061	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	062	0	1	04	01	H5216_062_0	3			1		08/03/2017	2018.03	08/03/2017 09:55:49 AM Eastern Daylight Time	08/04/2017 09:18:46 PM Eastern Daylight Time	08/04/2017 09:53:27 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-062 (PPO)	01	04		1			H5216	062	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	063	0	1	04	01	H5216_063_0	3			1		05/27/2017	2018.03	05/27/2017 03:37:39 PM Eastern Daylight Time	08/04/2017 04:37:20 PM Eastern Daylight Time	08/04/2017 09:53:28 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-063 (PPO)	01	04		1			H5216	063	0	2018	Select Counties in Minnesota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	064	0	1	04	01	H5216_064_0	3			1		05/27/2017	2018.03	05/27/2017 02:10:48 PM Eastern Daylight Time	08/04/2017 02:12:03 PM Eastern Daylight Time	08/04/2017 09:53:28 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-064 (PPO)	01	04		1			H5216	064	0	2018	Select Louisiana Parishes		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	065	0	1	04	01	H5216_065_0	3			1		06/28/2017	2018.03	06/28/2017 11:40:41 AM Eastern Daylight Time	08/04/2017 06:57:22 PM Eastern Daylight Time	08/04/2017 09:53:29 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-065 (PPO)	01	04		1			H5216	065	0	2018	Broward, Miami-Dade and Palm Beach Counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	066	0	1	04	01	H5216_066_0	2			1		05/27/2017	2018.03	05/27/2017 02:11:30 PM Eastern Daylight Time	08/04/2017 02:11:07 PM Eastern Daylight Time	08/04/2017 09:53:30 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-066 (PPO)	01	04		1			H5216	066	0	2018	Gulf Coast / Biloxi Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	067	0	1	04	01	H5216_067_0	2			1		05/27/2017	2018.03	05/27/2017 02:12:27 PM Eastern Daylight Time	08/04/2017 02:11:34 PM Eastern Daylight Time	08/04/2017 09:53:30 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-067 (PPO)	01	04		1			H5216	067	0	2018	Select Counties in Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	068	0	1	04	01	H5216_068_0	4			1		08/03/2017	2018.03	08/03/2017 09:49:38 AM Eastern Daylight Time	08/05/2017 10:44:19 AM Eastern Daylight Time	08/04/2017 09:53:31 AM Eastern Daylight Time			08/06/2017 09:24:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-068 (PPO)	01	04		1			H5216	068	0	2018	Broward, Miami-Dade and Palm Beach Counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	070	0	1	04	01	H5216_070_0	3			1		08/02/2017	2018.03	08/02/2017 01:19:39 PM Eastern Daylight Time	08/06/2017 10:35:18 AM Eastern Daylight Time	08/04/2017 09:53:31 AM Eastern Daylight Time			08/06/2017 10:57:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-070 (PPO)	01	04		1			H5216	070	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	071	0	1	04	01	H5216_071_0	3			1		06/28/2017	2018.03	06/28/2017 11:18:10 AM Eastern Daylight Time	08/04/2017 03:09:42 PM Eastern Daylight Time	08/04/2017 09:53:32 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-071 (PPO)	01	04		1			H5216	071	0	2018	Western Atlanta Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	072	0	1	04	01	H5216_072_0	3			1		08/02/2017	2018.03	08/02/2017 01:21:15 PM Eastern Daylight Time	08/04/2017 08:23:15 PM Eastern Daylight Time	08/04/2017 09:53:32 AM Eastern Daylight Time			08/06/2017 08:45:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-072 (PPO)	01	04		1			H5216	072	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	073	0	1	04	01	H5216_073_0	2			1		05/27/2017	2018.03	05/27/2017 03:08:30 PM Eastern Daylight Time	08/04/2017 03:05:15 PM Eastern Daylight Time	08/04/2017 09:53:33 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-073 (PPO)	01	04		1			H5216	073	0	2018	Atlanta Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	074	0	1	04	01	H5216_074_0	4			1		08/02/2017	2018.03	08/02/2017 01:22:49 PM Eastern Daylight Time	08/06/2017 10:36:00 AM Eastern Daylight Time	08/04/2017 09:53:33 AM Eastern Daylight Time			08/06/2017 10:57:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice Florida H5216-074 (PPO)	01	04		1			H5216	074	0	2018	Lake, Marion and Sumter counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	075	0	1	04	01	H5216_075_0	2			1		05/27/2017	2018.03	05/27/2017 03:09:46 PM Eastern Daylight Time	08/04/2017 03:05:43 PM Eastern Daylight Time	08/04/2017 09:53:34 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-075 (PPO)	01	04		1			H5216	075	0	2018	Charleston Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	076	0	1	04	01	H5216_076_0	2			1		05/27/2017	2018.03	05/27/2017 03:12:11 PM Eastern Daylight Time	08/04/2017 03:06:13 PM Eastern Daylight Time	08/04/2017 09:53:34 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-076 (PPO)	01	04		1			H5216	076	0	2018	Spartanburg/Greenville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	077	0	1	04	01	H5216_077_0	3			1		05/27/2017	2018.03	05/27/2017 12:33:14 PM Eastern Daylight Time	06/01/2017 12:13:11 PM Eastern Daylight Time				06/02/2017 09:04:18 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-077 (PPO)	01	04		1			H5216	077	0	2018	Select Counties in Colorado and New Mexico		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						1	01	4b;8a1;8a2;8b3;	
H5216	078	1	1	04	01	H5216_078_1	2			1		05/27/2017	2018.03	05/27/2017 12:33:53 PM Eastern Daylight Time	08/04/2017 04:18:56 PM Eastern Daylight Time	08/04/2017 09:53:35 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-078 (PPO)	01	04		1			H5216	078	1	2018	Select Counties in Colorado	Select Counties in Colorado	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	4b;8a1;8a2;8b3;	
H5216	078	2	1	04	01	H5216_078_2	2			1		08/03/2017	2018.03	08/03/2017 11:57:21 AM Eastern Daylight Time	08/04/2017 04:22:47 PM Eastern Daylight Time	08/04/2017 09:53:35 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-078 (PPO)	01	04		1			H5216	078	2	2018	Select Counties in Colorado	Colorado Springs/Grand Junction	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	4b;8a1;8a2;8b3;	
H5216	079	0	1	04	01	H5216_079_0	5			1		06/28/2017	2018.03	06/28/2017 11:17:43 AM Eastern Daylight Time	08/04/2017 04:24:32 PM Eastern Daylight Time	08/04/2017 09:53:36 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-079 (PPO)	01	04		1			H5216	079	0	2018	Select Counties in New Mexico		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						1	01	4b;8a1;8a2;8b3;	
H5216	080	1	1	04	01	H5216_080_1	2			1		05/29/2017	2018.03	05/29/2017 12:52:02 PM Eastern Daylight Time	08/04/2017 04:33:44 PM Eastern Daylight Time	08/04/2017 09:53:37 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-080 (PPO)	01	04		1			H5216	080	1	2018	Select Counties in Minnesota and Wisconsin	Twin Cities	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	080	2	1	04	01	H5216_080_2	2			1		05/29/2017	2018.03	05/29/2017 12:53:48 PM Eastern Daylight Time	08/04/2017 04:34:11 PM Eastern Daylight Time	08/04/2017 09:53:37 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-080 (PPO)	01	04		1			H5216	080	2	2018	Select Counties in Minnesota and Wisconsin	Rochester	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	080	3	1	04	01	H5216_080_3	2			1		05/31/2017	2018.03	05/31/2017 04:44:02 PM Eastern Daylight Time	08/04/2017 04:35:05 PM Eastern Daylight Time	08/04/2017 09:53:38 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-080 (PPO)	01	04		1			H5216	080	3	2018	Select Counties in Minnesota and Wisconsin	Duluth	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	081	0	1	04	01	H5216_081_0	3			1		06/28/2017	2018.03	06/28/2017 11:24:40 AM Eastern Daylight Time	08/04/2017 03:49:53 PM Eastern Daylight Time	08/04/2017 09:53:38 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-081 (PPO)	01	04		1			H5216	081	0	2018	Select counties in Oklahoma		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	082	0	1	04	01	H5216_082_0	2			1		05/27/2017	2018.03	05/27/2017 02:38:02 PM Eastern Daylight Time	08/04/2017 03:50:29 PM Eastern Daylight Time	08/04/2017 09:53:39 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-082 (PPO)	01	04		1			H5216	082	0	2018	Select counties in AR, KS and MO		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	083	0	1	04	01	H5216_083_0	2			1		05/29/2017	2018.03	05/29/2017 11:11:42 AM Eastern Daylight Time	08/04/2017 03:51:08 PM Eastern Daylight Time	08/04/2017 09:53:39 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-083 (PPO)	01	04		1			H5216	083	0	2018	Select counties in AR, KS, MO and OK		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	084	0	1	04	01	H5216_084_0	2			1		05/30/2017	2018.03	05/30/2017 05:23:30 PM Eastern Daylight Time	08/04/2017 04:28:19 PM Eastern Daylight Time	08/04/2017 09:53:40 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-084 (PPO)	01	04		1			H5216	084	0	2018	Select Counties in South Dakota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	085	0	1	04	01	H5216_085_0	2			1		05/30/2017	2018.03	05/30/2017 05:23:35 PM Eastern Daylight Time	08/04/2017 04:27:53 PM Eastern Daylight Time	08/04/2017 09:53:40 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-085 (PPO)	01	04		1			H5216	085	0	2018	Omaha Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	086	0	1	04	01	H5216_086_0	3			1		06/28/2017	2018.03	06/28/2017 10:49:13 AM Eastern Daylight Time	06/01/2017 07:11:06 PM Eastern Daylight Time				06/29/2017 11:26:16 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-086 (PPO)	01	04		1			H5216	086	0	2018	Select Counties in IA, MN, MT, ND, NE, SD		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	087	0	1	04	01	H5216_087_0	2			1		05/30/2017	2018.03	05/30/2017 05:23:47 PM Eastern Daylight Time	08/04/2017 04:28:46 PM Eastern Daylight Time	08/04/2017 09:53:41 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-087 (PPO)	01	04		1			H5216	087	0	2018	Select Counties in North Dakota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	088	0	1	04	01	H5216_088_0	3			1		06/28/2017	2018.03	06/28/2017 10:49:31 AM Eastern Daylight Time	08/04/2017 04:29:13 PM Eastern Daylight Time	08/04/2017 09:53:42 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-088 (PPO)	01	04		1			H5216	088	0	2018	Select Counties in South Dakota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	089	0	1	04	01	H5216_089_0	2			1		05/30/2017	2018.03	05/30/2017 05:24:01 PM Eastern Daylight Time	08/04/2017 04:31:01 PM Eastern Daylight Time	08/04/2017 09:53:42 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-089 (PPO)	01	04		1			H5216	089	0	2018	Select Counties in Montana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	091	0	1	04	01	H5216_091_0	2			1		05/30/2017	2018.03	05/30/2017 05:24:13 PM Eastern Daylight Time	08/04/2017 04:32:22 PM Eastern Daylight Time	08/04/2017 09:53:43 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-091 (PPO)	01	04		1			H5216	091	0	2018	Select Counties in Iowa		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	092	0	1	04	01	H5216_092_0	2			1		08/02/2017	2018.03	08/02/2017 01:51:24 PM Eastern Daylight Time	08/04/2017 04:34:38 PM Eastern Daylight Time	08/04/2017 09:53:43 AM Eastern Daylight Time			08/06/2017 09:21:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-092 (PPO)	01	04		1			H5216	092	0	2018	Select Counties in MN, ND and SD		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	093	0	1	04	01	H5216_093_0	3			1		05/27/2017	2018.03	05/27/2017 01:58:13 PM Eastern Daylight Time	08/04/2017 02:15:51 PM Eastern Daylight Time	08/04/2017 09:53:44 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-093 (PPO)	01	04		1			H5216	093	0	2018	Memphis Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	094	0	1	04	01	H5216_094_0	2			1		05/27/2017	2018.03	05/27/2017 12:04:13 PM Eastern Daylight Time	08/04/2017 02:19:19 PM Eastern Daylight Time	08/04/2017 09:53:44 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-094 (PPO)	01	04		1			H5216	094	0	2018	Select Counties in Alabama		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	095	0	1	04	01	H5216_095_0	2			1		05/31/2017	2018.03	05/31/2017 01:30:03 PM Eastern Daylight Time	08/04/2017 02:18:00 PM Eastern Daylight Time	08/04/2017 09:53:45 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-095 (PPO)	01	04		1			H5216	095	0	2018	Select Counties in Alabama		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	096	0	1	04	01	H5216_096_0	4			1		05/27/2017	2018.03	05/27/2017 12:06:13 PM Eastern Daylight Time	08/04/2017 02:18:26 PM Eastern Daylight Time	08/04/2017 09:53:45 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-096 (PPO)	01	04		1			H5216	096	0	2018	Dothan Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	097	0	1	04	01	H5216_097_0	2			1		05/27/2017	2018.03	05/27/2017 01:59:25 PM Eastern Daylight Time	08/04/2017 02:16:17 PM Eastern Daylight Time	08/04/2017 09:53:46 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-097 (PPO)	01	04		1			H5216	097	0	2018	Nashville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	098	0	1	04	01	H5216_098_0	2			1		05/27/2017	2018.03	05/27/2017 02:00:17 PM Eastern Daylight Time	08/04/2017 02:16:43 PM Eastern Daylight Time	08/04/2017 09:53:46 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-098 (PPO)	01	04		1			H5216	098	0	2018	Chattanooga Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	099	0	1	04	01	H5216_099_0	2			1		05/27/2017	2018.03	05/27/2017 02:01:04 PM Eastern Daylight Time	08/04/2017 02:17:09 PM Eastern Daylight Time	08/04/2017 09:53:47 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-099 (PPO)	01	04		1			H5216	099	0	2018	Knoxville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	100	0	1	04	01	H5216_100_0	2			1		05/27/2017	2018.03	05/27/2017 02:01:48 PM Eastern Daylight Time	08/04/2017 02:17:35 PM Eastern Daylight Time	08/04/2017 09:53:48 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-100 (PPO)	01	04		1			H5216	100	0	2018	Select Counties in the Tri-Cities Area of Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	103	0	1	04	01	H5216_103_0	2			1		05/30/2017	2018.03	05/30/2017 10:58:31 AM Eastern Daylight Time	08/04/2017 04:37:47 PM Eastern Daylight Time	08/04/2017 09:53:48 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-103 (PPO)	01	04		1			H5216	103	0	2018	Select Counties in North Dakota and South Dakota		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	104	0	1	04	01	H5216_104_0	2			1		05/27/2017	2018.03	05/27/2017 03:41:03 PM Eastern Daylight Time	08/04/2017 04:38:13 PM Eastern Daylight Time	08/04/2017 09:53:49 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-104 (PPO)	01	04		1			H5216	104	0	2018	Dallas and Polk counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	105	0	1	04	01	H5216_105_0	2			1		05/30/2017	2018.03	05/30/2017 10:28:26 AM Eastern Daylight Time	06/01/2017 09:33:58 PM Eastern Daylight Time				06/02/2017 08:34:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-105 (PPO)	01	04		1			H5216	105	0	2018	Select counties in Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	106	0	1	04	01	H5216_106_0	2			1		08/02/2017	2018.03	08/02/2017 03:13:10 PM Eastern Daylight Time	08/04/2017 02:00:02 PM Eastern Daylight Time	08/04/2017 09:53:49 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-106 (PPO)	01	04		1			H5216	106	0	2018	Select counties in Northeast Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	107	0	1	04	01	H5216_107_0	2			1		05/30/2017	2018.03	05/30/2017 04:27:07 PM Eastern Daylight Time	08/04/2017 05:36:54 PM Eastern Daylight Time	08/04/2017 09:53:50 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-107 (PPO)	01	04		1			H5216	107	0	2018	Select counties in Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	108	0	1	04	01	H5216_108_0	2			1		08/02/2017	2018.03	08/02/2017 03:46:13 PM Eastern Daylight Time	08/04/2017 02:00:32 PM Eastern Daylight Time	08/04/2017 09:53:50 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-108 (PPO)	01	04		1			H5216	108	0	2018	Select counties in Northwest Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	109	0	1	04	01	H5216_109_0	2			1		08/02/2017	2018.03	08/02/2017 03:18:52 PM Eastern Daylight Time	08/04/2017 02:01:30 PM Eastern Daylight Time	08/04/2017 09:53:51 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-109 (PPO)	01	04		1			H5216	109	0	2018	Select counties in Southwest Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	110	0	1	04	01	H5216_110_0	2			1		05/27/2017	2018.03	05/27/2017 04:50:58 PM Eastern Daylight Time	08/04/2017 02:01:01 PM Eastern Daylight Time	08/04/2017 09:53:51 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-110 (PPO)	01	04		1			H5216	110	0	2018	Select counties in Southeast Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	111	0	1	04	01	H5216_111_0	2			1		08/02/2017	2018.03	08/02/2017 03:20:07 PM Eastern Daylight Time	08/04/2017 02:02:00 PM Eastern Daylight Time	08/04/2017 09:53:52 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-111 (PPO)	01	04		1			H5216	111	0	2018	Select counties in Northwest and Central IN		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	112	0	1	04	01	H5216_112_0	2			1		08/02/2017	2018.03	08/02/2017 03:21:24 PM Eastern Daylight Time	08/04/2017 02:03:23 PM Eastern Daylight Time	08/04/2017 09:53:53 AM Eastern Daylight Time			08/06/2017 11:34:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-112 (PPO)	01	04		1			H5216	112	0	2018	Select counties in Northeast and Fort Wayne IN		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	113	0	1	04	01	H5216_113_0	2			1		08/02/2017	2018.03	08/02/2017 03:23:58 PM Eastern Daylight Time	08/04/2017 02:02:28 PM Eastern Daylight Time	08/04/2017 09:53:53 AM Eastern Daylight Time			08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-113 (PPO)	01	04		1			H5216	113	0	2018	Select counties in Southern Indiana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	114	0	1	04	01	H5216_114_0	2			1		08/02/2017	2018.03	08/02/2017 03:25:19 PM Eastern Daylight Time	08/04/2017 02:02:56 PM Eastern Daylight Time	08/04/2017 09:53:54 AM Eastern Daylight Time			08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-114 (PPO)	01	04		1			H5216	114	0	2018	Select counties in Indianapolis		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	115	0	1	04	01	H5216_115_0	3			1		08/02/2017	2018.03	08/02/2017 03:07:20 PM Eastern Daylight Time	08/04/2017 05:38:15 PM Eastern Daylight Time	08/04/2017 09:53:54 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Value Plus H5216-115 (PPO)	01	04		1			H5216	115	0	2018	Select counties in Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	116	0	1	04	01	H5216_116_0	1			1		05/30/2017	2018.03	05/30/2017 10:28:53 AM Eastern Daylight Time	06/01/2017 09:34:27 PM Eastern Daylight Time				06/02/2017 08:34:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-116 (PPO)	01	04		1			H5216	116	0	2018	Select counties in Pennsylvania		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	117	0	1	04	01	H5216_117_0	3			1		06/02/2017	2018.03	06/02/2017 03:14:51 PM Eastern Daylight Time	08/04/2017 05:38:42 PM Eastern Daylight Time	08/04/2017 09:53:55 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Value Plus H5216-117 (PPO)	01	04		1			H5216	117	0	2018	Select counties in Pennsylvania		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	119	0	1	04	01	H5216_119_0	2			1		05/30/2017	2018.03	05/30/2017 04:29:12 PM Eastern Daylight Time	08/04/2017 05:37:48 PM Eastern Daylight Time	08/04/2017 09:53:55 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-119 (PPO)	01	04		1			H5216	119	0	2018	Western Pennsylvania Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	120	0	1	04	01	H5216_120_0	2			1		05/30/2017	2018.03	05/30/2017 04:29:52 PM Eastern Daylight Time	08/04/2017 05:40:27 PM Eastern Daylight Time	08/04/2017 09:53:56 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-120 (PPO)	01	04		1			H5216	120	0	2018	South Central Pennsylvania Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	121	0	1	04	01	H5216_121_0	2			1		05/30/2017	2018.03	05/30/2017 04:31:45 PM Eastern Daylight Time	08/04/2017 05:40:53 PM Eastern Daylight Time	08/04/2017 09:53:56 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-121 (PPO)	01	04		1			H5216	121	0	2018	North Central Pennsylvania Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	122	0	1	04	01	H5216_122_0	2			1		05/30/2017	2018.03	05/30/2017 04:32:44 PM Eastern Daylight Time	08/04/2017 05:40:00 PM Eastern Daylight Time	08/04/2017 09:53:57 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-122 (PPO)	01	04		1			H5216	122	0	2018	Greater Philadelphia Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	123	0	1	04	01	H5216_123_0	1			1		05/30/2017	2018.03	05/30/2017 10:29:22 AM Eastern Daylight Time	06/01/2017 09:34:55 PM Eastern Daylight Time				06/02/2017 08:46:49 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-123 (PPO)	01	04		1			H5216	123	0	2018	Select counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	124	0	1	04	01	H5216_124_0	2			1		05/30/2017	2018.03	05/30/2017 04:33:44 PM Eastern Daylight Time	08/04/2017 05:37:21 PM Eastern Daylight Time	08/04/2017 09:53:57 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-124 (PPO)	01	04		1			H5216	124	0	2018	Select counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	125	0	1	04	01	H5216_125_0	3			1		06/02/2017	2018.03	06/02/2017 03:18:52 PM Eastern Daylight Time	08/04/2017 05:39:08 PM Eastern Daylight Time	08/04/2017 09:53:58 AM Eastern Daylight Time			08/06/2017 10:37:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Value Plus H5216-125 (PPO)	01	04		1			H5216	125	0	2018	Select counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	126	0	1	04	01	H5216_126_0	3			1		07/11/2017	2018.03	07/11/2017 01:00:32 PM Eastern Daylight Time	08/04/2017 05:37:07 PM Eastern Daylight Time	08/04/2017 09:53:58 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-126 (PPO)	01	04		1			H5216	126	0	2018	Northern Virginia area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	127	0	1	04	01	H5216_127_0	2			1		05/27/2017	2018.03	05/27/2017 11:23:39 AM Eastern Daylight Time	06/01/2017 06:38:04 PM Eastern Daylight Time				06/02/2017 09:37:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-127 (PPO)	01	04		1			H5216	127	0	2018	Kent, New Castle and Sussex counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	128	0	1	04	01	H5216_128_0	2			1		05/30/2017	2018.03	05/30/2017 02:30:44 PM Eastern Daylight Time	06/01/2017 04:30:44 PM Eastern Daylight Time				06/02/2017 08:21:00 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-128 (PPO)	01	04		1			H5216	128	0	2018	Select Counties in Texas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	129	0	1	04	01	H5216_129_0	1			1		05/27/2017	2018.03	05/27/2017 11:22:45 AM Eastern Daylight Time	06/01/2017 06:26:17 PM Eastern Daylight Time				06/02/2017 09:37:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-129 (PPO)	01	04		1			H5216	129	0	2018	Select Counties in Western Maryland		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	131	0	1	04	01	H5216_131_0	4			1		08/02/2017	2018.03	08/02/2017 03:52:34 PM Eastern Daylight Time	08/04/2017 05:33:12 PM Eastern Daylight Time	08/04/2017 09:53:59 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-131 (PPO)	01	04		1			H5216	131	0	2018	Davis, Salt Lake, Utah and Weber Counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	132	0	1	04	01	H5216_132_0	4			1		06/28/2017	2018.03	06/28/2017 10:39:59 AM Eastern Daylight Time	08/04/2017 05:34:06 PM Eastern Daylight Time	08/04/2017 09:53:59 AM Eastern Daylight Time			08/06/2017 09:17:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-132 (PPO)	01	04		1			H5216	132	0	2018	Select Counties in Idaho and Malheur County Oregon		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	133	0	1	04	01	H5216_133_0	2			1		05/29/2017	2018.03	05/29/2017 05:48:39 PM Eastern Daylight Time	08/04/2017 02:49:59 PM Eastern Daylight Time	08/04/2017 09:54:00 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Value Plus H5216-133 (PPO)	01	04		1			H5216	133	0	2018	Macomb, Oakland and Wayne counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	135	0	1	04	01	H5216_135_0	2			1		05/27/2017	2018.03	05/27/2017 02:13:41 PM Eastern Daylight Time	08/04/2017 02:13:02 PM Eastern Daylight Time	08/04/2017 09:54:00 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-135 (PPO)	01	04		1			H5216	135	0	2018	Select Louisiana Parishes		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	136	0	1	04	01	H5216_136_0	2			1		05/27/2017	2018.03	05/27/2017 02:14:22 PM Eastern Daylight Time	08/04/2017 02:14:29 PM Eastern Daylight Time	08/04/2017 09:54:01 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-136 (PPO)	01	04		1			H5216	136	0	2018	Select Counties in Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	137	0	1	04	01	H5216_137_0	5			1		08/02/2017	2018.03	08/02/2017 12:14:55 PM Eastern Daylight Time	08/04/2017 04:26:02 PM Eastern Daylight Time	08/04/2017 09:54:01 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-137 (PPO)	01	04		1			H5216	137	0	2018	Select Counties in New Mexico		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	138	0	1	04	01	H5216_138_0	5			1		06/28/2017	2018.03	06/28/2017 10:20:02 AM Eastern Daylight Time	08/05/2017 10:17:15 AM Eastern Daylight Time	08/04/2017 09:54:02 AM Eastern Daylight Time			08/06/2017 09:08:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-138 (PPO)	01	04		1			H5216	138	0	2018	Select Counties in New Hampshire		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	139	0	1	04	01	H5216_139_0	4			1		08/02/2017	2018.03	08/02/2017 02:33:10 PM Eastern Daylight Time	08/04/2017 03:52:18 PM Eastern Daylight Time	08/04/2017 09:54:02 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-139 (PPO)	01	04		1			H5216	139	0	2018	Select counties in Arkansas and Oklahoma		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	140	0	1	04	01	H5216_140_0	2			1		06/28/2017	2018.03	06/28/2017 10:14:12 AM Eastern Daylight Time	06/02/2017 12:13:04 AM Eastern Daylight Time				06/29/2017 11:06:26 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-140 (PPO)	01	04		1			H5216	140	0	2018	Select counties in Arkansas and Oklahoma		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5216	141	0	1	04	01	H5216_141_0	3			1		08/02/2017	2018.03	08/02/2017 03:09:37 PM Eastern Daylight Time	08/04/2017 01:13:56 PM Eastern Daylight Time	08/04/2017 09:54:03 AM Eastern Daylight Time			08/06/2017 09:17:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice H5216-141 (PPO)	01	04		1			H5216	141	0	2018	Clark and Nye (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5216	805	0	1	04	01	H5216_805_0	4			1		06/13/2017	2018.03	06/13/2017 10:10:09 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5216	805	0	2018	Select Counties in Multi-States		1	2037564	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5216	806	0	1	04	01	H5216_806_0	4			1		06/13/2017	2018.03	06/13/2017 10:11:01 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5216	806	0	2018	Select Counties in Multi-States		1	2551056	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711									1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5216	807	0	1	04	01	H5216_807_0	4			1		06/13/2017	2018.03	06/13/2017 10:11:48 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		1			H5216	807	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5216	808	0	2	04	01	H5216_808_0	4			1		06/13/2017	2018.03	06/13/2017 10:12:39 AM Eastern Daylight Time					06/13/2017 10:28:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5216	808	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5216	809	0	2	04	01	H5216_809_0	5			1		06/13/2017	2018.03	06/13/2017 10:13:29 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5216	809	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711									1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5216	810	0	2	04	01	H5216_810_0	5			1		06/13/2017	2018.03	06/13/2017 10:14:12 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		2	1		H5216	810	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	(888)396-8810	711	(888)396-8810	711	(800)824-8242	711	(800)824-8242	711	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5253	004	0	1	01	01	H5253_004_0	3			1		08/04/2017	2018.03	08/04/2017 08:49:48 AM Central Daylight Time	08/03/2017 01:39:39 PM Central Daylight Time	08/01/2017 10:59:55 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	004	0	2018	Milwaukee Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	007	0	1	02	01	H5253_007_0	5		1	1		08/03/2017	2018.03	08/03/2017 01:06:53 PM Central Daylight Time	08/03/2017 01:40:17 PM Central Daylight Time	08/01/2017 11:00:22 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H5253	007	0	2018	Select Counties in Wisconsin		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	011	0	1	01	01	H5253_011_0	3			1		06/01/2017	2018.03	06/01/2017 09:07:47 AM Central Daylight Time	08/03/2017 01:40:54 PM Central Daylight Time	08/01/2017 11:00:48 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	011	0	2018	Select counties in Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	021	0	1	01	01	H5253_021_0	3			1		05/18/2017	2018.03	05/18/2017 04:47:57 PM Central Daylight Time	06/01/2017 01:08:28 PM Central Daylight Time				07/06/2017 03:56:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H5253	021	0	2018	Select counties in Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5253	024	0	1	01	01	H5253_024_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:46:00 AM Central Daylight Time	08/03/2017 01:42:12 PM Central Daylight Time	08/01/2017 11:01:14 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H5253	024	0	2018	Select counties in Wisconsin		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(877)702-5110		(877)702-5110		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	030	0	1	01	01	H5253_030_0	4			1		06/01/2017	2018.03	06/01/2017 09:08:25 AM Central Daylight Time	08/04/2017 08:29:02 AM Central Daylight Time	08/01/2017 11:01:40 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	030	0	2018	Select Counties in Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	033	0	1	01	01	H5253_033_0	4			1		08/02/2017	2018.03	08/02/2017 01:47:43 PM Central Daylight Time	08/03/2017 01:43:28 PM Central Daylight Time	08/01/2017 11:02:07 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Value (HMO)	01	01		1			H5253	033	0	2018	Milwaukee Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	034	0	1	01	01	H5253_034_0	4			1		08/02/2017	2018.03	08/02/2017 01:48:27 PM Central Daylight Time	08/03/2017 01:44:06 PM Central Daylight Time	08/01/2017 11:02:33 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Value (HMO)	01	01		1			H5253	034	0	2018	Select Counties in Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	035	0	1	02	01	H5253_035_0	4			1		08/02/2017	2018.03	08/02/2017 01:47:15 PM Central Daylight Time	08/03/2017 01:44:43 PM Central Daylight Time	08/01/2017 11:02:59 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H5253	035	0	2018	Graham, Pima, and Santa Cruz counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	036	0	1	01	01	H5253_036_0	3			1		06/01/2017	2018.03	06/01/2017 09:10:26 AM Central Daylight Time	08/03/2017 01:45:20 PM Central Daylight Time	08/01/2017 11:03:25 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	036	0	2018	Yavapai county		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	037	0	1	01	01	H5253_037_0	3			1		06/02/2017	2018.03	06/02/2017 08:19:48 AM Central Daylight Time	08/03/2017 01:45:57 PM Central Daylight Time	08/01/2017 11:03:51 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	037	0	2018	Select counties in North Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;7d;	
H5253	038	0	1	01	01	H5253_038_0	3			1		08/02/2017	2018.03	08/02/2017 01:42:02 PM Central Daylight Time	08/03/2017 01:46:34 PM Central Daylight Time	08/01/2017 11:04:17 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	038	0	2018	Select counties in North Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;7d;	
H5253	039	0	1	01	01	H5253_039_0	4			1		08/02/2017	2018.03	08/02/2017 01:42:22 PM Central Daylight Time	08/03/2017 01:47:11 PM Central Daylight Time	08/01/2017 11:04:43 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	039	0	2018	Durham and Wake counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	040	0	1	01	01	H5253_040_0	2			1		05/22/2017	2018.03	05/22/2017 08:27:09 AM Central Daylight Time	06/01/2017 01:13:11 PM Central Daylight Time				07/06/2017 03:18:57 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H5253	040	0	2018	Select counties in North Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	1	01	7a;7d;	
H5253	041	0	1	01	01	H5253_041_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 09:52:06 AM Central Daylight Time	08/03/2017 01:47:49 PM Central Daylight Time	08/01/2017 11:05:11 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5253	041	0	2018	Select Counties in North Carolina		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	042	0	1	01	01	H5253_042_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:26:10 PM Central Daylight Time	08/03/2017 01:48:26 PM Central Daylight Time	08/01/2017 11:05:38 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H5253	042	0	2018	Select Counties in North Carolina		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	043	0	1	02	01	H5253_043_0	5		1	1		08/07/2017	2018.03	08/07/2017 03:57:06 PM Central Daylight Time	08/03/2017 01:49:03 PM Central Daylight Time	08/01/2017 11:06:04 AM Central Daylight Time			08/07/2017 04:12:50 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (HMO-POS SNP)	01	02		1			H5253	043	0	2018	Select Counties in North Carolina		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	044	0	1	01	01	H5253_044_0	4			1		05/25/2017	2018.03	05/25/2017 11:28:24 AM Central Daylight Time	08/04/2017 08:29:47 AM Central Daylight Time	08/01/2017 11:06:30 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	044	0	2018	Select counties in Iowa		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	045	0	1	01	01	H5253_045_0	4			1		08/02/2017	2018.03	08/02/2017 02:29:54 PM Central Daylight Time	08/04/2017 08:30:30 AM Central Daylight Time	08/01/2017 11:06:56 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	045	0	2018	Select counties in Iowa		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	046	0	1	01	01	H5253_046_0	4			1		05/25/2017	2018.03	05/25/2017 11:28:42 AM Central Daylight Time	08/03/2017 01:50:57 PM Central Daylight Time	08/01/2017 11:07:23 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	046	0	2018	Peoria area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	047	0	1	02	01	H5253_047_0	4			1		08/03/2017	2018.03	08/03/2017 08:27:38 AM Central Daylight Time	08/04/2017 08:31:13 AM Central Daylight Time	08/01/2017 11:07:49 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H5253	047	0	2018	Select Counties in Tennessee and Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	048	0	1	02	01	H5253_048_0	4			1		07/20/2017	2018.03	07/20/2017 10:56:09 AM Central Daylight Time	08/04/2017 08:31:53 AM Central Daylight Time	08/01/2017 11:08:15 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 2 (HMO-POS)	01	02		1			H5253	048	0	2018	Select Counties in Tennessee and Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	049	0	1	01	01	H5253_049_0	4			1		08/02/2017	2018.03	08/02/2017 01:49:03 PM Central Daylight Time	08/04/2017 08:32:35 AM Central Daylight Time	08/01/2017 11:08:41 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 7 (HMO)	01	01		1			H5253	049	0	2018	Cleveland Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	050	0	1	01	01	H5253_050_0	5			1		08/02/2017	2018.03	08/02/2017 01:51:09 PM Central Daylight Time	08/04/2017 08:33:18 AM Central Daylight Time	08/01/2017 11:09:07 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	050	0	2018	Cleveland Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	051	0	1	01	01	H5253_051_0	4			1		06/28/2017	2018.03	06/28/2017 09:52:44 AM Central Daylight Time	08/04/2017 08:34:01 AM Central Daylight Time	08/01/2017 11:09:33 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5253	051	0	2018	Cleveland Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	052	0	1	01	01	H5253_052_0	4			1		08/02/2017	2018.03	08/02/2017 01:51:51 PM Central Daylight Time	08/04/2017 08:34:44 AM Central Daylight Time	08/01/2017 11:09:59 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 6 (HMO)	01	01		1			H5253	052	0	2018	Cincinnati/Dayton Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	053	0	1	01	01	H5253_053_0	4			1		06/01/2017	2018.03	06/01/2017 09:12:35 AM Central Daylight Time	08/03/2017 01:55:20 PM Central Daylight Time	08/01/2017 11:10:26 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	053	0	2018	Select counties in Ohio and Kentucky		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	054	0	1	01	01	H5253_054_0	4			1		06/28/2017	2018.03	06/28/2017 09:55:08 AM Central Daylight Time	08/04/2017 08:35:27 AM Central Daylight Time	08/01/2017 11:10:52 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5253	054	0	2018	Cincinnati/Dayton Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	055	0	1	01	01	H5253_055_0	4			1		06/28/2017	2018.03	06/28/2017 09:55:50 AM Central Daylight Time	08/04/2017 08:36:13 AM Central Daylight Time	08/01/2017 11:11:18 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5253	055	0	2018	Toledo Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	056	0	1	01	01	H5253_056_0	4			1		06/02/2017	2018.03	06/02/2017 08:44:55 AM Central Daylight Time	08/04/2017 08:24:30 AM Central Daylight Time	08/01/2017 11:11:44 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 4 (HMO)	01	01		1			H5253	056	0	2018	Toledo Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	057	0	1	01	01	H5253_057_0	4			1		08/02/2017	2018.03	08/02/2017 01:52:35 PM Central Daylight Time	08/04/2017 08:24:58 AM Central Daylight Time	08/01/2017 11:12:10 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 8 (HMO)	01	01		1			H5253	057	0	2018	Toledo Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	059	0	1	01	01	H5253_059_0	3		1	1	2	06/28/2017	2018.03	06/28/2017 10:46:26 AM Central Daylight Time	08/03/2017 01:58:31 PM Central Daylight Time	08/01/2017 11:12:37 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5253	059	0	2018	Select Counties in Ohio		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	060	0	1	02	01	H5253_060_0	4		1	1		08/02/2017	2018.03	08/02/2017 04:26:50 PM Central Daylight Time	08/03/2017 01:59:09 PM Central Daylight Time	08/01/2017 11:13:04 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H5253	060	0	2018	Select Counties in Ohio		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	061	0	1	02	01	H5253_061_0	4		1	1		06/28/2017	2018.03	06/28/2017 10:07:54 AM Central Daylight Time	08/03/2017 01:59:48 PM Central Daylight Time	08/01/2017 11:13:30 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (HMO-POS SNP)	01	02		1			H5253	061	0	2018	Select Counties in Ohio		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	062	0	1	01	01	H5253_062_0	4			1		08/02/2017	2018.03	08/02/2017 01:53:20 PM Central Daylight Time	08/04/2017 08:25:27 AM Central Daylight Time	08/01/2017 11:13:56 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 5 (HMO)	01	01		1			H5253	062	0	2018	Central Ohio area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	063	0	1	01	01	H5253_063_0	4			1		06/28/2017	2018.03	06/28/2017 09:56:36 AM Central Daylight Time	08/04/2017 08:25:56 AM Central Daylight Time	08/01/2017 11:14:23 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5253	063	0	2018	Central Ohio area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	064	0	1	02	01	H5253_064_0	4		1	1		08/07/2017	2018.03	08/07/2017 03:51:17 PM Central Daylight Time	08/03/2017 02:01:39 PM Central Daylight Time	08/01/2017 11:14:49 AM Central Daylight Time			08/07/2017 04:12:50 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Assisted Living Plan (HMO-POS SNP)	01	02		1			H5253	064	0	2018	Select Counties in Wisconsin		2		2			1	1	2				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	067	0	1	01	01	H5253_067_0	5			1		06/02/2017	2018.03	06/02/2017 08:45:16 AM Central Daylight Time	08/03/2017 02:02:17 PM Central Daylight Time	08/01/2017 11:15:15 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	067	0	2018	Lexington Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	068	0	1	01	01	H5253_068_0	5			1		06/28/2017	2018.03	06/28/2017 09:57:19 AM Central Daylight Time	08/03/2017 02:02:54 PM Central Daylight Time	08/01/2017 11:15:42 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	068	0	2018	Lexington Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	072	0	1	01	01	H5253_072_0	5			1		08/02/2017	2018.03	08/02/2017 01:53:55 PM Central Daylight Time	08/04/2017 08:26:24 AM Central Daylight Time	08/01/2017 11:16:08 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Value (HMO)	01	01		1			H5253	072	0	2018	Central Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	073	0	1	01	01	H5253_073_0	5			1		06/02/2017	2018.03	06/02/2017 08:46:52 AM Central Daylight Time	08/04/2017 08:26:53 AM Central Daylight Time	08/01/2017 11:16:34 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H5253	073	0	2018	Central Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	074	0	1	01	01	H5253_074_0	5			1		06/02/2017	2018.03	06/02/2017 08:47:27 AM Central Daylight Time	08/04/2017 08:27:22 AM Central Daylight Time	08/01/2017 11:17:01 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Premier (HMO)	01	01		1			H5253	074	0	2018	Central Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	075	0	1	01	01	H5253_075_0	5			1		06/02/2017	2018.03	06/02/2017 09:18:29 AM Central Daylight Time	08/03/2017 02:05:24 PM Central Daylight Time	08/01/2017 11:17:27 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Premier (HMO)	01	01		1			H5253	075	0	2018	Milwaukee Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	076	0	1	01	01	H5253_076_0	5			1		06/02/2017	2018.03	06/02/2017 08:48:24 AM Central Daylight Time	08/03/2017 02:06:03 PM Central Daylight Time	08/01/2017 11:17:53 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Premier (HMO)	01	01		1			H5253	076	0	2018	Green Bay and Northeast Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	077	0	1	01	01	H5253_077_0	5			1		06/02/2017	2018.03	06/02/2017 09:18:47 AM Central Daylight Time	08/04/2017 08:27:51 AM Central Daylight Time	08/01/2017 11:18:19 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Premier (HMO)	01	01		1			H5253	077	0	2018	Rural Wisconsin		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	079	0	1	01	01	H5253_079_0	4			1		06/01/2017	2018.03	06/01/2017 09:07:54 AM Central Daylight Time	08/03/2017 02:07:20 PM Central Daylight Time	08/01/2017 11:18:45 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	079	0	2018	Asheville Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;7d;	
H5253	080	0	1	01	01	H5253_080_0	4			1		06/01/2017	2018.03	06/01/2017 09:08:25 AM Central Daylight Time	08/03/2017 02:07:58 PM Central Daylight Time	08/01/2017 11:19:11 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	080	0	2018	Asheville Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;7d;	
H5253	081	0	1	01	01	H5253_081_0	4			1		06/01/2017	2018.03	06/01/2017 09:08:54 AM Central Daylight Time	08/03/2017 02:08:35 PM Central Daylight Time	08/01/2017 11:19:38 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	081	0	2018	Fayette, McNairy, and Shelby counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	082	0	1	01	01	H5253_082_0	4			1		06/01/2017	2018.03	06/01/2017 09:09:21 AM Central Daylight Time	08/03/2017 02:09:12 PM Central Daylight Time	08/01/2017 11:20:04 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	082	0	2018	Fayette, McNairy, and Shelby Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	083	0	1	01	01	H5253_083_0	4			1		08/02/2017	2018.03	08/02/2017 01:44:14 PM Central Daylight Time	08/04/2017 08:28:20 AM Central Daylight Time	08/01/2017 11:20:30 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	083	0	2018	Nashville Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	084	0	1	01	01	H5253_084_0	4			1		06/01/2017	2018.03	06/01/2017 09:10:17 AM Central Daylight Time	08/04/2017 08:28:49 AM Central Daylight Time	08/01/2017 11:20:56 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	084	0	2018	Nashville Metro Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	085	0	1	01	01	H5253_085_0	3			1		08/02/2017	2018.03	08/02/2017 01:48:05 PM Central Daylight Time	08/03/2017 02:11:05 PM Central Daylight Time	08/01/2017 11:21:22 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	085	0	2018	Select counties in Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	086	0	1	01	01	H5253_086_0	3			1		06/01/2017	2018.03	06/01/2017 09:10:56 AM Central Daylight Time	08/03/2017 02:11:43 PM Central Daylight Time	08/01/2017 11:21:48 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	086	0	2018	Select counties in Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	087	0	1	01	01	H5253_087_0	4			1		08/02/2017	2018.03	08/02/2017 01:48:58 PM Central Daylight Time	08/03/2017 02:12:20 PM Central Daylight Time	08/01/2017 11:22:14 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	087	0	2018	Southeastern Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	088	0	1	01	01	H5253_088_0	4			1		07/19/2017	2018.03	07/19/2017 04:01:02 PM Central Daylight Time	08/03/2017 02:12:57 PM Central Daylight Time	08/01/2017 11:22:40 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	088	0	2018	Southeastern Virginia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	089	0	1	01	01	H5253_089_0	4			1		06/01/2017	2018.03	06/01/2017 09:12:00 AM Central Daylight Time	08/03/2017 02:13:34 PM Central Daylight Time	08/01/2017 11:23:05 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5253	089	0	2018	Northern VA and Washington DC Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	090	0	1	01	01	H5253_090_0	4			1		06/01/2017	2018.03	06/01/2017 09:12:17 AM Central Daylight Time	08/03/2017 02:14:12 PM Central Daylight Time	08/01/2017 11:23:31 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H5253	090	0	2018	Northern VA and Washington DC Area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	091	0	1	01	01	H5253_091_0	5			1		08/02/2017	2018.03	08/02/2017 01:54:33 PM Central Daylight Time	08/03/2017 02:14:49 PM Central Daylight Time	08/01/2017 11:23:57 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5253	091	0	2018	Select counties in Lexington		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	097	0	1	01	01	H5253_097_0	5			1		08/04/2017	2018.03	08/04/2017 08:44:12 AM Central Daylight Time	08/04/2017 08:29:17 AM Central Daylight Time	08/01/2017 11:24:23 AM Central Daylight Time			08/04/2017 11:46:48 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Value (HMO)	01	01		1			H5253	097	0	2018	Select counties in Southern WI		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5253	801	0	1	01	01	H5253_801_0	2			1		06/08/2017	2018.03	06/08/2017 11:39:21 AM Central Daylight Time					06/13/2017 05:04:53 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	801	0	2018	Milwaukee and Green Bay Area Counties		1	324	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	802	0	1	01	01	H5253_802_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:16 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	802	0	2018	Milwaukee and Green Bay Area Counties		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H5253	805	0	1	01	01	H5253_805_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:23 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	805	0	2018	Select Counties in WI		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	810	0	1	01	01	H5253_810_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:29 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	810	0	2018	Arizona		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	811	0	1	01	01	H5253_811_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:36 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	811	0	2018	Arizona		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	812	0	1	01	01	H5253_812_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:43 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	812	0	2018	Arizona		1	0	2			2						9999	www.AARPMedicarePlans.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H5253	813	0	1	01	01	H5253_813_0	2			1		06/08/2017	2018.03	06/08/2017 11:39:42 AM Central Daylight Time					06/13/2017 05:04:53 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	813	0	2018	Select counties in North Carolina		1	5136	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	814	0	1	01	01	H5253_814_0	1			1		05/24/2017	2018.03	05/24/2017 01:35:56 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	814	0	2018	Select counties in North Carolina		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	815	0	1	01	01	H5253_815_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:03 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	815	0	2018	Select counties in North Carolina		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H5253	816	0	2	01	01	H5253_816_0	1			1		05/25/2017	2018.03	05/25/2017 12:46:51 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H5253	816	0	2018	Select counties in North Carolina		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	817	0	2	01	01	H5253_817_0	1			1		05/25/2017	2018.03	05/25/2017 10:57:46 AM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H5253	817	0	2018	Select counties in North Carolina		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	818	0	1	01	01	H5253_818_0	2			1		06/08/2017	2018.03	06/08/2017 11:41:11 AM Central Daylight Time					06/13/2017 05:04:53 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	818	0	2018	Select counties in IA, IL, TN, & VA		1	3996	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	819	0	1	01	01	H5253_819_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:16 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	819	0	2018	Select counties in IA, IL, TN, & VA		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H5253	820	0	1	01	01	H5253_820_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:23 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	820	0	2018	Select counties in IA, IL, TN, & VA		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	821	0	1	01	01	H5253_821_0	2			1		06/08/2017	2018.03	06/08/2017 11:43:58 AM Central Daylight Time					06/13/2017 05:04:53 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	821	0	2018	Select counties in Kentucky and Ohio		1	1032	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5253	822	0	1	01	01	H5253_822_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:36 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	822	0	2018	Select counties in Kentucky and Ohio		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H5253	823	0	1	01	01	H5253_823_0	1			1		05/24/2017	2018.03	05/24/2017 01:36:43 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	823	0	2018	Select counties in Kentucky and Ohio		1	0	2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H5256	001	0	1	18	06	H5256_001_0	3			2		06/26/2017	2018.03	06/26/2017 08:59:21 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H5256	001	0	2018	Grant, Crawford, Iowa, Lafayette Counties		2	33054	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2943		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H5256	002	0	1	18	06	H5256_002_0	3			2		06/26/2017	2018.03	06/26/2017 08:59:47 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H5256	002	0	2018	Grant, Crawford, Iowa, Lafayette Counties		2	4390	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H5256	004	0	1	18	06	H5256_004_0	3			2		06/26/2017	2018.03	06/26/2017 09:00:13 AM Central Daylight Time					06/26/2017 11:30:52 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H5256	004	0	2018	Grant, Crawford, Iowa, Lafayette Counties		2	3987	2			2									(866)821-1365		(563)584-4885		(800)747-8900		(563)556-8070										(800)735-2942		(800)735-2942		(800)735-2942		(800)735-2942										2					2					2	2			
H5262	001	0	1	01	01	H5262_001_0	2			1		06/02/2017	2018.03	06/02/2017 04:31:23 PM Central Daylight Time	06/05/2017 01:49:00 PM Central Daylight Time	06/05/2017 01:49:05 PM Central Daylight Time			06/05/2017 02:17:19 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	Gundersen Senior Preferred Elite (w/Rx) (HMO)	01	01		1			H5262	001	0	2018	La Crosse and SW Wisconsin and NE Iowa		2	61796	2			2						https://www.seniorpreferred.org/seniorpreferredgundersen/DrugCoverage/FindaPharmacy	https://www.seniorpreferred.org/seniorpreferredgundersen/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredgundersen/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	003	0	1	01	01	H5262_003_0	4			1		07/12/2017	2018.03	07/12/2017 11:39:16 AM Central Daylight Time	06/05/2017 01:49:00 PM Central Daylight Time	06/05/2017 01:49:05 PM Central Daylight Time			07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	Gundersen Senior Preferred Value (w/Rx) (HMO)	01	01		1			H5262	003	0	2018	La Crosse and SW Wisconsin and NE Iowa		2	67550	2			2						https://www.seniorpreferred.org/seniorpreferredgundersen/DrugCoverage/FindaPharmacy	https://www.seniorpreferred.org/seniorpreferredgundersen/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredgundersen/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	004	0	1	01	01	H5262_004_0	4			1		07/12/2017	2018.03	07/12/2017 11:39:41 AM Central Daylight Time	06/05/2017 01:49:01 PM Central Daylight Time				07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	Gundersen Senior Preferred Value (no Rx) (HMO)	01	01		1			H5262	004	0	2018	La Crosse and SW Wisconsin and NE Iowa		2	22612	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferredgundersen/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H5262	005	0	1	01	01	H5262_005_0	3			1		05/18/2017	2018.03	05/18/2017 10:21:24 AM Central Daylight Time	06/21/2017 08:33:39 AM Central Daylight Time				06/22/2017 08:37:40 AM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	Gundersen Senior Preferred Elite (no Rx) (HMO)	01	01		1			H5262	005	0	2018	La Crosse and SW Wisconsin and NE Iowa		2	21100	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferredgundersen/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H5262	007	0	1	01	01	H5262_007_0	4			1		07/12/2017	2018.03	07/12/2017 11:40:09 AM Central Daylight Time	06/05/2017 01:49:01 PM Central Daylight Time	06/05/2017 01:49:06 PM Central Daylight Time			07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	UW Health Senior Preferred Elite (w/Rx) (HMO)	01	01		1			H5262	007	0	2018	Columbia, Dane, Iowa, Richland, and Sauk Counties		2	7547	2			2						https://www.seniorpreferred.org/seniorpreferreduw/DrugCoverage/FindAPharmacy	https://www.seniorpreferred.org/seniorpreferreduw/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferreduw/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	008	0	1	01	01	H5262_008_0	4			1		07/12/2017	2018.03	07/12/2017 11:40:34 AM Central Daylight Time	06/05/2017 01:49:01 PM Central Daylight Time	06/05/2017 01:49:06 PM Central Daylight Time			07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	UW Health Senior Preferred Value (w/Rx) (HMO)	01	01		1			H5262	008	0	2018	Columbia, Dane, Iowa, Richland, and Sauk Counties		2	4535	2			2						https://www.seniorpreferred.org/seniorpreferreduw/DrugCoverage/FindAPharmacy	https://www.seniorpreferred.org/seniorpreferreduw/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferreduw/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	009	0	1	01	01	H5262_009_0	4			1		07/12/2017	2018.03	07/12/2017 11:41:02 AM Central Daylight Time	06/05/2017 01:49:02 PM Central Daylight Time				07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	UW Health Senior Preferred Value (no Rx) (HMO)	01	01		1			H5262	009	0	2018	Columbia, Dane, Iowa, Richland, and Sauk Counties		2	1069	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferreduw/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H5262	010	0	1	01	01	H5262_010_0	4			1		07/12/2017	2018.03	07/12/2017 11:41:27 AM Central Daylight Time	06/05/2017 01:49:02 PM Central Daylight Time				07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	UW Health Senior Preferred Elite (no Rx) (HMO)	01	01		1			H5262	010	0	2018	Columbia, Dane, Iowa, Richland, and Sauk Counties		2	1781	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferreduw/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H5262	011	0	1	01	01	H5262_011_0	4			1		07/12/2017	2018.03	07/12/2017 11:41:52 AM Central Daylight Time	06/05/2017 01:49:02 PM Central Daylight Time	06/05/2017 01:49:06 PM Central Daylight Time			07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	ProHealth Senior Preferred Elite (w/Rx) (HMO)	01	01		1			H5262	011	0	2018	Waukesha County		2	2944	2			2						https://www.seniorpreferred.org/seniorpreferredprohealth/DrugCoverage/FindAPharmacy	https://www.seniorpreferred.org/seniorpreferredprohealth/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredprohealth/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	012	0	1	01	01	H5262_012_0	5			1		08/04/2017	2018.03	08/04/2017 11:14:08 AM Central Daylight Time	08/07/2017 08:11:34 AM Central Daylight Time	08/07/2017 08:11:34 AM Central Daylight Time			08/07/2017 08:30:54 AM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	ProHealth Senior Preferred Value (w/Rx) (HMO)	01	01		1			H5262	012	0	2018	Waukesha County		2	659	2			2						https://www.seniorpreferred.org/seniorpreferredprohealth/DrugCoverage/FindAPharmacy	https://www.seniorpreferred.org/seniorpreferredprohealth/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredprohealth/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H5262	013	0	1	01	01	H5262_013_0	4			1		07/12/2017	2018.03	07/12/2017 11:42:43 AM Central Daylight Time	06/05/2017 01:49:03 PM Central Daylight Time				07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN	Senior Preferred	www.seniorpreferred.org	ProHealth Senior Preferred Elite (no Rx) (HMO)	01	01		1			H5262	013	0	2018	Waukesha County		2	340	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferredprohealth/FindADoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H5264	002	0	1	18	06	H5264_002_0	2			2		06/02/2017	2018.03	06/02/2017 11:04:58 AM Central Daylight Time					06/02/2017 11:24:14 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	deancare.com/medicare	DeanCare Gold Enhanced (Cost)	06	18		1			H5264	002	0	2018	South Central Wisconsin		2	208886	2			2								www.deancare.com/doctors-locations	(888)422-3326		(608)827-4372		(888)422-3326		(608)827-4372										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5264	003	0	1	18	06	H5264_003_0	2			2		06/01/2017	2018.03	06/01/2017 01:39:26 PM Central Daylight Time					06/02/2017 11:24:14 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	deancare.com/medicare	DeanCare Gold Basic (Cost)	06	18		1			H5264	003	0	2018	South Central Wisconsin		2	1203	2			2						www.deancare.com/pharmacy	www.deancare.com/drugformulary	www.deancare.com/doctors-locations	(888)422-3326		(608)827-4372		(888)422-3326		(608)827-4372										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5264	005	0	1	18	06	H5264_005_0	2			2		06/01/2017	2018.03	06/01/2017 01:43:06 PM Central Daylight Time					06/02/2017 11:24:14 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	deancare.com/medicare	DeanCare Gold Shared Value (Cost)	06	18		1			H5264	005	0	2018	South Central Wisconsin		2	44628	2			2						www.deancare.com/pharmacy	www.deancare.com/drugformulary	www.deancare.com/doctors-locations	(888)422-3326		(608)827-4372		(888)422-3326		(608)827-4372										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5280	001	0	1	48	05	H5280_001_0	4			1		08/23/2017	2018.03	08/23/2017 01:47:52 PM Pacific Daylight Time					08/24/2017 02:43:42 PM Pacific Daylight Time	MOLINA HEALTHCARE OF OHIO, INC.	Molina Healthcare of Ohio	www.molinahealthcare.com/duals	Molina Dual Options  MyCareOhio (Medicare-Medicaid Plan)	05	48		1			H5280	001	0	2018	Ohio		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(855)665-4623		(855)665-4623		(866)856-8295		(866)856-8295		(855)665-4623		(855)665-4623		(866)856-8295		(866)856-8295		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H5294	002	1	1	01	01	H5294_002_1	3		1	1	2	08/01/2017	2018.03	08/01/2017 05:18:05 PM Pacific Daylight Time	08/04/2017 04:35:02 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Allwell	allwell.superiorhealthplan.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5294	002	1	2018	Bex, Coll, Cam, Dall, Hidalgo, Nueces, Rock, Tarr	Collin, Rockwall	2		2			1	3		1		1	http://advantage.superiorhealthplan.com	http://advantage.superiorhealthplan.com	www.allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5294	002	2	1	01	01	H5294_002_2	4		1	1	2	08/07/2017	2018.03	08/07/2017 09:18:00 AM Pacific Daylight Time	08/04/2017 04:49:50 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/07/2017 10:44:06 AM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Allwell	allwell.superiorhealthplan.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5294	002	2	2018	Bex, Coll, Cam, Dall, Hidalgo, Nueces, Rock, Tarr	Cameron, Hidalgo	2		2			1	3		1		1	http://advantage.superiorhealthplan.com	http://advantage.superiorhealthplan.com	www.allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5294	002	3	1	01	01	H5294_002_3	4		1	1	2	08/07/2017	2018.03	08/07/2017 09:18:28 AM Pacific Daylight Time	08/04/2017 04:49:50 PM Pacific Daylight Time	08/04/2017 04:49:27 PM Pacific Daylight Time			08/07/2017 10:44:06 AM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Allwell	allwell.superiorhealthplan.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5294	002	3	2018	Bex, Coll, Cam, Dall, Hidalgo, Nueces, Rock, Tarr	Dallas, Tarrant	2		2			1	3		1		1	http://advantage.superiorhealthplan.com	http://advantage.superiorhealthplan.com	www.allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5294	002	4	1	01	01	H5294_002_4	5		1	1	2	08/03/2017	2018.03	08/03/2017 11:57:06 AM Pacific Daylight Time	08/04/2017 04:35:02 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/05/2017 06:30:19 PM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Allwell	allwell.superiorhealthplan.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5294	002	4	2018	Bex, Coll, Cam, Dall, Hidalgo, Nueces, Rock, Tarr	Bexar, Nueces	2		2			1	3		1		1	http://advantage.superiorhealthplan.com	http://advantage.superiorhealthplan.com	www.allwell.superiorhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H5302	011	0	1	01	01	H5302_011_0	4			1		06/28/2017	2018.03	06/28/2017 06:42:49 AM Central Daylight Time	08/02/2017 02:34:24 PM Central Daylight Time	07/31/2017 05:02:19 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA HEALTH INC. (GA)	Coventry Health Care	www.coventry-medicare.com	Advantra Platinum (HMO)	01	01		1			H5302	011	0	2018	Atlanta and Savannah Metro, GA		2	150	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)613-4977		(866)613-4977		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5302	809	0	1	01	01	H5302_809_0	1			1		05/31/2017	2018.03	05/31/2017 08:05:27 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (GA)	Coventry Health Care	http://ga.chcadvantra.com	Advantra (HMO)	01	01		1			H5302	809	0	2018	Georgia		1	120	2			2						http://www.PharmacyLocator.coventry-medicare.com	http://Formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)613-4977		(866)613-4977		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H5302	810	0	1	01	01	H5302_810_0	1			1		05/31/2017	2018.03	05/31/2017 08:05:36 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (GA)	Coventry Health Care	http://ga.chcadvantra.com	Advantra (HMO)	01	01		1			H5302	810	0	2018	Georgia		1	120	2			2						http://www.PharmacyLocator.coventry-medicare.com	http://Formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)613-4977		(866)613-4977		(855)338-7027		(855)338-7027		(844)741-8423		(844)741-8423		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H5322	001	0	1	02	01	H5322_001_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:28:26 PM Central Daylight Time	08/03/2017 01:31:13 PM Central Daylight Time	08/01/2017 11:24:50 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H5322	001	0	2018	Select Counties in AL, OH, SC and VA		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	003	0	1	01	01	H5322_003_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:28:43 PM Central Daylight Time	08/03/2017 01:31:48 PM Central Daylight Time	08/01/2017 11:25:17 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H5322	003	0	2018	Select Counties in FL, IN and NJ		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	004	0	1	02	01	H5322_004_0	5		1	1		08/02/2017	2018.03	08/02/2017 04:28:55 PM Central Daylight Time	08/03/2017 01:32:26 PM Central Daylight Time	08/01/2017 11:25:43 AM Central Daylight Time			08/04/2017 12:03:19 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H5322	004	0	2018	Atlanta and Augusta Metro areas		2		2			1	1	1				www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(800)393-0993		(800)393-0993		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	024	0	1	01	01	H5322_024_0	3			1		05/26/2017	2018.03	05/26/2017 09:53:26 AM Central Daylight Time	08/03/2017 01:33:02 PM Central Daylight Time	08/01/2017 11:26:09 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5322	024	0	2018	Grafton, Hillsborough, and Rockingham Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	025	0	1	01	01	H5322_025_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:46:50 AM Central Daylight Time	08/03/2017 01:33:38 PM Central Daylight Time	08/01/2017 11:26:36 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5322	025	0	2018	Hardin, Harrison, McLennan, Orange, Rusk counties		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	026	0	1	01	01	H5322_026_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:47:11 AM Central Daylight Time	08/03/2017 01:34:14 PM Central Daylight Time	08/01/2017 11:27:02 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5322	026	0	2018	Cameron, Hidalgo, and Willacy Counties		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	028	0	1	02	01	H5322_028_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 09:21:55 AM Central Daylight Time	08/03/2017 01:34:53 PM Central Daylight Time	08/01/2017 11:27:29 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H5322	028	0	2018	Select Counties in Ohio		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	029	0	1	02	01	H5322_029_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 09:35:14 AM Central Daylight Time	08/03/2017 01:35:29 PM Central Daylight Time	08/01/2017 11:27:57 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H5322	029	0	2018	Johnson, Sedgwick, and Wyandotte Counties		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)262-9947		(866)262-9947		(888)834-3721		(888)834-3721		(866)262-9947		(866)262-9947		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	030	0	1	02	01	H5322_030_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:49:00 AM Central Daylight Time	08/03/2017 01:36:07 PM Central Daylight Time	08/01/2017 11:28:23 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H5322	030	0	2018	Select Counties in Georgia		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5322	031	0	1	01	01	H5322_031_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:37:35 PM Central Daylight Time	08/03/2017 01:36:44 PM Central Daylight Time	08/01/2017 11:28:50 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5322	031	0	2018	Select Counites in OK		2		2			1	3		2		2	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5355	001	0	1	48	05	H5355_001_0	5			1		09/18/2017	2018.03	09/18/2017 04:41:06 PM Pacific Daylight Time					09/18/2017 04:41:19 PM Pacific Daylight Time	IEHP HEALTH ACCESS	IEHP DualChoice	www.iehp.org	IEHP DualChoice (Medicare-Medicaid Plan)	05	48		1			H5355	001	0	2018	Riverside and San Bernardino Counties		2	320126	2			2						www.iehp.org	www.iehp.org	www.iehp.org	(877)273-4347		(877)273-4347		(800)741-4347		(800)741-4347		(877)273-4347		(877)273-4347		(800)741-4347		(800)741-4347		(800)718-4347		(800)718-4347		(800)718-4347		(800)718-4347		(800)718-4347		(800)718-4347		(800)718-4347		(800)718-4347																
H5386	003	0	1	01	01	H5386_003_0	5			1		08/03/2017	2018.03	08/03/2017 09:25:51 AM Pacific Daylight Time	08/02/2017 04:09:04 PM Pacific Daylight Time	08/02/2017 07:18:56 AM Pacific Daylight Time			08/03/2017 03:31:27 PM Pacific Daylight Time	SHARP HEALTH PLAN	Sharp Health Plan	sharpmedicareadvantage.com	Sharp Direct Advantage Gold Card (HMO)	01	01		1			H5386	003	0	2018	Sharp Direct Advantage Gold San Diego County		2	500	2			2						sharpmedicareadvantage.com	sharpmedicareadvantage.com	sharpmedicareadvantage.com	(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5386	004	0	1	01	01	H5386_004_0	5			1		08/03/2017	2018.03	08/03/2017 09:40:55 AM Pacific Daylight Time	08/02/2017 04:09:39 PM Pacific Daylight Time	08/02/2017 07:19:21 AM Pacific Daylight Time			08/03/2017 03:31:27 PM Pacific Daylight Time	SHARP HEALTH PLAN	Sharp Health Plan	sharpmedicareadvantage.com	Sharp Direct Advantage Platinum Card (HMO)	01	01		1			H5386	004	0	2018	Sharp Direct Advantage Platinum San Diego County		2	400	2			2						sharpmedicareadvantage.com	sharpmedicareadvantage.com	sharpmedicareadvantage.com	(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(855)562-8853		(858)499-8050		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5386	801	0	1	01	01	H5386_801_0	3			1		06/08/2017	2018.03	06/08/2017 10:24:31 AM Pacific Daylight Time					06/13/2017 10:55:04 AM Pacific Daylight Time	SHARP HEALTH PLAN	Sharp Health Plan	sharpmedicareadvantage.com	Sharp Advantage Calendar Year (HMO)	01	01		1			H5386	801	0	2018	Sharp Advantage San Diego County		1	5100	2			2						sharpmedicareadvantage.com	sharpmedicareadvantage.com	sharpmedicareadvantage.com	(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;9b;15;	1	3-1;3-2;3-3;6;7b;7c;7d;7i;8a;8b1;8b2;8b3;9a;12;14d;14e2;17a;18a;	1					1				
H5386	802	0	1	01	01	H5386_802_0	3			1		06/08/2017	2018.03	06/08/2017 10:25:15 AM Pacific Daylight Time					06/13/2017 10:55:04 AM Pacific Daylight Time	SHARP HEALTH PLAN	Sharp Health Plan	sharpmedicareadvantage.com	Sharp Advantage Non-Calendar Year (HMO)	01	01		1			H5386	802	0	2018	Sharp Advantage San Diego County		1	4800	2			2						sharpmedicareadvantage.com	sharpmedicareadvantage.com	sharpmedicareadvantage.com	(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;9b;15;	1	3-1;3-2;3-3;6;7b;7c;7d;7i;8a;8b1;8b2;8b3;9a;12;14d;14e2;17a;18a;	1					1				
H5386	803	0	1	01	01	H5386_803_0	2			1		04/25/2017	2018.03	04/25/2017 12:24:09 PM Pacific Daylight Time					06/02/2017 09:27:47 AM Pacific Daylight Time	SHARP HEALTH PLAN	Sharp Health Plan	sharpmedicareadvantage.com	Sharp Advantage MA Only (HMO)	01	01		1			H5386	803	0	2018	Sharp Advantage San Diego County		1	0	2			2						sharpmedicareadvantage.com	sharpmedicareadvantage.com	sharpmedicareadvantage.com	(855)820-2112		(855)820-2112		(855)820-2112		(855)820-2112										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;9b;15;	1	3-1;3-2;3-3;6;7b;7c;7d;7i;8a;8b1;8b2;8b3;9a;12;14d;14e2;17a;18a;	1					1				
H5403	001	0	1	20	08	H5403_001_0	1			1		05/24/2017	2018.03	05/24/2017 03:22:33 PM Pacific Daylight Time		05/24/2017 03:16:50 PM Pacific Daylight Time			05/24/2017 03:26:43 PM Pacific Daylight Time	ON LOK SENIOR HEALTH SERVICES	On Lok Lifeways	www.onloklifeways.org	On Lok Lifeways (Dual Eligibles) (PACE)	08	20		1			H5403	001	0	2018	San Francisco, Alameda and Santa Clara counties		2		2			2						www.onloklifeways.org	N/A										(888)996-6565		(415)292-8895		(888)886-6565		(415)300-1477										(888)996-6565		(415)292-8898		(888)886-6565		(415)292-8898																
H5403	002	0	1	20	08	H5403_002_0	1			1		05/24/2017	2018.03	05/24/2017 03:23:32 PM Pacific Daylight Time		05/24/2017 03:16:43 PM Pacific Daylight Time			05/24/2017 03:26:43 PM Pacific Daylight Time	ON LOK SENIOR HEALTH SERVICES	On Lok Lifeways	www.onloklifeways.org	On Lok Lifeways (Medicare Only) (PACE)	08	20		1			H5403	002	0	2018	San Francisco, Alameda and Santa Clara counties		2		2			2						www.onloklifeways.org	N/A										(888)996-6565		(415)292-8895		(888)886-6565		(415)300-1477										(888)996-6565		(415)292-8898		(888)886-6565		(415)292-8898																
H5405	001	0	1	20	08	H5405_001_0	2			1		05/24/2017	2018.03	05/24/2017 10:06:16 AM Pacific Daylight Time		05/23/2017 01:59:18 PM Pacific Daylight Time			05/24/2017 10:11:52 AM Pacific Daylight Time	CENTER FOR ELDERS INDEPENDENCE	Center For Elders' Independence	www.cei.elders.org	Center for Elders' Independence - Part D (PACE)	08	20		1			H5405	001	0	2018	Alameda and West Contra Costa Counties		2		2			2						www.cei.elders.org	www.cei.elders.org										(510)433-1150		(510)433-1150		(510)433-1150		(510)433-1150										(510)433-1165		(510)433-1165		(510)433-1165		(510)433-1165																
H5405	002	0	1	20	08	H5405_002_0	2			1		05/24/2017	2018.03	05/24/2017 10:08:27 AM Pacific Daylight Time		05/23/2017 01:59:11 PM Pacific Daylight Time			05/24/2017 10:11:52 AM Pacific Daylight Time	CENTER FOR ELDERS INDEPENDENCE	Center For Elders' Independence	www.cei.elders.org	Center for Elders' Independence (PACE)	08	20		1			H5405	002	0	2018	Alameda and West Contra Costa Counties		2		2			2						www.cei.elders.org	www.cei.elders.org										(510)433-1150		(510)433-1150		(510)433-1150		(510)433-1150										(510)433-1165		(510)433-1165		(510)433-1165		(510)433-1165																
H5406	001	0	1	20	08	H5406_001_0	1			1		05/26/2017	2018.03	05/26/2017 09:11:30 AM Pacific Daylight Time		05/26/2017 09:01:29 AM Pacific Daylight Time			05/26/2017 09:21:45 AM Pacific Daylight Time	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare PACE	www.sutterseniorcare.org	Sutter SeniorCare (PACE)	08	20		1			H5406	001	0	2018	Sacramento Counties		2		2			2						N/A	N/A	N/A									(916)424-8412	13415	(916)424-8412	13415	(916)424-8412	13422	(916)491-3422	13422									(916)393-1112		(916)393-1112		(916)393-1112		(916)393-1112																
H5406	002	0	1	20	08	H5406_002_0	1			1		05/26/2017	2018.03	05/26/2017 09:12:15 AM Pacific Daylight Time		05/26/2017 09:03:21 AM Pacific Daylight Time			05/26/2017 09:21:45 AM Pacific Daylight Time	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare PACE	www.sutterseniorcare.org	Sutter SeniorCare (PACE)	08	20		1			H5406	002	0	2018	Yolo Counties		2		2			2						N/A	N/A	N/A									(916)424-8412	13415	(916)424-8412	13415	(916)424-8412	13422	(916)491-3422	13422									(916)393-1112		(916)393-1112		(916)393-1112		(916)393-1112																
H5410	001	0	1	01	01	H5410_001_0	6			1		08/03/2017	2018.03	08/03/2017 01:16:03 PM Central Daylight Time	08/03/2017 02:06:38 PM Central Daylight Time	08/01/2017 02:14:58 PM Central Daylight Time			08/04/2017 04:40:54 PM Central Daylight Time	HEALTHSPRING OF FLORIDA	HealthSpring of Florida, Inc.	www.lmchealthplans.com	Leon Medical Centers Health Plans - Leon Cares (HMO)	01	01		1			H5410	001	0	2018	Miami-Dade county		2	0	2			2						www.cignahealthspring.com	www.lmchealthplans.com		(866)393-5366		(305)559-5366		(866)393-5366		(305)559-5366		(866)393-5366		(305)559-5366		(866)393-5366		(305)559-5366		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5410	004	0	1	01	01	H5410_004_0	4			1		05/12/2017	2018.03	05/12/2017 03:39:34 PM Central Daylight Time	05/31/2017 12:46:01 PM Central Daylight Time				06/02/2017 08:10:40 AM Central Daylight Time	HEALTHSPRING OF FLORIDA	HealthSpring of Florida, Inc.	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H5410	004	0	2018	Northern Florida		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)821-2508		(888)821-2508										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5410	013	0	1	01	01	H5410_013_0	5		1	1	2	06/28/2017	2018.03	06/28/2017 09:13:44 PM Central Daylight Time	08/03/2017 10:28:26 AM Central Daylight Time	08/01/2017 02:15:19 PM Central Daylight Time			08/04/2017 04:40:54 PM Central Daylight Time	HEALTHSPRING OF FLORIDA	HealthSpring of Florida, Inc.	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H5410	013	0	2018	Northern Florida		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)821-2508		(888)821-2508		(800)668-3813		(800)668-3813		(888)821-2508		(888)821-2508		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5410	018	0	1	02	01	H5410_018_0	4			1		08/02/2017	2018.03	08/02/2017 12:56:23 PM Central Daylight Time	08/03/2017 10:28:47 AM Central Daylight Time	08/01/2017 02:15:42 PM Central Daylight Time			08/04/2017 04:40:54 PM Central Daylight Time	HEALTHSPRING OF FLORIDA	HealthSpring of Florida, Inc.	www.cignahealthspring.com	Cigna-HealthSpring Premier (HMO-POS)	01	02		1			H5410	018	0	2018	Northern Florida		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com		(800)668-3813		(800)668-3813		(888)821-2508		(888)821-2508		(800)668-3813		(800)668-3813		(888)821-2508		(888)821-2508		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5410	807	0	1	01	01	H5410_807_0	3			1		05/23/2017	2018.03	05/23/2017 03:25:59 PM Central Daylight Time					06/02/2017 07:59:49 AM Central Daylight Time	HEALTHSPRING OF FLORIDA	HealthSpring of Florida, Inc.	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H5410	807	0	2018	Florida		1	1356	2			2						www.cignahealthspring.com	www.cignahealthspring.com		(888)281-7867		(888)281-7867		(888)821-2508		(888)821-2508		(888)281-7867		(888)281-7867		(888)821-2508		(888)821-2508		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;12;14a;14d;15;17a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;16b;17a;17b;	1					1				
H5420	001	0	1	01	01	H5420_001_0	3			1		08/03/2017	2018.03	08/03/2017 12:45:25 PM Central Daylight Time	08/03/2017 01:37:19 PM Central Daylight Time	08/01/2017 11:29:16 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	MEDICA HEALTHCARE PLANS, INC.	UnitedHealthcare	www.Medicaplans.com	Medica HealthCare Plans MedicareMax (HMO)	01	01		1			H5420	001	0	2018	Miami-Dade County		2		2			2						www.Medicaplans.com	www.Medicaplans.com	www.Medicaplans.com	(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5420	003	0	1	01	01	H5420_003_0	3			1		08/02/2017	2018.03	08/02/2017 04:39:29 PM Central Daylight Time	08/03/2017 01:37:55 PM Central Daylight Time	08/01/2017 11:29:43 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	MEDICA HEALTHCARE PLANS, INC.	UnitedHealthcare	www.Medicaplans.com	Medica HealthCare Plans MedicareMax (HMO)	01	01		1			H5420	003	0	2018	Broward County		2		2			2						www.Medicaplans.com	www.Medicaplans.com	www.Medicaplans.com	(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5420	006	0	1	01	01	H5420_006_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 04:40:16 PM Central Daylight Time	08/03/2017 01:38:31 PM Central Daylight Time	08/01/2017 11:30:09 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	MEDICA HEALTHCARE PLANS, INC.	UnitedHealthcare	www.Medicaplans.com	Medica HealthCare Plans MedicareMax Plus (HMO SNP)	01	01		1			H5420	006	0	2018	Miami-Dade and Broward County		2		2			1	3		2		2	www.Medicaplans.com	www.Medicaplans.com	www.Medicaplans.com	(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(800)407-9069		(800)407-9069		(800)507-0544		(800)507-0544		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5422	007	0	1	01	01	H5422_007_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 10:19:50 AM Pacific Daylight Time	08/07/2017 05:55:29 AM Pacific Daylight Time	08/06/2017 12:07:44 PM Pacific Daylight Time			08/07/2017 12:38:53 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/shop	BCBSHP MediBlue Dual Advantage (HMO SNP)	01	01		1			H5422	007	0	2018	Select Counties in Georgia		2	14400	2			1	3		1		1	www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(844)887-6355		(844)887-6355		(844)227-8228		(844)227-8228		(844)887-6355		(844)887-6355		(844)227-8229		(844)227-8229		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5422	008	0	1	01	01	H5422_008_0	4			1		06/09/2017	2018.03	06/09/2017 08:47:10 AM Pacific Daylight Time	08/07/2017 05:55:30 AM Pacific Daylight Time	08/06/2017 12:07:44 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/shop	BCBSHP MediBlue Essential (HMO)	01	01		1			H5422	008	0	2018	Select Counties in Georgia		2	17508	2			2						www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(855)690-7797		(855)690-7797		(800)797-1769		(800)797-1769		(855)690-7797		(855)690-7797		(844)364-2117		(844)364-2117		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5422	009	0	1	01	01	H5422_009_0	5			1		08/04/2017	2018.03	08/04/2017 10:30:53 AM Pacific Daylight Time	08/07/2017 05:55:30 AM Pacific Daylight Time	08/06/2017 12:07:44 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/shop	BCBSHP MediBlue Plus (HMO)	01	01		1			H5422	009	0	2018	Clayton, Dekalb, and Fulton Counties		2	30216	2			2						www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(855)690-7797		(855)690-7797		(800)797-1769		(800)797-1769		(855)690-7797		(855)690-7797		(844)364-2117		(844)364-2117		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7d;7e1;7e2;7f;7h1;7h2;	
H5422	803	0	1	01	01	H5422_803_0	7			1		06/03/2017	2018.03	06/03/2017 01:09:40 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO)	01	01		1			H5422	803	0	2018	Georgia Select Counties		1	600	2			2						www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(866)207-8869		(866)207-8869		(866)412-3060		(866)412-3060										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H5422	804	0	1	01	01	H5422_804_0	7			1		06/03/2017	2018.03	06/03/2017 01:09:51 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO)	01	01		1			H5422	804	0	2018	Georgia - Select Counties		1	600	2			2						www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(866)207-8869		(866)207-8869		(866)412-3060		(866)412-3060		(866)207-8869		(866)207-8869		(866)412-3060		(866)412-3060		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H5422	806	0	1	02	01	H5422_806_0	7			1		06/03/2017	2018.03	06/03/2017 01:09:57 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO-POS)	01	02		1			H5422	806	0	2018	Georgia - Select counties		1	600	2			2						www.bcbsga.com/medicare	www.bcbsga.com/medicare	www.bcbsga.com/medicare	(866)207-8869		(866)207-8869		(866)412-3060		(866)412-3060		(866)207-8869		(866)207-8869		(866)412-3060		(866)412-3060		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H5425	001	0	1	01	01	H5425_001_0	5			1		08/07/2017	2018.03	08/07/2017 02:21:58 PM Pacific Daylight Time	08/03/2017 03:52:40 PM Pacific Daylight Time	07/31/2017 03:27:42 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	001	0	2018	Ventura County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	004	0	1	01	01	H5425_004_0	3			1		08/04/2017	2018.03	08/04/2017 09:37:38 AM Pacific Daylight Time	08/03/2017 03:57:00 PM Pacific Daylight Time	07/31/2017 03:29:16 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Scripps Signature offered by SCAN Health Plan (HMO)	01	01		1			H5425	004	0	2018	San Diego County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	005	0	1	01	01	H5425_005_0	3			1		08/04/2017	2018.03	08/04/2017 09:39:11 AM Pacific Daylight Time	08/03/2017 04:03:36 PM Pacific Daylight Time	07/31/2017 03:35:16 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Scripps Classic offered by SCAN Health Plan (HMO)	01	01		1			H5425	005	0	2018	San Diego County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	006	0	1	01	01	H5425_006_0	3			1		08/07/2017	2018.03	08/07/2017 11:45:55 AM Pacific Daylight Time	08/03/2017 04:12:12 PM Pacific Daylight Time	07/31/2017 03:35:58 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	006	0	2018	Los Angeles County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	007	0	1	01	01	H5425_007_0	3			1		08/04/2017	2018.03	08/04/2017 09:41:58 AM Pacific Daylight Time	08/03/2017 04:19:40 PM Pacific Daylight Time	07/31/2017 03:38:14 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	007	0	2018	Orange County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	008	0	1	01	01	H5425_008_0	3			1		08/04/2017	2018.03	08/04/2017 09:44:48 AM Pacific Daylight Time	08/03/2017 04:22:12 PM Pacific Daylight Time	07/31/2017 03:38:46 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	008	0	2018	Riverside County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	009	0	1	01	01	H5425_009_0	4			1		08/04/2017	2018.03	08/04/2017 09:46:27 AM Pacific Daylight Time	08/03/2017 04:24:22 PM Pacific Daylight Time	07/31/2017 03:39:42 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	009	0	2018	San Bernardino County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	010	0	1	01	01	H5425_010_0	5		1	1	2	06/05/2017	2018.03	06/05/2017 09:57:48 AM Pacific Daylight Time	08/04/2017 10:08:08 AM Pacific Daylight Time	07/31/2017 03:40:46 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H5425	010	0	2018	Los Angeles, Riverside and San Bernardino Counties		2		2			1	3		1		1	www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	019	0	1	01	01	H5425_019_0	5			1		08/08/2017	2018.03	08/08/2017 03:06:43 PM Pacific Daylight Time	08/03/2017 04:41:54 PM Pacific Daylight Time	07/31/2017 03:41:40 PM Pacific Daylight Time			08/08/2017 03:37:29 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	019	0	2018	San Francisco County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	020	0	1	01	01	H5425_020_0	6			1		08/08/2017	2018.03	08/08/2017 03:09:55 PM Pacific Daylight Time	08/03/2017 04:47:48 PM Pacific Daylight Time	07/31/2017 03:44:20 PM Pacific Daylight Time			08/08/2017 03:37:29 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	020	0	2018	Santa Clara County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	028	0	1	01	01	H5425_028_0	4		1	1		08/07/2017	2018.03	08/07/2017 04:23:37 PM Pacific Daylight Time	08/03/2017 04:50:04 PM Pacific Daylight Time	07/31/2017 03:45:30 PM Pacific Daylight Time			08/07/2017 04:24:35 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Heart First (HMO SNP)	01	01		1			H5425	028	0	2018	Orange County		2		2			1	4			00000000000000010000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	029	0	1	01	01	H5425_029_0	5		1	1	2	08/07/2017	2018.03	08/07/2017 12:56:32 PM Pacific Daylight Time	08/04/2017 04:26:26 PM Pacific Daylight Time	07/31/2017 03:45:58 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	029	0	2018	Los Angeles County		2		2			1	3		1		1	www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	030	0	1	01	01	H5425_030_0	5		1	1	2	06/05/2017	2018.03	06/05/2017 09:58:56 AM Pacific Daylight Time	08/04/2017 10:14:36 AM Pacific Daylight Time	07/31/2017 03:46:32 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	030	0	2018	Riverside County		2		2			1	3		1		1	www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	031	0	1	01	01	H5425_031_0	5		1	1	2	06/05/2017	2018.03	06/05/2017 09:59:16 AM Pacific Daylight Time	08/04/2017 10:21:42 AM Pacific Daylight Time	07/31/2017 03:47:10 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	031	0	2018	San Bernardino County		2		2			1	3		1		1	www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(866)722-6725		(866)722-6725		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	033	0	1	01	01	H5425_033_0	3		1	1		08/04/2017	2018.03	08/04/2017 10:00:57 AM Pacific Daylight Time	08/03/2017 04:57:40 PM Pacific Daylight Time	07/31/2017 03:50:00 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Heart First (HMO SNP)	01	01		1			H5425	033	0	2018	Riverside and San Bernardino Counties		2		2			1	4			00000000000000010000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	034	0	1	01	01	H5425_034_0	3		1	1		08/04/2017	2018.03	08/04/2017 10:02:12 AM Pacific Daylight Time	08/03/2017 05:00:38 PM Pacific Daylight Time	07/31/2017 03:50:36 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Balance (HMO SNP)	01	01		1			H5425	034	0	2018	Los Angeles and Orange Counties		2		2			1	4			00000010000000000000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	037	0	1	01	01	H5425_037_0	5			1		06/05/2017	2018.03	06/05/2017 09:59:49 AM Pacific Daylight Time	08/04/2017 10:27:18 AM Pacific Daylight Time	07/31/2017 03:50:58 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Plus (HMO)	01	01		1			H5425	037	0	2018	Orange County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	040	0	1	01	01	H5425_040_0	4			1		08/04/2017	2018.03	08/04/2017 10:03:15 AM Pacific Daylight Time	08/04/2017 10:30:22 AM Pacific Daylight Time	07/31/2017 03:51:34 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Scripps Plus offered by SCAN Health Plan (HMO)	01	01		1			H5425	040	0	2018	San Diego County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	045	0	1	01	01	H5425_045_0	5			1		08/04/2017	2018.03	08/04/2017 10:05:26 AM Pacific Daylight Time	08/04/2017 10:33:16 AM Pacific Daylight Time	07/31/2017 03:52:12 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Plus (HMO)	01	01		1			H5425	045	0	2018	Selected Southern and Northern CA Counties		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	046	0	1	01	01	H5425_046_0	6			1		08/08/2017	2018.03	08/08/2017 03:35:57 PM Pacific Daylight Time	08/04/2017 03:34:32 PM Pacific Daylight Time	07/31/2017 03:55:20 PM Pacific Daylight Time			08/08/2017 03:37:29 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	046	0	2018	Marin County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	047	0	1	01	01	H5425_047_0	6		1	1		08/08/2017	2018.03	08/08/2017 03:12:47 PM Pacific Daylight Time	08/04/2017 03:39:40 PM Pacific Daylight Time	07/31/2017 03:55:50 PM Pacific Daylight Time			08/08/2017 03:37:29 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Heart First (HMO SNP)	01	01		1			H5425	047	0	2018	Marin County		2		2			1	4			00000000000000010000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	048	0	1	01	01	H5425_048_0	6		1	1		08/08/2017	2018.03	08/08/2017 03:13:38 PM Pacific Daylight Time	08/04/2017 03:42:58 PM Pacific Daylight Time	07/31/2017 03:56:48 PM Pacific Daylight Time			08/08/2017 03:37:29 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Balance (HMO SNP)	01	01		1			H5425	048	0	2018	Marin County		2		2			1	4			00000010000000000000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	052	0	1	01	01	H5425_052_0	5			1		08/04/2017	2018.03	08/04/2017 03:43:41 PM Pacific Daylight Time	08/03/2017 05:06:18 PM Pacific Daylight Time	07/31/2017 03:57:20 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	052	0	2018	Napa and Sonoma Counties		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	053	0	1	01	01	H5425_053_0	4		1	1		08/04/2017	2018.03	08/04/2017 03:44:11 PM Pacific Daylight Time	08/03/2017 05:03:12 PM Pacific Daylight Time	07/31/2017 03:57:46 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Heart First (HMO SNP)	01	01		1			H5425	053	0	2018	Napa and Sonoma Counties		2		2			1	4			00000000000000010000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	054	0	1	01	01	H5425_054_0	4		1	1		08/04/2017	2018.03	08/04/2017 03:44:37 PM Pacific Daylight Time	08/03/2017 04:42:10 PM Pacific Daylight Time	07/31/2017 03:58:18 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Balance (HMO SNP)	01	01		1			H5425	054	0	2018	Napa and Sonoma Counties		2		2			1	4			00000010000000000000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	055	0	1	01	01	H5425_055_0	4		1	1		08/08/2017	2018.03	08/08/2017 11:38:03 AM Pacific Daylight Time	08/08/2017 11:36:27 AM Pacific Daylight Time	07/31/2017 04:00:52 PM Pacific Daylight Time			08/08/2017 11:39:00 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Scripps Heart First offered by SCAN Health Plan (HMO SNP)	01	01		1			H5425	055	0	2018	San Diego County		2		2			1	4			00000000000000010000		www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	061	0	1	01	01	H5425_061_0	3			1		08/04/2017	2018.03	08/04/2017 10:16:36 AM Pacific Daylight Time	08/03/2017 04:33:48 PM Pacific Daylight Time	07/31/2017 04:01:32 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic II (HMO)	01	01		1			H5425	061	0	2018	Riverside County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	062	0	1	01	01	H5425_062_0	3			1		08/04/2017	2018.03	08/04/2017 10:18:50 AM Pacific Daylight Time	08/03/2017 04:26:18 PM Pacific Daylight Time	07/31/2017 04:02:00 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic II (HMO)	01	01		1			H5425	062	0	2018	San Bernardino County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	064	0	1	01	01	H5425_064_0	3			1		08/04/2017	2018.03	08/04/2017 10:21:09 AM Pacific Daylight Time	08/03/2017 04:23:28 PM Pacific Daylight Time	07/31/2017 04:02:26 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic II (HMO)	01	01		1			H5425	064	0	2018	Los Angeles County		2		2			2						www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	803	0	1	01	01	H5425_803_0	3			1		06/02/2017	2018.03	06/02/2017 04:03:36 PM Pacific Daylight Time					06/02/2017 04:06:09 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Employer Group (HMO)	01	01		1			H5425	803	0	2018	Southern and Northern California Counties		1	37898	2			2						https://www.scanhealthplan.com/	https://www.scanhealthplan.com/	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5425	804	0	1	01	01	H5425_804_0	3			1		06/02/2017	2018.03	06/02/2017 04:03:54 PM Pacific Daylight Time					06/02/2017 04:06:09 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Employer Group (HMO)	01	01		1			H5425	804	0	2018	Southern and Northern California Counties		1	9427	2			2						https://www.scanhealthplan.com/	https://www.scanhealthplan.com/	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	052	0	1	01	01	H5427_052_0	4			1		05/25/2017	2018.03	05/25/2017 11:32:50 AM Eastern Daylight Time	06/04/2017 08:53:34 PM Eastern Daylight Time				06/05/2017 11:51:03 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Savings Plan (HMO)	01	01		1			H5427	052	0	2018	Select Counties in Florida		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5427	059	0	1	01	01	H5427_059_0	5			1		08/04/2017	2018.03	08/04/2017 08:52:46 PM Eastern Daylight Time	08/04/2017 06:59:13 PM Eastern Daylight Time	08/03/2017 12:44:31 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medicare Plan Rx (HMO)	01	01		1			H5427	059	0	2018	Select Counties in Florida		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	060	0	1	01	01	H5427_060_0	5			1		05/25/2017	2018.03	05/25/2017 11:33:20 AM Eastern Daylight Time	08/04/2017 07:00:29 PM Eastern Daylight Time	08/03/2017 12:45:25 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medicare Plan Rx (HMO)	01	01		1			H5427	060	0	2018	Select Counties in Florida		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	070	0	1	01	01	H5427_070_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:33:38 AM Eastern Daylight Time	08/04/2017 07:02:53 PM Eastern Daylight Time	08/03/2017 12:46:17 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Care (HMO SNP)	01	01		1			H5427	070	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000000000010		www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	072	0	1	01	01	H5427_072_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:33:54 AM Eastern Daylight Time	08/04/2017 07:04:02 PM Eastern Daylight Time	08/03/2017 12:47:11 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings (HMO SNP)	01	01		1			H5427	072	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000000000010		www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	077	0	1	01	01	H5427_077_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:34:08 AM Eastern Daylight Time	08/04/2017 07:05:11 PM Eastern Daylight Time	08/03/2017 12:48:06 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings COPD (HMO SNP)	01	01		1			H5427	077	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000100000000		www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	078	0	1	01	01	H5427_078_0	5		1	1	2	05/26/2017	2018.03	05/26/2017 08:43:31 PM Eastern Daylight Time	08/04/2017 07:06:19 PM Eastern Daylight Time	08/03/2017 12:49:02 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medi-Medi Partial (HMO SNP)	01	01		1			H5427	078	0	2018	Select Counties in Florida		2	0	2			1	3		2		2	www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	082	0	1	01	01	H5427_082_0	5		1	1		08/04/2017	2018.03	08/04/2017 08:52:20 PM Eastern Daylight Time	08/04/2017 07:07:32 PM Eastern Daylight Time	08/03/2017 12:49:55 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings (HMO SNP)	01	01		1			H5427	082	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000000000010		www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	083	0	1	01	01	H5427_083_0	5		1	1		08/04/2017	2018.03	08/04/2017 08:52:04 PM Eastern Daylight Time	08/04/2017 07:09:14 PM Eastern Daylight Time	08/03/2017 12:50:50 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings COPD (HMO SNP)	01	01		1			H5427	083	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000100000000		www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	087	0	1	01	01	H5427_087_0	5		1	1	2	05/26/2017	2018.03	05/26/2017 08:43:43 PM Eastern Daylight Time	08/04/2017 07:10:26 PM Eastern Daylight Time	08/03/2017 12:51:46 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medi-Medi Full (HMO SNP)	01	01		1			H5427	087	0	2018	Select Counties in Florida		2	0	2			1	3		1		1	www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	088	0	1	01	01	H5427_088_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:05 AM Eastern Daylight Time	08/04/2017 07:11:32 PM Eastern Daylight Time	08/03/2017 12:52:41 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	088	0	2018	select counties in Florida		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	089	0	1	01	01	H5427_089_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:15 AM Eastern Daylight Time	08/04/2017 07:12:41 PM Eastern Daylight Time	08/03/2017 12:53:37 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	089	0	2018	Select Counties in FL		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	091	0	1	01	01	H5427_091_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:25 AM Eastern Daylight Time	08/04/2017 07:13:52 PM Eastern Daylight Time	08/03/2017 12:54:30 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	091	0	2018	Select Counties in FL		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	092	0	1	01	01	H5427_092_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:37 AM Eastern Daylight Time	08/04/2017 07:15:02 PM Eastern Daylight Time	08/03/2017 12:55:25 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	092	0	2018	Select Counties in FL		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	093	0	1	01	01	H5427_093_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:47 AM Eastern Daylight Time	08/04/2017 07:16:08 PM Eastern Daylight Time	08/03/2017 12:56:17 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	093	0	2018	Select Counties in FL		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5427	094	0	1	01	01	H5427_094_0	5			1		05/25/2017	2018.03	05/25/2017 11:35:56 AM Eastern Daylight Time	08/04/2017 07:17:28 PM Eastern Daylight Time	08/03/2017 12:57:08 PM Eastern Daylight Time			08/06/2017 09:37:56 AM Eastern Daylight Time	FREEDOM HEALTH, INC.	Freedom Health, Inc.	http://www.FreedomHealth.com	Freedom Platinum Plan Rx (HMO)	01	01		1			H5427	094	0	2018	Select Counties in FL		2	0	2			2						www.freedomhealth.com	www.freedomhealth.com	http://www.FreedomHealth.com	(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(800)401-2740		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5430	001	0	1	01	01	H5430_001_0	2		1	1	2	06/02/2017	2018.03	06/02/2017 01:27:04 PM Eastern Daylight Time	08/03/2017 04:54:28 PM Eastern Daylight Time	07/31/2017 07:18:42 PM Eastern Daylight Time			08/04/2017 04:24:37 PM Eastern Daylight Time	ONECARE BY CARE1ST HEALTH PLAN ARIZONA INC.	Care1st+	www.care1st.com/az/medicare	Care1st+ (HMO SNP)	01	01		1			H5430	001	0	2018	Counties:  Maricopa and Pima		2	30825	2			1	3		1		1	www.care1st.com/az/medicare	www.care1st.com/az/medicare	www.care1st.com/az/medicare	(877)778-1855		(602)778-8345		(877)778-1855		(602)778-8345		(877)778-1855		(602)778-8345		(877)778-1855		(602)778-8345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5431	001	0	1	01	01	H5431_001_0	8			1		07/07/2017	2018.03	07/07/2017 10:20:13 AM Eastern Daylight Time	08/03/2017 05:46:11 PM Eastern Daylight Time	08/03/2017 03:09:59 PM Eastern Daylight Time			08/07/2017 12:19:01 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.HealthSun.com	HealthSun SunPlus Advantage Plan (HMO)	01	01		1			H5431	001	0	2018	Miami-Dade		2	76464	2			2						www.HealthSun.com	www.HealthSun.com	www.HealthSun.com	(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		2					2					2	2			
H5431	006	0	1	01	01	H5431_006_0	8			1		07/07/2017	2018.03	07/07/2017 10:20:58 AM Eastern Daylight Time	08/03/2017 05:49:25 PM Eastern Daylight Time	08/03/2017 03:11:19 PM Eastern Daylight Time			08/07/2017 12:19:01 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.HealthSun.com	HealthSun MediMax (HMO)	01	01		1			H5431	006	0	2018	Broward and Miami-Dade		2	443880	2			2						www.HealthSun.com	www.HealthSun.com	www.HealthSun.com	(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		2					2					2	2			
H5431	012	0	1	01	01	H5431_012_0	8			1		07/07/2017	2018.03	07/07/2017 10:21:44 AM Eastern Daylight Time	08/03/2017 05:53:33 PM Eastern Daylight Time	08/03/2017 03:12:36 PM Eastern Daylight Time			08/07/2017 12:19:01 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.HealthSun.com	HealthSun HealthAdvantage Plan (HMO)	01	01		1			H5431	012	0	2018	Broward County		2	22038	2			2						www.HealthSun.com	www.HealthSun.com	www.HealthSun.com	(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)336-2069		(305)447-4458		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		(877)206-0500		2					2					2	2			
H5433	001	0	1	01	01	H5433_001_0	7		1	1	2	06/02/2017	2018.03	06/02/2017 04:59:21 PM Pacific Daylight Time	06/02/2017 05:43:07 PM Pacific Daylight Time	06/02/2017 05:49:16 PM Pacific Daylight Time			06/02/2017 07:34:20 PM Pacific Daylight Time	ORANGE COUNTY HEALTH AUTHORITY	OneCare	www.caloptima.org/onecare	OneCare (HMO SNP)	01	01		1			H5433	001	0	2018	Orange County		2	16749	2			1	3		1		1	www.caloptima.org/onecare	https://www.caloptima.org/en/Members/OneCare/MedicarePartD.aspx	www.caloptima.org/onecare	(877)412-2734		(877)412-2734		(877)412-2734		(877)412-2734		(877)412-2734		(877)412-2734		(877)412-2734		(877)412-2734		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		2					2					2	2			
H5434	002	0	1	04	01	H5434_002_0	13			1		08/10/2017	2018.03	08/10/2017 10:18:08 AM Eastern Daylight Time	08/04/2017 11:20:35 AM Eastern Daylight Time	08/02/2017 01:11:31 PM Eastern Daylight Time			08/10/2017 01:53:37 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Select (PPO)	01	04		1			H5434	002	0	2018	Select counties in S.FL/ W.FL/C.FL,N.C. FL/N.W FL		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2						2			
H5434	801	0	1	04	01	H5434_801_0	2			1		06/14/2017	2018.03	06/14/2017 01:46:19 PM Eastern Daylight Time					06/15/2017 09:42:43 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Group PPO (PPO)	01	04		1			H5434	801	0	2018	State of Florida with National Coverage		1	43200	2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		1	1	1a;1b;2;5;7c;7i;8a;8b1;8b2;8b3;9c;11a;	2		1									
H5434	802	0	1	04	01	H5434_802_0	2			1		06/14/2017	2018.03	06/14/2017 01:46:44 PM Eastern Daylight Time					06/15/2017 09:42:43 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Group PPO (PPO)	01	04		1			H5434	802	0	2018	State of Florida with National Coverage		1	2400	2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		1	1	1a;1b;2;5;7c;7i;8a;8b1;8b2;8b3;9c;11a;	2		1									
H5435	001	0	1	09	04	H5435_001_0	2			1		05/11/2017	2018.03	05/11/2017 01:38:27 PM Central Daylight Time	06/01/2017 12:56:06 PM Central Daylight Time				07/06/2017 03:19:00 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareDirect Essential (PFFS)	04	09	2	1			H5435	001	0	2018	Select counties nationwide		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)579-8774		(866)579-8774		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2										2	2			
H5435	024	0	1	09	04	H5435_024_0	3			1		06/01/2017	2018.03	06/01/2017 09:15:52 AM Central Daylight Time	08/03/2017 01:39:09 PM Central Daylight Time	08/01/2017 11:30:35 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareDirect Rx (PFFS)	04	09	2	1			H5435	024	0	2018	Select counties nationwide		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)579-8774		(866)579-8774		(800)555-5757		(800)555-5757		(866)579-8774		(866)579-8774		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2										2	2			
H5439	010	0	1	04	01	H5439_010_0	3			1		06/29/2017	2018.03	06/29/2017 09:49:49 AM Pacific Daylight Time	07/13/2017 11:56:26 AM Pacific Daylight Time				07/14/2017 05:37:24 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Aqua (PPO)	01	04		1			H5439	010	0	2018	10 Northern Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888										(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888										2					2						2			
H5439	011	0	1	04	01	H5439_011_0	4			1		08/02/2017	2018.03	08/02/2017 06:28:07 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 1 (PPO)	01	04		1			H5439	011	0	2018	10 Northerin Counties		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	012	0	1	04	01	H5439_012_0	3			1		05/29/2017	2018.03	05/29/2017 12:55:57 PM Pacific Daylight Time	07/13/2017 11:56:26 AM Pacific Daylight Time				07/14/2017 05:37:24 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Aqua (PPO)	01	04		1			H5439	012	0	2018	Douglas, Jackson, Josephine		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888										(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888										2					2						2			
H5439	013	0	1	04	01	H5439_013_0	4			1		08/02/2017	2018.03	08/02/2017 05:54:29 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 1 (PPO)	01	04		1			H5439	013	0	2018	Douglas, Jackson, Josephine		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	014	1	1	04	01	H5439_014_1	5			1		08/02/2017	2018.03	08/02/2017 12:04:01 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	014	1	2018	10 Northern Counties	Clackamas, Lane, Multnomah, Washington	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	014	2	1	04	01	H5439_014_2	4			1		08/02/2017	2018.03	08/02/2017 12:04:11 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	014	2	2018	10 Northern Counties	Benton, Linn, Yamhill	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	014	3	1	04	01	H5439_014_3	4			1		08/02/2017	2018.03	08/02/2017 12:04:26 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:51 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	014	3	2018	10 Northern Counties	Marion, Polk	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	014	4	1	04	01	H5439_014_4	4			1		08/04/2017	2018.03	08/04/2017 10:18:13 AM Pacific Daylight Time	08/04/2017 05:04:51 PM Pacific Daylight Time	08/04/2017 05:04:51 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	014	4	2018	10 Northern Counties	Clark, WA	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	015	0	1	04	01	H5439_015_0	4			1		08/02/2017	2018.03	08/02/2017 12:06:07 PM Pacific Daylight Time	08/04/2017 05:04:51 PM Pacific Daylight Time	08/04/2017 05:04:51 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 3 (PPO)	01	04		1			H5439	015	0	2018	Douglas, Josephine		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	016	1	1	04	01	H5439_016_1	4			1		08/04/2017	2018.03	08/04/2017 10:18:38 AM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	016	1	2018	Jackson	Jackson	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	016	2	1	04	01	H5439_016_2	4			1		08/02/2017	2018.03	08/02/2017 12:05:53 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Violet 2 (PPO)	01	04		1			H5439	016	2	2018	Jackson	Josephine, Douglas	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H5439	801	0	1	04	01	H5439_801_0	2			1		06/08/2017	2018.03	06/08/2017 03:45:50 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	801	0	2018	48 States - All Counties		1	240	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)960-4638		(800)960-4638		(800)977-6738		(800)977-6738		(800)960-4638		(800)960-4638		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5439	802	0	1	04	01	H5439_802_0	2			1		06/08/2017	2018.03	06/08/2017 03:46:06 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	802	0	2018	48 States - All Counties		1	240	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)960-4638		(800)960-4638		(800)977-6738		(800)977-6738										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5439	803	0	1	04	01	H5439_803_0	2			1		06/08/2017	2018.03	06/08/2017 03:46:29 PM Pacific Daylight Time					06/09/2017 09:12:35 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com/medicare	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	803	0	2018	48 States - All Counties		1	240	2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(800)960-4638		(800)960-4638		(800)977-6738		(800)977-6738		(800)960-4638		(800)960-4638		(800)977-6738		(800)977-6738		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5441	001	0	1	48	05	H5441_001_0	5			1		07/05/2017	2018.03	07/05/2017 04:57:23 PM Eastern Daylight Time					07/05/2017 05:12:20 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	www.healthfirst.org/medicare	Healthfirst AbsoluteCare FIDA Plan (Medicare-Medicaid Plan)	05	48		1			H5441	001	0	2018	Counties: Ki, Qu, Brx, NY, Rich, Wes, and Na		2	13000	2			2						www.healthfirst.org/medicare	www.healthfirst.org/medicare	www.healthfirst.org/medicare	(855)675-7630		(855)675-7630		(855)675-7630		(855)675-7630		(855)675-7630		(855)675-7630		(855)675-7630		(855)675-7630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H5471	001	0	1	01	01	H5471_001_0	6		1	1	2	08/05/2017	2018.03	08/05/2017 04:56:03 PM Eastern Daylight Time	08/07/2017 08:55:31 AM Eastern Daylight Time	08/06/2017 03:07:45 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	001	0	2018	Miami-Dade County		2	231555	2			1	3		2		1	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	002	0	1	01	01	H5471_002_0	6			1		08/04/2017	2018.03	08/04/2017 09:19:59 AM Eastern Daylight Time	08/07/2017 08:55:31 AM Eastern Daylight Time	08/06/2017 03:07:45 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	002	0	2018	Miami-Dade County		2	124704	2			2						http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	007	0	1	01	01	H5471_007_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 09:20:23 AM Eastern Daylight Time	08/07/2017 08:55:32 AM Eastern Daylight Time	08/06/2017 03:07:45 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	007	0	2018	Polk County		2	66689	2			1	3		2		1	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	008	0	1	01	01	H5471_008_0	7		1	1		08/04/2017	2018.03	08/04/2017 09:21:11 AM Eastern Daylight Time	08/07/2017 08:55:32 AM Eastern Daylight Time	08/06/2017 03:07:45 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Care (HMO SNP)	01	01		1			H5471	008	0	2018	Miami-Dade County		2	273	2			1	1	1				http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	009	0	1	01	01	H5471_009_0	7		1	1		08/04/2017	2018.03	08/04/2017 09:21:47 AM Eastern Daylight Time	08/07/2017 08:55:32 AM Eastern Daylight Time	08/06/2017 03:07:45 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Comfort (HMO SNP)	01	01		1			H5471	009	0	2018	Miami-Dade County		2	1845	2			1	1	2				http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	012	0	1	01	01	H5471_012_0	6		1	1		08/04/2017	2018.03	08/04/2017 09:22:28 AM Eastern Daylight Time	08/07/2017 08:55:33 AM Eastern Daylight Time	08/06/2017 03:07:46 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	012	0	2018	Miami-Dade County		2	22621	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	020	0	1	01	01	H5471_020_0	6		1	1		08/05/2017	2018.03	08/05/2017 01:41:37 PM Eastern Daylight Time	08/07/2017 01:38:56 PM Eastern Daylight Time	08/06/2017 03:07:46 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	020	0	2018	Polk County		2	17944	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	021	0	1	01	01	H5471_021_0	6			1		08/05/2017	2018.03	08/05/2017 01:57:51 PM Eastern Daylight Time	08/07/2017 08:55:34 AM Eastern Daylight Time	08/06/2017 03:07:46 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	021	0	2018	Polk County		2	35551	2			2						http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	039	0	1	01	01	H5471_039_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 09:50:37 AM Eastern Daylight Time	08/07/2017 08:55:34 AM Eastern Daylight Time	08/06/2017 03:07:47 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	039	0	2018	Orange, Osceola and Seminole Counties		2	11102	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	042	0	1	01	01	H5471_042_0	6		1	1		08/04/2017	2018.03	08/04/2017 09:51:38 AM Eastern Daylight Time	08/07/2017 08:55:34 AM Eastern Daylight Time	08/06/2017 03:07:47 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	042	0	2018	Orange, Osceola and Seminole Counties		2	8057	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	043	0	1	01	01	H5471_043_0	6			1		08/04/2017	2018.03	08/04/2017 09:53:32 AM Eastern Daylight Time	08/07/2017 08:55:35 AM Eastern Daylight Time	08/06/2017 03:07:47 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	043	0	2018	Orange, Osceola and Seminole Counties		2	51592	2			2						http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefits	http://www.simplyhealthcareplans.com/medicare/prescription-drug-benefit/formularies	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	049	0	1	01	01	H5471_049_0	6		1	1		08/04/2017	2018.03	08/04/2017 09:54:29 AM Eastern Daylight Time	08/07/2017 08:55:35 AM Eastern Daylight Time	08/06/2017 03:07:47 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	049	0	2018	Hillsborough, Pinellas, Hernando, Pasco Counties		2	1824	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	050	0	1	01	01	H5471_050_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 09:55:36 AM Eastern Daylight Time	08/07/2017 08:55:36 AM Eastern Daylight Time	08/06/2017 03:07:47 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	050	0	2018	Broward County		2	5482	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	051	0	1	01	01	H5471_051_0	6			1		08/04/2017	2018.03	08/04/2017 09:59:47 AM Eastern Daylight Time	08/07/2017 08:55:36 AM Eastern Daylight Time	08/06/2017 03:07:48 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	051	0	2018	Broward County		2	13034	2			2						http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	052	0	1	01	01	H5471_052_0	6			1		08/04/2017	2018.03	08/04/2017 10:00:57 AM Eastern Daylight Time	08/07/2017 08:55:36 AM Eastern Daylight Time	08/06/2017 03:07:48 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	052	0	2018	Hillsborough, Pinellas, Hernando, Pasco Counties		2	15399	2			2						http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	053	0	1	01	01	H5471_053_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:01:58 AM Eastern Daylight Time	08/07/2017 08:55:37 AM Eastern Daylight Time	08/06/2017 03:07:48 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Care (HMO SNP)	01	01		1			H5471	053	0	2018	Broward County		2	96	2			1	1	1				http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	054	0	1	01	01	H5471_054_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:02:58 AM Eastern Daylight Time	08/07/2017 08:55:37 AM Eastern Daylight Time	08/06/2017 03:07:49 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	054	0	2018	Broward County		2	1506	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	055	0	1	01	01	H5471_055_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:05:14 AM Eastern Daylight Time	08/07/2017 08:55:38 AM Eastern Daylight Time	08/06/2017 03:07:49 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Comfort (HMO SNP)	01	01		1			H5471	055	0	2018	Broward County		2	161	2			1	1	2				http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	056	0	1	01	01	H5471_056_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 10:07:34 AM Eastern Daylight Time	08/07/2017 08:55:38 AM Eastern Daylight Time	08/06/2017 03:07:49 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	056	0	2018	Hillsborough, Pinellas, Hernando, Pasco Counties		2	4300	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	057	0	1	01	01	H5471_057_0	6			1		08/04/2017	2018.03	08/04/2017 10:09:38 AM Eastern Daylight Time	08/07/2017 10:47:42 AM Eastern Daylight Time	08/06/2017 03:07:49 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	057	0	2018	Palm Beach		2	5545	2			2						http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	058	0	1	01	01	H5471_058_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 10:10:23 AM Eastern Daylight Time	08/07/2017 10:47:42 AM Eastern Daylight Time	08/06/2017 03:07:50 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	058	0	2018	Palm Beach		2	966	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	059	0	1	01	01	H5471_059_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:13:45 AM Eastern Daylight Time	08/07/2017 08:55:39 AM Eastern Daylight Time	08/06/2017 03:07:50 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Level (HMO SNP)	01	01		1			H5471	059	0	2018	Palm Beach		2	342	2			1	4			00000010000000000000		http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	060	0	1	01	01	H5471_060_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:15:25 AM Eastern Daylight Time	08/07/2017 08:55:39 AM Eastern Daylight Time	08/06/2017 03:07:50 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Advantage (HMO SNP)	01	01		1			H5471	060	0	2018	Orange, Osceola, Seminole		2	1863	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	061	0	1	01	01	H5471_061_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:24:08 AM Eastern Daylight Time	08/07/2017 08:55:40 AM Eastern Daylight Time	08/06/2017 03:07:50 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Advantage (HMO SNP)	01	01		1			H5471	061	0	2018	Broward		2	4302	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	062	0	1	01	01	H5471_062_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:25:07 AM Eastern Daylight Time	08/07/2017 08:55:25 AM Eastern Daylight Time	08/06/2017 03:07:51 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Advantage (HMO SNP)	01	01		1			H5471	062	0	2018	Hillsborough, Pinellas, Hernando, Pasco Counties		2	5576	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5471	063	0	1	01	01	H5471_063_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:25:52 AM Eastern Daylight Time	08/07/2017 08:55:25 AM Eastern Daylight Time	08/06/2017 03:07:43 PM Eastern Daylight Time			08/07/2017 03:41:36 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Healthcare Plans, Inc.	www.mysimplymedicare.com	Simply Advantage (HMO SNP)	01	01		1			H5471	063	0	2018	Palm Beach		2	963	2			1	3		1		1	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	www.mysimplymedicare.com	(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(877)577-0115		(877)577-0115		(888)577-0212		(888)577-0212		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	001	0	1	01	01	H5475_001_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:01:06 PM Eastern Daylight Time	08/02/2017 04:10:54 PM Eastern Daylight Time	07/31/2017 05:59:54 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	001	0	2018	Genesee, Macomb, Saginaw, Oakland & Wayne Counties		2	55964	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	003	0	1	01	01	H5475_003_0	8			1		08/07/2017	2018.03	08/07/2017 04:41:53 PM Eastern Daylight Time	08/04/2017 12:47:46 PM Eastern Daylight Time	07/31/2017 06:01:08 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Elite (HMO)	01	01		1			H5475	003	0	2018	Genesee, Macomb, Saginaw, Oakland & Wayne Counties		2	4696	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	004	0	1	01	01	H5475_004_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:01:23 PM Eastern Daylight Time	08/02/2017 04:12:30 PM Eastern Daylight Time	07/31/2017 06:02:20 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	004	0	2018	Barry, Kalamazoo, Kent, Muskegon, Ottawa Counties		2	13223	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	005	0	1	01	01	H5475_005_0	8			1		08/02/2017	2018.03	08/02/2017 05:38:41 PM Eastern Daylight Time	08/02/2017 04:13:16 PM Eastern Daylight Time	07/31/2017 06:03:26 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	005	0	2018	Barry, Kalamazoo, Kent, Muskegon, Ottawa Counties		2	14933	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	006	0	1	01	01	H5475_006_0	9			1		08/02/2017	2018.03	08/02/2017 06:27:31 PM Eastern Daylight Time	08/02/2017 04:14:04 PM Eastern Daylight Time	07/31/2017 06:04:36 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	006	0	2018	GEN, MAC, SAG, OAK & WAY in MI and DuPage in IL		2	69276	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	007	0	1	01	01	H5475_007_0	8			1		08/02/2017	2018.03	08/02/2017 05:31:14 PM Eastern Daylight Time	08/02/2017 04:14:52 PM Eastern Daylight Time	07/31/2017 06:05:50 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Enhanced (HMO)	01	01		1			H5475	007	0	2018	Genesee, Macomb, Saginaw, Oakland & Wayne Counties		2	8409	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	008	0	1	01	01	H5475_008_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:02:13 PM Eastern Daylight Time	08/02/2017 04:15:38 PM Eastern Daylight Time	07/31/2017 06:07:02 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	008	0	2018	Livingston, Monroe, Washtenaw Counties		2	5530	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	009	0	1	01	01	H5475_009_0	9			1		08/02/2017	2018.03	08/02/2017 06:34:04 PM Eastern Daylight Time	08/02/2017 04:16:26 PM Eastern Daylight Time	07/31/2017 06:08:16 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	009	0	2018	Livingston, Monroe, Washtenaw Counties		2	7256	2			2						www.medicaremeridian.com	www.medicaremeridian.com	www.medicaremeridian.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	010	0	1	01	01	H5475_010_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:07:23 PM Eastern Daylight Time	08/02/2017 04:17:14 PM Eastern Daylight Time	07/31/2017 06:09:24 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	010	0	2018	Fulton, Henry, Lucas and Wood Counties		2	5126	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	011	0	1	01	01	H5475_011_0	9			1		08/02/2017	2018.03	08/02/2017 06:35:50 PM Eastern Daylight Time	08/02/2017 04:18:00 PM Eastern Daylight Time	07/31/2017 06:10:36 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	011	0	2018	Fulton, Henry, Lucas and Wood Counties		2	9399	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	012	0	1	01	01	H5475_012_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:09:09 PM Eastern Daylight Time	08/02/2017 04:18:48 PM Eastern Daylight Time	07/31/2017 06:11:48 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	012	0	2018	Clermont and Hamilton Counties		2	5425	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	013	0	1	01	01	H5475_013_0	9			1		08/02/2017	2018.03	08/02/2017 06:37:13 PM Eastern Daylight Time	08/02/2017 04:19:36 PM Eastern Daylight Time	07/31/2017 06:13:00 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	013	0	2018	Clermont and Hamilton Counties		2	12912	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	014	0	1	01	01	H5475_014_0	8			1		08/02/2017	2018.03	08/02/2017 05:27:58 PM Eastern Daylight Time	08/02/2017 04:20:22 PM Eastern Daylight Time	07/31/2017 06:14:08 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Enhanced (HMO)	01	01		1			H5475	014	0	2018	Clermont and Hamilton Counties		2	4872	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	015	0	1	01	01	H5475_015_0	9		1	1	2	08/02/2017	2018.03	08/02/2017 05:09:48 PM Eastern Daylight Time	08/02/2017 04:21:10 PM Eastern Daylight Time	07/31/2017 06:15:18 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Extra (HMO SNP)	01	01		1			H5475	015	0	2018	Butler County		2	3183	2			1	3		1		1	www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	016	0	1	01	01	H5475_016_0	9			1		08/02/2017	2018.03	08/02/2017 06:38:31 PM Eastern Daylight Time	08/02/2017 04:21:56 PM Eastern Daylight Time	07/31/2017 06:16:28 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	016	0	2018	Butler County		2	4335	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5475	018	0	1	01	01	H5475_018_0	8			1		08/02/2017	2018.03	08/02/2017 06:39:04 PM Eastern Daylight Time	08/02/2017 04:22:42 PM Eastern Daylight Time	07/31/2017 06:17:36 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5475	018	0	2018	Marshall and St. Joseph Counties		2	3796	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5493	001	0	1	20	08	H5493_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:26:50 PM Eastern Daylight Time		05/25/2017 12:48:56 PM Eastern Daylight Time			05/25/2017 01:50:53 PM Eastern Daylight Time	LIFE AT ST. FRANCIS HEALTHCARE, INC.	Saint Francis LIFE	http://stfrancishealthcare.org/life/	LIFE at St. Francis Healthcare, Inc (PACE)	08	20		1			H5493	001	0	2018	New Castle County, Delaware		2		2			2						www.stfrancishealthcare.org	www.stfrancishealthcare.org												(302)660-3355		(800)000-0000		(302)660-3351												(800)232-5460		(800)676-3777		(000)000-0000																
H5493	002	0	1	20	08	H5493_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:21:49 PM Eastern Daylight Time		05/25/2017 12:49:32 PM Eastern Daylight Time			05/25/2017 01:50:53 PM Eastern Daylight Time	LIFE AT ST. FRANCIS HEALTHCARE, INC.	Saint Francis LIFE	http://stfrancishealthcare.org/life/	LIFE at St. Francis Healthcare, Inc (PACE)	08	20		1			H5493	002	0	2018	LIFE at St. Francis Healthcare, Inc		2		2			2						www.stfrancishealthcare.org	www.stfrancishealthcare.org												(302)660-3355				(302)660-3351												(800)232-5460				(800)232-5460																
H5496	005	0	1	01	01	H5496_005_0	5		1	1		08/02/2017	2018.03	08/02/2017 02:16:01 PM Eastern Daylight Time	08/02/2017 12:56:15 PM Mountain Daylight Time	08/02/2017 12:40:23 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Senior Value (HMO SNP)	01	01		1			H5496	005	0	2018	County: San Francisco		2	1800	2			1	4			00000000000000000010		www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5496	006	0	1	01	01	H5496_006_0	6			1		08/02/2017	2018.03	08/02/2017 02:16:54 PM Eastern Daylight Time	08/02/2017 12:54:54 PM Mountain Daylight Time	08/02/2017 12:39:19 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Traditional-LA (HMO)	01	01		1			H5496	006	0	2018	County: Los Angeles		2	6000	2			2						www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5496	007	0	1	01	01	H5496_007_0	6			1		08/02/2017	2018.03	08/02/2017 03:44:59 PM Eastern Daylight Time	08/02/2017 01:42:09 PM Mountain Daylight Time	08/02/2017 12:38:10 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Traditional-SF (HMO)	01	01		1			H5496	007	0	2018	County: San Francisco		2	2400	2			2						www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5496	008	0	1	01	01	H5496_008_0	6			1		08/02/2017	2018.03	08/02/2017 02:16:46 PM Eastern Daylight Time	08/02/2017 12:51:56 PM Mountain Daylight Time	08/02/2017 12:36:56 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Traditional Plus-LA (HMO)	01	01		1			H5496	008	0	2018	County: Los Angeles		2	6000	2			2						www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5496	009	0	1	01	01	H5496_009_0	6			1		08/02/2017	2018.03	08/02/2017 02:16:35 PM Eastern Daylight Time	08/02/2017 12:50:30 PM Mountain Daylight Time	08/02/2017 12:35:37 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Traditional Plus-SF (HMO)	01	01		1			H5496	009	0	2018	County: San Francisco		2	2400	2			2						www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5496	010	0	1	01	01	H5496_010_0	6		1	1		08/02/2017	2018.03	08/02/2017 02:16:29 PM Eastern Daylight Time	08/02/2017 12:47:27 PM Mountain Daylight Time	08/02/2017 12:34:08 PM Mountain Daylight Time			08/02/2017 02:50:58 PM Mountain Daylight Time	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Imperial Health Plan of California, Inc.	www.imperialhealthplan.com	Senior Value-LA (HMO SNP)	01	01		1			H5496	010	0	2018	County: Los Angeles		2	2400	2			1	4			00000000000000000010		www.imperialhealthplan.com	www.imperialhealthplan.com	www.imperialhealthplan.com	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(800)497-5509		(626)838-5100	201	(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5521	012	0	1	04	01	H5521_012_0	4			1		07/13/2017	2018.03	07/13/2017 07:31:30 PM Eastern Daylight Time	08/03/2017 01:54:03 PM Eastern Daylight Time	07/31/2017 05:53:49 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	012	0	2018	Central and NE PA		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	013	0	1	04	01	H5521_013_0	3			1		08/02/2017	2018.03	08/02/2017 11:46:54 AM Central Daylight Time	08/02/2017 02:55:10 PM Central Daylight Time	07/31/2017 04:43:12 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	013	0	2018	Connecticut		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	015	0	1	04	01	H5521_015_0	3			1		06/27/2017	2018.03	06/27/2017 07:46:24 PM Eastern Daylight Time	08/01/2017 07:07:16 PM Eastern Daylight Time	07/31/2017 05:54:11 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	015	0	2018	District of Columbia		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	016	0	1	04	01	H5521_016_0	3			1		06/28/2017	2018.03	06/28/2017 08:48:37 AM Central Daylight Time	08/03/2017 03:57:37 PM Eastern Daylight Time	07/31/2017 05:41:03 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	016	0	2018	Cook County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	020	0	1	04	01	H5521_020_0	3			1		06/27/2017	2018.03	06/27/2017 07:46:33 PM Eastern Daylight Time	08/03/2017 09:37:00 AM Eastern Daylight Time	07/31/2017 05:54:34 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	020	0	2018	Ohio and Northern Kentucky		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	022	0	1	04	01	H5521_022_0	3			1		06/28/2017	2018.03	06/28/2017 08:48:48 AM Central Daylight Time	08/02/2017 02:44:06 PM Eastern Daylight Time	07/31/2017 05:41:32 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (PPO)	01	04		1			H5521	022	0	2018	Clark County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	027	0	1	04	01	H5521_027_0	5			1		06/27/2017	2018.03	06/27/2017 07:46:48 PM Eastern Daylight Time	08/01/2017 07:09:28 PM Eastern Daylight Time	07/31/2017 05:54:56 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	027	0	2018	Fairfax County and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	033	0	1	04	01	H5521_033_0	6			1		08/01/2017	2018.03	08/01/2017 05:08:51 PM Eastern Daylight Time	08/02/2017 02:14:38 PM Eastern Daylight Time	08/08/2017 03:35:09 PM Eastern Daylight Time			08/10/2017 11:06:07 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	033	0	2018	North, Central, West, SW, Treasure Coast, South FL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	037	0	1	04	01	H5521_037_0	4			1		08/02/2017	2018.03	08/02/2017 11:03:20 AM Eastern Daylight Time	08/02/2017 03:47:02 PM Central Daylight Time	07/31/2017 04:43:38 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	037	0	2018	Northern New Jersey		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	040	0	1	04	01	H5521_040_0	5			1		07/13/2017	2018.03	07/13/2017 04:37:14 PM Central Daylight Time	08/02/2017 07:28:12 PM Central Daylight Time	07/31/2017 04:44:04 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	040	0	2018	Metro (Manhattan, Queens, Staten Island)		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	053	0	1	04	01	H5521_053_0	6			1		07/19/2017	2018.03	07/19/2017 02:00:52 PM Central Daylight Time	08/03/2017 02:59:49 PM Eastern Daylight Time	07/31/2017 05:42:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	053	0	2018	San Diego County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	055	0	1	04	01	H5521_055_0	4			1		06/28/2017	2018.03	06/28/2017 08:49:13 AM Central Daylight Time	08/02/2017 02:44:56 PM Eastern Daylight Time	07/31/2017 05:42:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	055	0	2018	Clark County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	056	0	1	04	01	H5521_056_0	5			1		07/19/2017	2018.03	07/19/2017 02:02:01 PM Central Daylight Time	08/03/2017 03:01:57 PM Eastern Daylight Time	07/31/2017 05:43:00 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	056	0	2018	Orange County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	057	0	1	04	01	H5521_057_0	3			1		06/28/2017	2018.03	06/28/2017 08:49:37 AM Central Daylight Time	08/02/2017 02:38:24 PM Eastern Daylight Time	07/31/2017 05:43:30 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (PPO)	01	04		1			H5521	057	0	2018	Denver and Surrounding Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	058	0	1	04	01	H5521_058_0	6			1		06/28/2017	2018.03	06/28/2017 06:43:14 AM Central Daylight Time	08/03/2017 04:46:23 PM Central Daylight Time	07/31/2017 05:12:51 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	058	0	2018	South Central Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	059	0	1	04	01	H5521_059_0	5			1		08/07/2017	2018.03	08/07/2017 01:01:48 PM Central Daylight Time	08/07/2017 11:27:19 AM Central Daylight Time	07/31/2017 05:13:17 PM Central Daylight Time			08/07/2017 02:35:52 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	059	0	2018	North Central Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	060	0	1	04	01	H5521_060_0	5			1		08/07/2017	2018.03	08/07/2017 01:03:07 PM Central Daylight Time	08/07/2017 11:30:28 AM Central Daylight Time	07/31/2017 05:13:45 PM Central Daylight Time			08/07/2017 02:35:52 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	060	0	2018	Southeast Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	076	0	1	04	01	H5521_076_0	4			1		06/27/2017	2018.03	06/27/2017 08:55:04 PM Eastern Daylight Time	08/02/2017 07:29:24 PM Central Daylight Time	07/31/2017 04:44:29 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	076	0	2018	Greater Rochester		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	077	0	1	04	01	H5521_077_0	4			1		08/01/2017	2018.03	08/01/2017 04:29:10 PM Eastern Daylight Time	08/02/2017 07:30:32 PM Central Daylight Time	07/31/2017 04:44:56 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	077	0	2018	Central Upstate		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	081	0	1	04	01	H5521_081_0	5			1		08/02/2017	2018.03	08/02/2017 12:40:13 PM Eastern Daylight Time	08/02/2017 04:07:26 PM Central Daylight Time	07/31/2017 05:14:11 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	081	0	2018	North Carolina		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	082	0	1	04	01	H5521_082_0	3			1		06/27/2017	2018.03	06/27/2017 07:47:03 PM Eastern Daylight Time	08/02/2017 03:16:08 PM Eastern Daylight Time	07/31/2017 05:55:19 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	082	0	2018	Richmond and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	083	0	1	04	01	H5521_083_0	3			1		06/27/2017	2018.03	06/27/2017 07:47:15 PM Eastern Daylight Time	08/01/2017 07:11:10 PM Eastern Daylight Time	07/31/2017 05:55:41 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	083	0	2018	Danville City and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	084	0	1	04	01	H5521_084_0	3			1		06/27/2017	2018.03	06/27/2017 07:47:28 PM Eastern Daylight Time	08/01/2017 07:12:00 PM Eastern Daylight Time	07/31/2017 05:56:03 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	084	0	2018	Newport News and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	085	0	1	04	01	H5521_085_0	6			1		08/02/2017	2018.03	08/02/2017 04:37:44 PM Eastern Daylight Time	08/03/2017 09:39:55 AM Eastern Daylight Time	07/31/2017 05:56:25 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	085	0	2018	Boone, Campbell and Kenton counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	086	0	1	04	01	H5521_086_0	4			1		08/02/2017	2018.03	08/02/2017 02:40:29 PM Eastern Daylight Time	08/03/2017 04:16:34 PM Eastern Daylight Time	07/31/2017 05:44:00 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	086	0	2018	DuPage, Kane, Cook Counties IL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	087	0	1	04	01	H5521_087_0	4			1		08/02/2017	2018.03	08/02/2017 04:42:16 PM Eastern Daylight Time	08/03/2017 09:42:11 AM Eastern Daylight Time	07/31/2017 05:56:46 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	087	0	2018	Cincinnati and Surrounding area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	088	0	1	04	01	H5521_088_0	4			1		08/02/2017	2018.03	08/02/2017 04:43:23 PM Eastern Daylight Time	08/03/2017 09:44:58 AM Eastern Daylight Time	07/31/2017 05:57:08 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	088	0	2018	Toledo and Surrounding area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	089	0	1	04	01	H5521_089_0	4			1		08/03/2017	2018.03	08/03/2017 08:31:59 AM Eastern Daylight Time	08/03/2017 09:47:14 AM Eastern Daylight Time	07/31/2017 05:57:30 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	089	0	2018	Columbus and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	090	0	1	04	01	H5521_090_0	4			1		08/03/2017	2018.03	08/03/2017 07:16:59 AM Central Daylight Time	08/03/2017 09:49:20 AM Eastern Daylight Time	07/31/2017 05:57:52 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	090	0	2018	Clark and Miami counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	091	0	1	04	01	H5521_091_0	5			1		08/02/2017	2018.03	08/02/2017 02:38:00 PM Eastern Daylight Time	08/02/2017 02:36:28 PM Central Daylight Time	07/31/2017 05:14:37 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	091	0	2018	Georgia and Alabama Counties		2	200	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	092	0	1	04	01	H5521_092_0	4			1		08/01/2017	2018.03	08/01/2017 07:11:02 PM Central Daylight Time	08/03/2017 04:49:41 PM Central Daylight Time	07/31/2017 05:15:04 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	092	0	2018	South Central Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	094	0	1	04	01	H5521_094_0	4			1		06/28/2017	2018.03	06/28/2017 06:44:21 AM Central Daylight Time	08/03/2017 04:50:29 PM Central Daylight Time	07/31/2017 05:15:30 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	094	0	2018	Southeast Texas		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	095	0	1	04	01	H5521_095_0	4			1		07/13/2017	2018.03	07/13/2017 07:33:47 PM Eastern Daylight Time	08/03/2017 01:55:10 PM Eastern Daylight Time	07/31/2017 05:58:15 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	095	0	2018	New Castle, Kent and Sussex Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	099	0	1	04	01	H5521_099_0	3			1		08/04/2017	2018.03	08/04/2017 01:42:32 PM Eastern Daylight Time	08/03/2017 04:18:23 PM Eastern Daylight Time	07/31/2017 05:44:29 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	099	0	2018	Allen County (Fort Wayne), IN		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	100	0	1	04	01	H5521_100_0	4			1		06/28/2017	2018.03	06/28/2017 08:50:12 AM Central Daylight Time	08/03/2017 03:19:06 PM Eastern Daylight Time	07/31/2017 05:44:59 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Prime Plan (PPO)	01	04		1			H5521	100	0	2018	Maricopa County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	101	0	1	04	01	H5521_101_0	3			1		08/02/2017	2018.03	08/02/2017 11:22:27 AM Mountain Daylight Time	08/02/2017 02:46:04 PM Eastern Daylight Time	07/31/2017 05:45:29 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	101	0	2018	Salt Lake and Utah counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	102	0	1	04	01	H5521_102_0	3			1		06/27/2017	2018.03	06/27/2017 07:48:54 PM Eastern Daylight Time	08/02/2017 11:12:03 PM Eastern Daylight Time	07/31/2017 05:58:37 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	102	0	2018	Roanoke and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	103	0	1	04	01	H5521_103_0	4			1		08/02/2017	2018.03	08/02/2017 04:14:12 PM Central Daylight Time	08/03/2017 04:51:31 PM Central Daylight Time	07/31/2017 05:15:56 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	103	0	2018	Austin and surrounding counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	104	0	1	04	01	H5521_104_0	4			1		08/02/2017	2018.03	08/02/2017 04:14:30 PM Central Daylight Time	08/03/2017 04:52:50 PM Central Daylight Time	07/31/2017 05:16:22 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare TX Connect Plus 1 (PPO)	01	04		1			H5521	104	0	2018	South Texas Non Metro counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	105	0	1	04	01	H5521_105_0	4			1		08/02/2017	2018.03	08/02/2017 04:14:51 PM Central Daylight Time	08/03/2017 04:53:49 PM Central Daylight Time	07/31/2017 05:16:48 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	105	0	2018	Corpus Christi and surrounding counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	107	0	1	04	01	H5521_107_0	4			1		08/02/2017	2018.03	08/02/2017 04:15:09 PM Central Daylight Time	08/03/2017 04:54:40 PM Central Daylight Time	07/31/2017 05:17:15 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	107	0	2018	El Paso County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	108	0	1	04	01	H5521_108_0	4			1		08/02/2017	2018.03	08/02/2017 04:15:51 PM Central Daylight Time	08/03/2017 04:56:27 PM Central Daylight Time	07/31/2017 05:17:42 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	108	0	2018	North Texas Metro counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	109	0	1	04	01	H5521_109_0	4			1		08/02/2017	2018.03	08/02/2017 04:16:15 PM Central Daylight Time	08/03/2017 04:57:20 PM Central Daylight Time	07/31/2017 05:18:09 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare TX Connect Plus 1 (PPO)	01	04		1			H5521	109	0	2018	North Texas Non Metro counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	110	0	1	04	01	H5521_110_0	3			1		06/27/2017	2018.03	06/27/2017 08:55:26 PM Eastern Daylight Time	08/02/2017 07:31:30 PM Central Daylight Time	07/31/2017 04:45:23 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	110	0	2018	Hudson Valley		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	111	0	1	04	01	H5521_111_0	3			1		06/27/2017	2018.03	06/27/2017 08:55:38 PM Eastern Daylight Time	08/02/2017 07:32:14 PM Central Daylight Time	07/31/2017 04:45:49 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	111	0	2018	Nassau county		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	112	0	1	04	01	H5521_112_0	4			1		08/02/2017	2018.03	08/02/2017 01:00:10 PM Eastern Daylight Time	08/02/2017 07:33:06 PM Central Daylight Time	07/31/2017 04:46:15 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	112	0	2018	Capital District		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	113	0	1	04	01	H5521_113_0	3			1		06/27/2017	2018.03	06/27/2017 08:56:08 PM Eastern Daylight Time	08/02/2017 07:33:50 PM Central Daylight Time	07/31/2017 04:46:40 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	113	0	2018	Brooklyn		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	114	0	1	04	01	H5521_114_0	4			1		08/02/2017	2018.03	08/02/2017 02:30:39 PM Eastern Daylight Time	08/02/2017 02:38:32 PM Central Daylight Time	07/31/2017 05:18:35 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	114	0	2018	Georgia counties		2	300	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	115	0	1	04	01	H5521_115_0	4			1		06/28/2017	2018.03	06/28/2017 06:47:29 AM Central Daylight Time	08/02/2017 02:40:04 PM Central Daylight Time	07/31/2017 05:19:02 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plus Plan (PPO)	01	04		1			H5521	115	0	2018	Georgia counties		2	150	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	116	0	1	04	01	H5521_116_0	4			1		08/02/2017	2018.03	08/02/2017 02:28:34 PM Eastern Daylight Time	08/02/2017 02:43:42 PM Central Daylight Time	07/31/2017 05:19:28 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Liberty Plan (PPO)	01	04		1			H5521	116	0	2018	Mobile Metro Area		2	40	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	117	0	1	04	01	H5521_117_0	3			1		08/02/2017	2018.03	08/02/2017 02:41:49 PM Eastern Daylight Time	08/02/2017 07:34:30 PM Central Daylight Time	07/31/2017 04:47:13 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	117	0	2018	Suffolk		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	118	0	1	04	01	H5521_118_0	4			1		08/03/2017	2018.03	08/03/2017 04:20:20 PM Eastern Daylight Time	08/02/2017 07:35:12 PM Central Daylight Time	07/31/2017 04:47:39 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (PPO)	01	04		1			H5521	118	0	2018	Upstate		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	119	0	1	04	01	H5521_119_0	3			1		08/02/2017	2018.03	08/02/2017 02:38:11 PM Eastern Daylight Time	08/02/2017 07:36:14 PM Central Daylight Time	07/31/2017 04:48:05 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (PPO)	01	04		1			H5521	119	0	2018	Hudson Valley		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	120	0	1	04	01	H5521_120_0	4			1		08/02/2017	2018.03	08/02/2017 04:17:49 PM Eastern Daylight Time	08/02/2017 07:37:06 PM Central Daylight Time	07/31/2017 04:48:32 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (PPO)	01	04		1			H5521	120	0	2018	Metro		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	121	0	1	04	01	H5521_121_0	3			1		08/02/2017	2018.03	08/02/2017 02:34:14 PM Eastern Daylight Time	08/02/2017 07:38:08 PM Central Daylight Time	07/31/2017 04:48:58 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	121	0	2018	Westchester, Rockland, Bronx		2	0	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	122	0	1	04	01	H5521_122_0	4			1		06/27/2017	2018.03	06/27/2017 07:49:07 PM Eastern Daylight Time	08/03/2017 01:56:24 PM Eastern Daylight Time	07/31/2017 05:58:59 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Gold Plan (PPO)	01	04		1			H5521	122	0	2018	Pennsylvania		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	123	0	1	04	01	H5521_123_0	4			1		07/19/2017	2018.03	07/19/2017 10:54:31 AM Central Daylight Time	08/02/2017 03:48:24 PM Central Daylight Time	07/31/2017 04:49:24 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare SNJ Prime Elite Plan (PPO)	01	04		1			H5521	123	0	2018	Burlington, Camden and Gloucester counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	124	0	1	04	01	H5521_124_0	3			1		06/27/2017	2018.03	06/27/2017 08:57:25 PM Eastern Daylight Time	08/02/2017 03:49:22 PM Central Daylight Time	07/31/2017 04:49:51 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	124	0	2018	Counties: ATL, BUR, CAM, CPM, CUM, GLO, SLM		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	125	0	1	04	01	H5521_125_0	5			1		07/19/2017	2018.03	07/19/2017 02:02:42 PM Central Daylight Time	08/03/2017 03:03:16 PM Eastern Daylight Time	07/31/2017 05:45:59 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	125	0	2018	Los Angeles County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	126	0	1	04	01	H5521_126_0	5			1		07/19/2017	2018.03	07/19/2017 02:03:21 PM Central Daylight Time	08/03/2017 03:04:11 PM Eastern Daylight Time	07/31/2017 05:46:28 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	126	0	2018	Riverside and San Bernardino counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	127	0	1	04	01	H5521_127_0	6			1		08/02/2017	2018.03	08/02/2017 09:40:21 AM Mountain Daylight Time	08/03/2017 03:07:02 PM Eastern Daylight Time	07/31/2017 05:46:58 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	127	0	2018	King, Pierce and Snohomish counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	128	0	1	04	01	H5521_128_0	3			1		06/28/2017	2018.03	06/28/2017 08:51:27 AM Central Daylight Time	08/03/2017 03:08:59 PM Eastern Daylight Time	07/31/2017 05:47:29 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (PPO)	01	04		1			H5521	128	0	2018	King, Pierce and Snohomish counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	130	0	1	04	01	H5521_130_0	3			1		06/28/2017	2018.03	06/28/2017 08:51:38 AM Central Daylight Time	08/02/2017 02:46:56 PM Eastern Daylight Time	07/31/2017 05:47:59 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (PPO)	01	04		1			H5521	130	0	2018	Washoe County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	131	0	1	04	01	H5521_131_0	3			1		06/28/2017	2018.03	06/28/2017 08:51:49 AM Central Daylight Time	08/02/2017 02:47:46 PM Eastern Daylight Time	07/31/2017 05:48:29 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (PPO)	01	04		1			H5521	131	0	2018	Northeast Utah		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	134	0	1	04	01	H5521_134_0	4			1		07/19/2017	2018.03	07/19/2017 02:07:22 PM Central Daylight Time	08/03/2017 09:52:17 AM Eastern Daylight Time	07/31/2017 05:59:21 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	134	0	2018	Select Counties in Ohio		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	139	0	1	04	01	H5521_139_0	4			1		06/28/2017	2018.03	06/28/2017 06:47:53 AM Central Daylight Time	08/02/2017 04:16:00 PM Central Daylight Time	07/31/2017 05:19:54 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	139	0	2018	Alleghany, Johnston, Wilkes Counties, NC		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	140	0	1	04	01	H5521_140_0	4			1		08/02/2017	2018.03	08/02/2017 12:42:44 PM Eastern Daylight Time	08/02/2017 04:14:40 PM Central Daylight Time	07/31/2017 05:20:20 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	140	0	2018	Greenville/Spartanburg and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	141	0	1	04	01	H5521_141_0	4			1		08/02/2017	2018.03	08/02/2017 04:23:33 PM Eastern Daylight Time	08/02/2017 04:17:02 PM Central Daylight Time	07/31/2017 05:20:46 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	141	0	2018	Nashville and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	142	0	1	04	01	H5521_142_0	3			1		08/01/2017	2018.03	08/01/2017 07:56:08 PM Central Daylight Time	08/02/2017 02:56:30 PM Central Daylight Time	07/31/2017 04:50:18 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	142	0	2018	Southern ME		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	143	0	1	04	01	H5521_143_0	4			1		08/02/2017	2018.03	08/02/2017 11:54:13 AM Central Daylight Time	08/02/2017 03:00:08 PM Central Daylight Time	07/31/2017 04:50:44 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	143	0	2018	Mid ME		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	144	0	1	04	01	H5521_144_0	3			1		06/27/2017	2018.03	06/27/2017 08:58:04 PM Eastern Daylight Time	08/02/2017 03:01:50 PM Central Daylight Time	07/31/2017 04:51:11 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	144	0	2018	Northern and Additional Maine		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	145	0	1	04	01	H5521_145_0	5			1		08/02/2017	2018.03	08/02/2017 04:16:38 PM Central Daylight Time	08/03/2017 04:58:29 PM Central Daylight Time	07/31/2017 05:21:13 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	145	0	2018	Rio Grande Valley and Laredo		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	146	0	1	04	01	H5521_146_0	4			1		08/02/2017	2018.03	08/02/2017 04:16:56 PM Central Daylight Time	08/03/2017 04:59:27 PM Central Daylight Time	07/31/2017 05:21:40 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plus Plan (PPO)	01	04		1			H5521	146	0	2018	El Paso county		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	147	0	1	04	01	H5521_147_0	5			1		08/02/2017	2018.03	08/02/2017 04:17:22 PM Central Daylight Time	08/03/2017 06:00:35 PM Eastern Daylight Time	08/08/2017 03:35:46 PM Eastern Daylight Time			08/10/2017 11:06:07 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	147	0	2018	Lubbock County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	148	0	1	04	01	H5521_148_0	3			1		06/28/2017	2018.03	06/28/2017 08:52:02 AM Central Daylight Time	08/03/2017 04:19:35 PM Eastern Daylight Time	07/31/2017 05:49:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	148	0	2018	Gladwin, Midland, Clare Counties MI		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	149	0	1	04	01	H5521_149_0	3			1		06/28/2017	2018.03	06/28/2017 08:52:19 AM Central Daylight Time	08/03/2017 04:21:16 PM Eastern Daylight Time	07/31/2017 05:49:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	149	0	2018	Wayne, Oakland Counties MI		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	http://www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	150	0	1	04	01	H5521_150_0	3			1		06/28/2017	2018.03	06/28/2017 08:52:29 AM Central Daylight Time	08/03/2017 04:22:40 PM Eastern Daylight Time	07/31/2017 05:50:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	150	0	2018	Milwaukee, Racine Counties WI		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	151	0	1	04	01	H5521_151_0	3			1		06/28/2017	2018.03	06/28/2017 08:52:42 AM Central Daylight Time	08/03/2017 04:24:32 PM Eastern Daylight Time	07/31/2017 05:50:32 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	151	0	2018	Marion county IN		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	152	0	1	04	01	H5521_152_0	3			1		06/28/2017	2018.03	06/28/2017 08:52:56 AM Central Daylight Time	08/03/2017 04:26:03 PM Eastern Daylight Time	07/31/2017 05:51:02 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	152	0	2018	Vanderburgh, Posey Counties IN		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	153	0	1	04	01	H5521_153_0	3			1		06/28/2017	2018.03	06/28/2017 08:53:12 AM Central Daylight Time	08/03/2017 04:27:06 PM Eastern Daylight Time	07/31/2017 05:51:32 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	153	0	2018	Kankakee county IL		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	154	0	1	04	01	H5521_154_0	4			1		06/28/2017	2018.03	06/28/2017 06:48:52 AM Central Daylight Time	08/02/2017 04:19:28 PM Central Daylight Time	07/31/2017 05:36:44 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	154	0	2018	Memphis and Surrounding Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	156	0	1	04	01	H5521_156_0	4			1		07/19/2017	2018.03	07/19/2017 01:55:17 PM Central Daylight Time	08/03/2017 09:54:35 AM Eastern Daylight Time	07/31/2017 05:59:43 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	156	0	2018	Louisville		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	157	0	1	04	01	H5521_157_0	3			1		08/03/2017	2018.03	08/03/2017 03:16:58 PM Central Daylight Time	08/02/2017 03:04:28 PM Central Daylight Time	07/31/2017 04:51:37 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (PPO)	01	04		1			H5521	157	0	2018	Connecticut		2	3369	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	158	0	1	04	01	H5521_158_0	3			1		08/02/2017	2018.03	08/02/2017 01:22:22 PM Central Daylight Time	08/02/2017 03:07:06 PM Central Daylight Time	07/31/2017 04:52:03 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	158	0	2018	Plymouth County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	159	0	1	04	01	H5521_159_0	3			1		08/02/2017	2018.03	08/02/2017 01:22:49 PM Central Daylight Time	08/02/2017 03:07:54 PM Central Daylight Time	07/31/2017 04:52:29 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	159	0	2018	Greater Boston area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	160	0	1	04	01	H5521_160_0	3			1		08/02/2017	2018.03	08/02/2017 01:23:09 PM Central Daylight Time	08/02/2017 03:08:58 PM Central Daylight Time	07/31/2017 04:52:56 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	160	0	2018	Worcester County		2	3369	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	167	0	1	04	01	H5521_167_0	5			1		08/04/2017	2018.03	08/04/2017 08:06:18 PM Central Daylight Time	08/03/2017 05:01:28 PM Central Daylight Time	07/31/2017 05:37:10 PM Central Daylight Time			08/04/2017 08:08:09 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (PPO)	01	04		1			H5521	167	0	2018	Cameron, Hidalgo and Webb Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	168	0	1	04	01	H5521_168_0	5			1		08/02/2017	2018.03	08/02/2017 12:41:40 PM Eastern Daylight Time	08/02/2017 04:20:44 PM Central Daylight Time	07/31/2017 05:37:37 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Essential Plan (PPO)	01	04		1			H5521	168	0	2018	Wake, Durham Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	169	0	1	04	01	H5521_169_0	4			1		06/28/2017	2018.03	06/28/2017 06:49:21 AM Central Daylight Time	08/02/2017 04:27:04 PM Central Daylight Time	07/31/2017 05:38:03 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	169	0	2018	Fayetteville and Sandhills Area		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	170	0	1	04	01	H5521_170_0	4			1		08/02/2017	2018.03	08/02/2017 01:25:37 PM Eastern Daylight Time	08/02/2017 04:28:18 PM Central Daylight Time	07/31/2017 05:38:30 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plus Plan (PPO)	01	04		1			H5521	170	0	2018	Alamance, Guilford, Randolph, Rockingham Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	171	0	1	04	01	H5521_171_0	4			1		08/02/2017	2018.03	08/02/2017 02:25:34 PM Eastern Daylight Time	08/02/2017 02:46:12 PM Central Daylight Time	07/31/2017 05:38:57 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	171	0	2018	Central Alabama		2	200	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	177	0	1	04	01	H5521_177_0	4			1		06/28/2017	2018.03	06/28/2017 06:50:39 AM Central Daylight Time	08/02/2017 02:48:16 PM Central Daylight Time	07/31/2017 05:39:23 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	177	0	2018	Cherokee County		2	200	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	178	0	1	04	01	H5521_178_0	4			1		08/02/2017	2018.03	08/02/2017 02:18:51 PM Eastern Daylight Time	08/02/2017 02:51:04 PM Central Daylight Time	07/31/2017 05:39:48 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Freedom Plan (PPO)	01	04		1			H5521	178	0	2018	Select Parishes across LA		2	200	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	179	0	1	04	01	H5521_179_0	3			1		06/28/2017	2018.03	06/28/2017 06:51:05 AM Central Daylight Time	05/30/2017 04:22:44 PM Central Daylight Time				07/07/2017 09:21:42 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basics Plan (PPO)	01	04		1			H5521	179	0	2018	Georgia Counties		2	200	2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5521	183	0	1	04	01	H5521_183_0	4			1		06/28/2017	2018.03	06/28/2017 06:51:16 AM Central Daylight Time	08/02/2017 04:30:10 PM Central Daylight Time	07/31/2017 05:40:13 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	183	0	2018	Wake, Durham Counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	184	0	1	04	01	H5521_184_0	3			1		06/28/2017	2018.03	06/28/2017 08:53:28 AM Central Daylight Time	08/03/2017 03:21:49 PM Eastern Daylight Time	07/31/2017 05:52:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (PPO)	01	04		1			H5521	184	0	2018	Maricopa County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	185	0	1	04	01	H5521_185_0	3			1		06/28/2017	2018.03	06/28/2017 08:53:41 AM Central Daylight Time	08/03/2017 03:23:13 PM Eastern Daylight Time	07/31/2017 05:52:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (PPO)	01	04		1			H5521	185	0	2018	Pima County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	186	0	1	04	01	H5521_186_0	3			1		06/28/2017	2018.03	06/28/2017 08:54:07 AM Central Daylight Time	08/03/2017 03:25:27 PM Eastern Daylight Time	07/31/2017 05:53:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (PPO)	01	04		1			H5521	186	0	2018	Pinal County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	187	0	1	04	01	H5521_187_0	3			1		06/28/2017	2018.03	06/28/2017 08:54:19 AM Central Daylight Time	08/02/2017 02:39:22 PM Eastern Daylight Time	07/31/2017 05:53:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Platinum Plan (PPO)	01	04		1			H5521	187	0	2018	Denver Metro		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	190	0	1	04	01	H5521_190_0	4			1		06/28/2017	2018.03	06/28/2017 08:54:36 AM Central Daylight Time	08/05/2017 10:47:17 AM Eastern Daylight Time	07/31/2017 05:54:01 PM Eastern Daylight Time			08/07/2017 10:25:23 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premium Plan (PPO)	01	04		1			H5521	190	0	2018	Allen County (Fort Wayne), IN		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	194	0	1	04	01	H5521_194_0	3			1		08/02/2017	2018.03	08/02/2017 06:00:33 PM Eastern Daylight Time	08/03/2017 04:31:26 PM Eastern Daylight Time	07/31/2017 05:54:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	194	0	2018	Gladwin, Midland, Clare Counties MI		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	195	0	1	04	01	H5521_195_0	4			1		08/04/2017	2018.03	08/04/2017 07:40:38 PM Eastern Daylight Time	08/03/2017 04:33:09 PM Eastern Daylight Time	07/31/2017 05:55:01 PM Eastern Daylight Time			08/04/2017 07:41:40 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	195	0	2018	Milwaukee, Racine Counties WI		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	196	0	1	04	01	H5521_196_0	3			1		06/28/2017	2018.03	06/28/2017 08:55:21 AM Central Daylight Time	08/02/2017 02:48:34 PM Eastern Daylight Time	07/31/2017 05:55:31 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Choice Plan (PPO)	01	04		1			H5521	196	0	2018	Southern Utah		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	197	0	1	04	01	H5521_197_0	3			1		06/28/2017	2018.03	06/28/2017 08:55:36 AM Central Daylight Time	08/02/2017 02:54:02 PM Eastern Daylight Time	07/31/2017 05:56:01 PM Eastern Daylight Time			08/04/2017 06:32:11 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H5521	197	0	2018	Davis, Weber and surrounding counties		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	199	0	1	04	01	H5521_199_0	4			1		08/03/2017	2018.03	08/03/2017 03:35:35 PM Central Daylight Time	08/03/2017 05:02:26 PM Central Daylight Time	07/31/2017 05:40:37 PM Central Daylight Time			08/04/2017 04:43:49 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plus Plan (PPO)	01	04		1			H5521	199	0	2018	Bexar County		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5521	801	0	1	04	01	H5521_801_0	2			1		05/30/2017	2018.03	05/30/2017 04:11:14 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (PPO)	01	04		1			H5521	801	0	2018	National		1	4610230	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5521	802	0	1	04	01	H5521_802_0	2			1		05/30/2017	2018.03	05/30/2017 04:28:14 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (PPO)	01	04		1			H5521	802	0	2018	National		1	2217600	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5521	805	0	2	04	01	H5521_805_0	2			1		05/30/2017	2018.03	05/30/2017 12:09:26 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Part B Only Plan (PPO)	01	04		2	1		H5521	805	0	2018	National		1	142430	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5521	806	0	2	04	01	H5521_806_0	2			1		05/30/2017	2018.03	05/30/2017 12:10:48 PM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Part B Only Plan w/Rx CY (PPO)	01	04		2	1		H5521	806	0	2018	National		1	720	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5522	001	0	1	04	01	H5522_001_0	4	2		1		08/04/2017	2018.03	08/04/2017 01:59:31 PM Central Daylight Time	08/03/2017 01:57:52 PM Eastern Daylight Time	07/31/2017 06:00:05 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	001	0	2018	Allegheny County		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	002	0	1	04	01	H5522_002_0	5	2		1		07/13/2017	2018.03	07/13/2017 07:29:27 PM Eastern Daylight Time	08/03/2017 01:59:05 PM Eastern Daylight Time	07/31/2017 06:00:28 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	002	0	2018	Central Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	004	0	1	04	01	H5522_004_0	3	2		1		08/02/2017	2018.03	08/02/2017 03:08:17 PM Eastern Daylight Time	08/03/2017 02:00:52 PM Eastern Daylight Time	07/31/2017 06:00:50 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H5522	004	0	2018	Central Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	005	0	1	04	01	H5522_005_0	4	1		1		06/27/2017	2018.03	06/27/2017 08:38:06 PM Eastern Daylight Time	08/02/2017 07:37:46 PM Eastern Daylight Time	07/31/2017 06:01:10 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H5522	005	0	2018	Western Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	013	0	1	04	01	H5522_013_0	3	2		1		06/27/2017	2018.03	06/27/2017 08:38:16 PM Eastern Daylight Time	08/03/2017 02:01:59 PM Eastern Daylight Time	07/31/2017 06:01:33 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Silver Plus (PPO)	01	04		1			H5522	013	0	2018	Central Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	014	0	1	04	01	H5522_014_0	4	2		1		07/13/2017	2018.03	07/13/2017 07:29:48 PM Eastern Daylight Time	08/03/2017 02:03:58 PM Eastern Daylight Time	07/31/2017 06:01:56 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	014	0	2018	Southeastern PA		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	017	0	1	04	01	H5522_017_0	3	2		1		08/02/2017	2018.03	08/02/2017 06:57:50 PM Eastern Daylight Time	08/03/2017 02:05:10 PM Eastern Daylight Time	07/31/2017 06:02:19 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	AdvantraOne (PPO)	01	04		1			H5522	017	0	2018	Pennsylvania		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	018	0	1	04	01	H5522_018_0	3	2		1		06/27/2017	2018.03	06/27/2017 07:51:04 PM Eastern Daylight Time	08/03/2017 02:06:13 PM Eastern Daylight Time	07/31/2017 06:02:42 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	www.coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H5522	018	0	2018	Allegheny		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(800)290-0190		(800)290-0190		(855)338-9566		(855)338-9566		(844)741-8423		(844)741-8423		(855)338-9566		(855)338-9566		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5522	802	0	1	04	01	H5522_802_0	1			1		05/31/2017	2018.03	05/31/2017 07:28:26 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra MA Only (PPO)	01	04		1			H5522	802	0	2018	Pennsylvania		1	120	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5522	803	0	1	04	01	H5522_803_0	1			1		05/31/2017	2018.03	05/31/2017 07:28:50 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (PPO)	01	04		1			H5522	803	0	2018	Pennsylvania		1	109140	2			2						http://www.coventry-medicare.com/findpharmacy	https://www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(855)275-5888		(855)275-5888		(844)741-8423		(844)741-8423		(855)275-5888		(855)275-5888		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H5525	004	0	1	04	01	H5525_004_0	5			1		06/28/2017	2018.03	06/28/2017 10:48:18 AM Eastern Daylight Time	08/04/2017 02:45:45 PM Eastern Daylight Time	08/04/2017 09:54:04 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-004 (PPO)	01	04		1			H5525	004	0	2018	Peoria Illinois area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	005	0	1	04	01	H5525_005_0	3			1		05/27/2017	2018.03	05/27/2017 11:56:50 AM Eastern Daylight Time	08/04/2017 05:30:11 PM Eastern Daylight Time	08/04/2017 09:54:04 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-005 (PPO)	01	04		1			H5525	005	0	2018	Greater Philadelphia Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	006	0	1	04	01	H5525_006_0	3			1		05/27/2017	2018.03	05/27/2017 11:57:50 AM Eastern Daylight Time	08/04/2017 05:27:01 PM Eastern Daylight Time	08/04/2017 09:54:05 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-006 (PPO)	01	04		1			H5525	006	0	2018	South Central Pennsylvania area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	007	0	1	04	01	H5525_007_0	3			1		05/27/2017	2018.03	05/27/2017 11:58:48 AM Eastern Daylight Time	08/04/2017 05:24:45 PM Eastern Daylight Time	08/04/2017 09:54:05 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-007 (PPO)	01	04		1			H5525	007	0	2018	North Central Pennsylvania area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	008	0	1	04	01	H5525_008_0	3			1		05/27/2017	2018.03	05/27/2017 04:30:45 PM Eastern Daylight Time	08/04/2017 01:54:22 PM Eastern Daylight Time	08/04/2017 09:54:06 AM Eastern Daylight Time			08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-008 (PPO)	01	04		1			H5525	008	0	2018	Select counties in Suburban Indiana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	015	0	1	04	01	H5525_015_0	3			1		05/27/2017	2018.03	05/27/2017 02:15:06 PM Eastern Daylight Time	08/04/2017 02:07:45 PM Eastern Daylight Time	08/04/2017 09:54:06 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-015 (PPO)	01	04		1			H5525	015	0	2018	Select Louisiana Parishes		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	017	0	1	04	01	H5525_017_0	3			1		05/30/2017	2018.03	05/30/2017 10:30:10 AM Eastern Daylight Time	08/04/2017 05:32:52 PM Eastern Daylight Time	08/04/2017 09:54:07 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-017 (PPO)	01	04		1			H5525	017	0	2018	Western Pennsylvania Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	020	0	1	04	01	H5525_020_0	2			1		05/27/2017	2018.03	05/27/2017 02:03:00 PM Eastern Daylight Time	08/04/2017 02:12:19 PM Eastern Daylight Time	08/04/2017 09:54:07 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-020 (PPO)	01	04		1			H5525	020	0	2018	Mobile Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	022	0	1	04	01	H5525_022_0	3			1		05/27/2017	2018.03	05/27/2017 12:00:35 PM Eastern Daylight Time	08/04/2017 05:35:06 PM Eastern Daylight Time	08/04/2017 09:54:08 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-022 (PPO)	01	04		1			H5525	022	0	2018	Select counties in Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	023	0	1	04	01	H5525_023_0	3			1		05/27/2017	2018.03	05/27/2017 12:01:32 PM Eastern Daylight Time	08/04/2017 05:34:39 PM Eastern Daylight Time	08/04/2017 09:54:08 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-023 (PPO)	01	04		1			H5525	023	0	2018	Select counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	024	0	1	04	01	H5525_024_0	5			1		06/28/2017	2018.03	06/28/2017 11:20:09 AM Eastern Daylight Time	08/04/2017 03:02:20 PM Eastern Daylight Time	08/04/2017 09:54:09 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-024 (PPO)	01	04		1			H5525	024	0	2018	Select Counties in Georgia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	025	0	1	04	01	H5525_025_0	6			1		06/28/2017	2018.03	06/28/2017 11:20:20 AM Eastern Daylight Time	08/04/2017 03:02:49 PM Eastern Daylight Time	08/04/2017 09:54:10 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-025 (PPO)	01	04		1			H5525	025	0	2018	Select Counties in South Carolina		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	026	0	1	04	01	H5525_026_0	5			1		06/28/2017	2018.03	06/28/2017 11:11:04 AM Eastern Daylight Time	08/04/2017 03:14:37 PM Eastern Daylight Time	08/04/2017 09:54:10 AM Eastern Daylight Time			08/06/2017 09:19:27 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-026 (PPO)	01	04		1			H5525	026	0	2018	Select Counties in North Carolina		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	027	0	1	04	01	H5525_027_0	3			1		05/30/2017	2018.03	05/30/2017 05:24:28 PM Eastern Daylight Time	08/04/2017 04:32:51 PM Eastern Daylight Time	08/04/2017 09:54:11 AM Eastern Daylight Time			08/06/2017 09:25:10 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-027 (PPO)	01	04		1			H5525	027	0	2018	Select Counties in Montana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	030	0	1	04	01	H5525_030_0	6			1		07/11/2017	2018.03	07/11/2017 01:10:31 PM Eastern Daylight Time	08/04/2017 01:54:53 PM Eastern Daylight Time	08/04/2017 09:54:11 AM Eastern Daylight Time			08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-030 (PPO)	01	04		1			H5525	030	0	2018	Select Counties in Ohio and Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5525	031	0	1	04	01	H5525_031_0	2			1		06/28/2017	2018.03	06/28/2017 10:11:16 AM Eastern Daylight Time	06/01/2017 07:18:46 PM Eastern Daylight Time				06/29/2017 11:26:43 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	HumanaChoice H5525-031 (PPO)	01	04		1			H5525	031	0	2018	Select Counties in Montana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5525	809	0	1	04	01	H5525_809_0	4			1		06/13/2017	2018.03	06/13/2017 10:15:05 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5525	809	0	2018	Select Counties in Multi-States		1	225612	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5525	810	0	1	04	01	H5525_810_0	4			1		06/13/2017	2018.03	06/13/2017 10:15:51 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5525	810	0	2018	Select Counties in Multi-States		1	25548	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5525	811	0	1	04	01	H5525_811_0	4			1		06/13/2017	2018.03	06/13/2017 10:16:34 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		1			H5525	811	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5525	812	0	2	04	01	H5525_812_0	4			1		06/13/2017	2018.03	06/13/2017 10:17:38 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5525	812	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5525	813	0	2	04	01	H5525_813_0	4			1		06/13/2017	2018.03	06/13/2017 10:18:20 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5525	813	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5525	814	0	2	04	01	H5525_814_0	4			1		06/13/2017	2018.03	06/13/2017 10:19:06 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		2	1		H5525	814	0	2018	Select Counties in Multi-States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5526	004	0	1	04	01	H5526_004_0	3			1		08/07/2017	2018.03	08/07/2017 09:44:25 AM Eastern Daylight Time	08/07/2017 05:05:57 PM Eastern Daylight Time	08/07/2017 05:06:20 PM Eastern Daylight Time			08/07/2017 05:36:41 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Forever Blue 751 (PPO)	01	04		1			H5526	004	0	2018	Western New York		2	37848	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5526	016	0	1	04	01	H5526_016_0	4			1		06/02/2017	2018.03	06/02/2017 10:05:24 AM Eastern Daylight Time	08/07/2017 05:05:57 PM Eastern Daylight Time	08/07/2017 05:06:20 PM Eastern Daylight Time			08/07/2017 05:36:41 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Forever Blue Value (PPO)	01	04		1			H5526	016	0	2018	Western New York		2	21108	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5526	017	0	1	04	01	H5526_017_0	3			1		08/07/2017	2018.03	08/07/2017 09:51:50 AM Eastern Daylight Time	08/07/2017 05:05:58 PM Eastern Daylight Time	08/07/2017 05:06:21 PM Eastern Daylight Time			08/07/2017 05:36:41 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com/medicare	BlueShield Forever Blue Value (PPO)	01	04		1			H5526	017	0	2018	Northeastern New York		2	25728	2			2						www.bsneny.com/medicare	www.bsneny.com/medicare	www.bsneny.com/medicare	(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5526	018	0	1	04	01	H5526_018_0	3			1		08/07/2017	2018.03	08/07/2017 10:00:48 AM Eastern Daylight Time	08/07/2017 05:05:59 PM Eastern Daylight Time	08/07/2017 05:06:22 PM Eastern Daylight Time			08/07/2017 05:36:41 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com/medicare	BlueShield Forever Blue 770 (PPO)	01	04		1			H5526	018	0	2018	Northeastern New York		2	6720	2			2						www.bsneny.com/medicare	www.bsneny.com/medicare	www.bsneny.com/medicare	(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(800)329-2792		(800)329-2792		(877)258-7453		(877)258-7453		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5526	019	0	1	04	01	H5526_019_0	3			1		06/02/2017	2018.03	06/02/2017 10:10:21 AM Eastern Daylight Time	08/07/2017 05:06:00 PM Eastern Daylight Time	08/07/2017 05:06:23 PM Eastern Daylight Time			08/07/2017 05:36:41 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com/medicare	BlueCross BlueShield Forever Blue Focus (PPO)	01	04		1			H5526	019	0	2018	Western New York		2	4932	2			2						www.bcbswny.com/medicare	www.bcbswny.com/medicare	www.bcbswny.com/medicare	(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(800)329-2792		(800)329-2792		(800)248-9296		(800)248-9296		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5526	806	0	1	04	01	H5526_806_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:56 AM Eastern Daylight Time					06/13/2017 11:09:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	PPO Group (MA Only) CY (PPO)	01	04		1			H5526	806	0	2018	Western and Northeastern New York		1	11928	2			2						www.bcbswny.com	http://www.bcbswny.com/pharmacy	www.nymedicare.com	(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;9a;9b;9c;11a;11b;11c;15;	2		1									
H5526	808	0	1	04	01	H5526_808_0	2			1		06/13/2017	2018.03	06/13/2017 10:43:35 AM Eastern Daylight Time					06/13/2017 11:09:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	PPO Group (MA-PD) CY (PPO)	01	04		1			H5526	808	0	2018	Western and Northeastern New York		1	120612	2			2						www.bcbswny.com	http://www.bcbswny.com/pharmacy	www.nymedicare.com	(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237		(800)329-2792		(800)329-2792		(855)215-9237		(855)215-9237		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7e;7h;8a;8b1;8b2;9a;9b;9c;11a;11b;11c;15;	2		1									
H5528	807	0	1	04	01	H5528_807_0	1			1		05/22/2017	2018.03	05/22/2017 06:43:03 PM Eastern Daylight Time					06/01/2017 11:29:50 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com/our-plans/medicare	EmblemHealth Group Access Rx (PPO)	01	04		1			H5528	807	0	2018	United States		1	213	2			2						www.emblemhealth.com	www.emblemhealth.com		(866)557-7300		(866)557-7300		(800)447-9169		(800)447-9169		(877)444-7097		(877)444-7097		(800)447-9169		(800)447-9169		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5533	003	0	1	04	01	H5533_003_0	5	1		1		06/04/2017	2018.03	06/04/2017 03:13:47 PM Eastern Daylight Time	08/02/2017 08:44:22 PM Eastern Daylight Time	08/01/2017 01:35:34 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO High Deductible with Rx (PPO)	01	04		1			H5533	003	0	2018	Western Pennsylvania		2	68155	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2						2			
H5533	005	0	1	04	01	H5533_005_0	5	1		1		06/04/2017	2018.03	06/04/2017 03:16:44 PM Eastern Daylight Time	08/02/2017 08:53:34 PM Eastern Daylight Time	08/01/2017 01:37:22 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO Rx Enhanced (PPO)	01	04		1			H5533	005	0	2018	Western PA		2	30843	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2						2			
H5533	007	0	1	04	01	H5533_007_0	8	2		1		06/04/2017	2018.03	06/04/2017 03:19:02 PM Eastern Daylight Time	08/02/2017 04:10:22 PM Eastern Daylight Time	08/01/2017 01:40:11 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO Rx Enhanced (PPO)	01	04		1			H5533	007	0	2018	Berks County		2	817	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2						2			
H5533	008	0	1	04	01	H5533_008_0	7	2		1		08/01/2017	2018.03	08/01/2017 12:56:14 PM Eastern Daylight Time	08/02/2017 04:11:18 PM Eastern Daylight Time	08/01/2017 01:42:56 PM Eastern Daylight Time			08/04/2017 09:06:59 AM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO Rx Enhanced (PPO)	01	04		1			H5533	008	0	2018	South Central PA		2	2219	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		2					2						2			
H5533	801	0	1	04	01	H5533_801_0	2			1		06/01/2017	2018.03	06/01/2017 04:39:59 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PPO)	01	04		1			H5533	801	0	2018	Western Pennsylvania		1	12	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765										(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629										1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1									
H5533	802	0	1	04	01	H5533_802_0	2			1		06/01/2017	2018.03	06/01/2017 05:02:28 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H5533	802	0	2018	Western Pennsylvania		1	3719	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1									
H5533	803	0	1	04	01	H5533_803_0	2			1		06/01/2017	2018.03	06/01/2017 05:19:37 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH NETWORK, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H5533	803	0	2018	Western Pennsylvania		1	12	2			2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/	www.upmchealthplan.com/medicare/	(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629		1	1	1a;1b;2;5;6;7e;7h;8b1;8b2;9a;9b;11a;15;	2		1									
H5549	002	0	1	01	01	H5549_002_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 11:25:14 AM Eastern Daylight Time	08/04/2017 12:10:05 PM Eastern Daylight Time	08/04/2017 12:10:06 PM Eastern Daylight Time			08/04/2017 12:12:00 PM Eastern Daylight Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Preferred (HMO SNP)	01	01		1			H5549	002	0	2018	NYC Metro Area and Capital Region		2		2			1	3		2		2	http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	www.vnsnychoice.org	(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5549	003	0	1	01	01	H5549_003_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 11:26:08 AM Eastern Daylight Time	08/04/2017 12:10:06 PM Eastern Daylight Time	08/04/2017 12:10:07 PM Eastern Daylight Time			08/04/2017 12:12:00 PM Eastern Daylight Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Total (HMO SNP)	01	01		1			H5549	003	0	2018	New York Metro Area		2		2			1	3		1		1	http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	www.vnsnychoice.org	(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5549	006	0	1	01	01	H5549_006_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 11:25:42 AM Eastern Daylight Time	08/04/2017 12:10:08 PM Eastern Daylight Time	08/04/2017 12:10:09 PM Eastern Daylight Time			08/04/2017 12:12:00 PM Eastern Daylight Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Maximum (HMO SNP)	01	01		1			H5549	006	0	2018	New York Metro Area		2		2			1	3		1		1	http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	www.vnsnychoice.org	(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5549	008	0	1	01	01	H5549_008_0	3			1		08/04/2017	2018.03	08/04/2017 11:26:27 AM Eastern Daylight Time	08/04/2017 12:10:10 PM Eastern Daylight Time	08/04/2017 12:10:11 PM Eastern Daylight Time			08/04/2017 12:12:00 PM Eastern Daylight Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Classic (HMO)	01	01		1			H5549	008	0	2018	NYC Metro Area and Capital Region		2		2			2						http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	www.vnsnychoice.org	(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(866)783-1444		(866)783-1444		(866)867-0047		(866)867-0047		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5576	008	0	1	01	01	H5576_008_0	10			1		08/04/2017	2018.03	08/04/2017 09:18:55 AM Central Daylight Time	08/07/2017 09:53:56 AM Central Daylight Time	08/04/2017 09:35:14 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA4 Vantage TRADITIONAL PLUS (HMO)	01	01		1			H5576	008	0	2018	State of Louisiana		2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	017	1	1	02	01	H5576_017_1	12			1		08/04/2017	2018.03	08/04/2017 09:19:22 AM Central Daylight Time	08/07/2017 09:55:44 AM Central Daylight Time	08/04/2017 09:41:26 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA0 Vantage STANDARD (HMO-POS)	01	02		1			H5576	017	1	2018	North, Central, and South LA	NE LA, EBR, SHEL, and TANG parishes	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	1	01	7a;7g;8a1;8b1;8b3;9a;14e2;	
H5576	017	2	1	02	01	H5576_017_2	12			1		08/04/2017	2018.03	08/04/2017 09:19:33 AM Central Daylight Time	08/07/2017 09:57:06 AM Central Daylight Time	08/04/2017 09:38:32 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA0 Vantage STANDARD (HMO-POS)	01	02		1			H5576	017	2	2018	North, Central, and South LA	North, Central, and South LA	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	018	1	1	02	01	H5576_018_1	12			1		08/04/2017	2018.03	08/04/2017 09:19:50 AM Central Daylight Time	08/07/2017 09:58:20 AM Central Daylight Time	08/04/2017 09:39:58 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA1 Vantage PREMIUM (HMO-POS)	01	02		1			H5576	018	1	2018	North, Central, and South LA	NE LA, EBR, SHEL, and TANG parishes	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	1	01	7a;7g;8a1;8b1;8b3;9a;14e2;	
H5576	018	2	1	02	01	H5576_018_2	12			1		08/04/2017	2018.03	08/04/2017 09:20:04 AM Central Daylight Time	08/07/2017 09:59:50 AM Central Daylight Time	08/04/2017 09:31:06 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA1 Vantage PREMIUM (HMO-POS)	01	02		1			H5576	018	2	2018	North, Central, and South LA	North, Central, and South LA	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	019	0	1	01	01	H5576_019_0	10		1	1	2	08/04/2017	2018.03	08/04/2017 09:20:45 AM Central Daylight Time	08/07/2017 10:01:52 AM Central Daylight Time	08/04/2017 09:29:20 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA7 Vantage Dual Special Needs Plan (HMO SNP)	01	01		1			H5576	019	0	2018	State of Louisiana		2		2			1	3		2		2	www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	020	1	1	02	01	H5576_020_1	11			1		08/04/2017	2018.03	08/04/2017 09:20:59 AM Central Daylight Time	08/07/2017 10:03:18 AM Central Daylight Time	08/04/2017 09:33:46 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA8 Vantage BASIC (HMO-POS)	01	02		1			H5576	020	1	2018	North, Central, and South LA	NE LA, EBR, SHEL, and TANG parishes	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	1	01	7a;7g;8a1;8b1;8b3;9a;14e2;	
H5576	020	2	1	02	01	H5576_020_2	11			1		08/04/2017	2018.03	08/04/2017 09:21:11 AM Central Daylight Time	08/07/2017 10:04:28 AM Central Daylight Time	08/04/2017 08:32:38 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA8 Vantage BASIC (HMO-POS)	01	02		1			H5576	020	2	2018	North, Central, and South LA	North, Central, and South LA	2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	022	0	1	02	01	H5576_022_0	7			1		08/04/2017	2018.03	08/04/2017 09:21:23 AM Central Daylight Time	08/07/2017 10:08:54 AM Central Daylight Time	08/04/2017 08:30:32 AM Central Daylight Time			08/07/2017 02:51:55 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	AAA9 Vantage 100 (HMO-POS)	01	02		1			H5576	022	0	2018	East and West Carroll parishes		2		2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	801	0	1	02	01	H5576_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:27:49 PM Central Daylight Time					06/13/2017 10:28:23 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	Vantage - MAPD Employer Calendar (HMO-POS)	01	02		1			H5576	801	0	2018	Louisiana		1	25788	2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	802	0	1	02	01	H5576_802_0	1			1		05/16/2017	2018.03	05/16/2017 07:11:06 PM Central Daylight Time					05/25/2017 05:05:58 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	Vantage - MAPD Emp Non-Calendar (HMO-POS)	01	02		1			H5576	802	0	2018	Louisiana		1	0	2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1	(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131		2					2					2	2			
H5576	803	0	1	02	01	H5576_803_0	1			1		05/16/2017	2018.03	05/16/2017 07:11:53 PM Central Daylight Time					05/25/2017 05:05:58 PM Central Daylight Time	VANTAGE HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.VantageMedicare.com	Vantage - MA Employer Calendar (HMO-POS)	01	02		1			H5576	803	0	2018	Louisiana		1	0	2			2						www.VantageMedicare.com	www.VantageMedicare.com	www.VantageMedicare.com	(866)704-0109		(318)361-0900	1	(866)704-0109		(318)361-0900	1									(866)524-5144		(318)361-2131		(866)524-5144		(318)361-2131										2					2					2	2			
H5577	002	0	1	01	01	H5577_002_0	4		1	1	1	08/07/2017	2018.03	08/07/2017 01:34:38 PM SA Western Standard Time	08/04/2017 11:38:06 PM SA Western Standard Time	08/04/2017 10:44:46 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino Ideal (HMO SNP)	01	01		1			H5577	002	0	2018	Puerto Rico		2	142128	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	005	0	1	01	01	H5577_005_0	4			1		08/07/2017	2018.03	08/07/2017 01:34:51 PM SA Western Standard Time	08/04/2017 11:39:54 PM SA Western Standard Time	08/04/2017 10:43:30 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare InteliCare (HMO)	01	01		1			H5577	005	0	2018	Puerto Rico		2	137886	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	1	01	7d;7f;8a2;	
H5577	008	0	1	02	01	H5577_008_0	5			1		08/07/2017	2018.03	08/07/2017 01:35:03 PM SA Western Standard Time	08/04/2017 11:42:14 PM SA Western Standard Time	08/04/2017 11:02:26 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Essential (HMO-POS)	01	02		1			H5577	008	0	2018	Puerto Rico		2	763728	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	1	01	7d;7f;8a2;	
H5577	014	0	1	01	01	H5577_014_0	4			1		06/05/2017	2018.03	06/05/2017 02:22:02 PM SA Western Standard Time	08/04/2017 11:44:12 PM SA Western Standard Time	08/04/2017 11:22:42 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MediCa$h (HMO)	01	01		1			H5577	014	0	2018	Puerto Rico		2	9450	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	016	0	1	01	01	H5577_016_0	3			1		05/30/2017	2018.03	05/30/2017 03:40:05 PM SA Western Standard Time	06/05/2017 04:35:08 PM SA Western Standard Time				06/05/2017 06:40:34 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MediOnlyNoRx (HMO)	01	01		1			H5577	016	0	2018	Puerto Rico		2	6858	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528										(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182										2					2					2	1	01	7d;7f;8a2;	
H5577	017	0	1	01	01	H5577_017_0	4		1	1	1	08/07/2017	2018.03	08/07/2017 01:35:16 PM SA Western Standard Time	08/04/2017 11:48:56 PM SA Western Standard Time	08/04/2017 11:24:14 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino Progreso (HMO SNP)	01	01		1			H5577	017	0	2018	Puerto Rico		2	720192	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	026	0	1	01	01	H5577_026_0	4		1	1	1	08/07/2017	2018.03	08/07/2017 01:35:26 PM SA Western Standard Time	08/04/2017 11:51:04 PM SA Western Standard Time	08/04/2017 11:29:44 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino Original (HMO SNP)	01	01		1			H5577	026	0	2018	Puerto Rico		2	29400	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	027	0	1	01	01	H5577_027_0	4		1	1	1	08/07/2017	2018.03	08/07/2017 01:35:41 PM SA Western Standard Time	08/04/2017 11:53:52 PM SA Western Standard Time	08/04/2017 11:32:04 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino Cmodo (HMO SNP)	01	01		1			H5577	027	0	2018	Puerto Rico		2	52368	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	028	0	1	01	01	H5577_028_0	4		1	1	1	08/04/2017	2018.03	08/04/2017 05:57:29 PM SA Western Standard Time	08/04/2017 11:55:54 PM SA Western Standard Time	08/04/2017 11:33:44 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino Clsico (HMO SNP)	01	01		1			H5577	028	0	2018	Puerto Rico		2	136494	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	029	0	1	01	01	H5577_029_0	4		1	1	1	08/04/2017	2018.03	08/04/2017 05:58:16 PM SA Western Standard Time	08/04/2017 11:57:52 PM SA Western Standard Time	08/04/2017 11:34:54 PM SA Western Standard Time			08/07/2017 01:44:09 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Platino MsCa$h (HMO SNP)	01	01		1			H5577	029	0	2018	Puerto Rico - 56		2	152223	2		1	1	3		2		1	www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		2					2					2	2			
H5577	801	0	1	01	01	H5577_801_0	3			1		06/05/2017	2018.03	06/05/2017 06:22:36 PM SA Western Standard Time					06/05/2017 06:40:34 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA Group (HMO)	01	01		1			H5577	801	0	2018	Puerto Rico		1	1200	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528										(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182										1	1	1a;1b;2;3-1;3-2;5;6;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		2					1				
H5577	802	0	1	01	01	H5577_802_0	3			1		06/05/2017	2018.03	06/05/2017 06:23:15 PM SA Western Standard Time					06/05/2017 06:40:34 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group (HMO)	01	01		1			H5577	802	0	2018	Puerto Rico		1	86076	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		1	1	1a;1b;2;3-1;3-2;5;6;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		2					1				
H5577	809	0	1	01	01	H5577_809_0	3			1		06/05/2017	2018.03	06/05/2017 06:23:41 PM SA Western Standard Time					06/05/2017 06:40:34 PM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group 2nd Formulary Opt. (HMO)	01	01		1			H5577	809	0	2018	Puerto Rico		1	255372	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8183		(787)620-2530		(866)627-8181		(787)620-2528		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		(866)627-8182		1	1	1a;1b;2;3-1;3-2;5;6;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;15;16b;	2		2					1				
H5580	001	0	1	01	01	H5580_001_0	4		1	1	2	08/01/2017	2018.03	08/01/2017 04:19:13 PM Pacific Daylight Time	08/01/2017 04:31:48 PM Pacific Daylight Time	08/02/2017 09:16:34 AM Pacific Daylight Time			08/02/2017 02:14:26 PM Pacific Daylight Time	SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION	Mercy Care Advantage	www.MercyCareAdvantage.com	Mercy Care Advantage (HMO SNP)	01	01		1			H5580	001	0	2018	Maricopa and Pima Counties		2	166291	2			1	3		1		1	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5580	004	0	1	01	01	H5580_004_0	5		1	1	2	08/02/2017	2018.03	08/02/2017 02:12:25 PM Pacific Daylight Time	08/01/2017 04:32:53 PM Pacific Daylight Time	08/02/2017 09:18:15 AM Pacific Daylight Time			08/02/2017 02:14:26 PM Pacific Daylight Time	SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION	Mercy Care Advantage	www.MercyCareAdvantage.com	Mercy Care Advantage (HMO SNP)	01	01		1			H5580	004	0	2018	Maricopa, Gila, Pinal, and Pima Counties		2	59943	2			1	3		1		1	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5580	005	0	1	01	01	H5580_005_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 02:12:30 PM Pacific Daylight Time	08/01/2017 04:36:18 PM Pacific Daylight Time	08/02/2017 09:19:09 AM Pacific Daylight Time			08/02/2017 02:14:26 PM Pacific Daylight Time	SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION	Mercy Care Advantage	www.MercyCareAdvantage.com	Mercy Care Advantage (HMO SNP)	01	01		1			H5580	005	0	2018	Maricopa, Pima and Santa Cruz Counties		2	16624	2			1	3		1		1	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	www.MercyCareAdvantage.com/members/mca/information	(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(800)624-3879		(602)263-3000		(866)571-5781		(602)414-7630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5587	002	0	1	01	01	H5587_002_0	6		1	1	2	08/06/2017	2018.03	08/06/2017 03:46:56 PM US Mountain Standard Time	08/04/2017 03:29:14 PM US Mountain Standard Time	08/04/2017 03:28:52 PM US Mountain Standard Time			08/06/2017 07:35:01 PM US Mountain Standard Time	HEALTH CHOICE ARIZONA, INC.	Health Choice Generations HMO SNP	www.healthchoicegenerations.com	Health Choice Generations (HMO SNP)	01	01		1			H5587	002	0	2018	Counties: APA,CCN, GIL, MAR, MOH, NAV, PIM, PIN		2	121526	2			1	3		2		1	http://www.hcgenerations.com	http://www.hcgenerations.com/index.asp?page=formulary.asp&f=partd	http://www.healthchoicearizona.com/Directory/search.asp?bl=hcg	(800)656-8991		(800)656-8991		(800)656-8991		(800)656-8991		(800)656-8991		(800)656-8991		(800)656-8991		(800)656-8991		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5590	003	0	1	01	01	H5590_003_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 02:22:32 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:21:10 PM Pacific Daylight Time	BRIDGEWAY HEALTH SOLUTIONS	Allwell	https://advantage.bridgewayhs.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H5590	003	0	2018	Maricopa		2		2			1	3		2		2	https://advantage.bridgewayhs.com/findadoctor	https://advantage.bridgewayhs.com/partdformulary	https://advantage.bridgewayhs.com/findadoctor	(877)935-8020		(877)935-8020		(877)826-5526		(877)826-5526		(877)826-5526		(877)826-5526		(877)826-5526		(877)826-5526		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	001	0	1	02	01	H5591_001_0	4			1		08/03/2017	2018.03	08/03/2017 04:33:04 PM Eastern Daylight Time	08/06/2017 09:41:38 AM Eastern Daylight Time	08/06/2017 09:41:45 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	001	0	2018	Aroo,Fran,Han,Knx,Linc,Oxf,Pen,Som,Pisc,Wald,Wash		2	144862	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	003	0	1	01	01	H5591_003_0	3			1		06/30/2017	2018.03	06/30/2017 10:22:52 AM Eastern Daylight Time	06/02/2017 03:23:40 PM Eastern Daylight Time				06/30/2017 11:15:14 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value (HMO)	01	01		1			H5591	003	0	2018	State of Maine		2	20114	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5591	005	0	1	02	01	H5591_005_0	4			1		08/03/2017	2018.03	08/03/2017 04:33:39 PM Eastern Daylight Time	08/06/2017 09:41:58 AM Eastern Daylight Time	08/06/2017 09:42:06 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	005	0	2018	Hillsborough, Strafford, NH		2	8174	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	006	1	1	02	01	H5591_006_1	5			1		08/03/2017	2018.03	08/03/2017 04:33:48 PM Eastern Daylight Time	08/06/2017 09:42:20 AM Eastern Daylight Time	08/06/2017 09:42:36 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	006	1	2018	Andr,Cumb,Kenn,Saga, York	Cumberland	2	136902	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	006	2	1	02	01	H5591_006_2	5			1		08/03/2017	2018.03	08/03/2017 04:34:29 PM Eastern Daylight Time	08/06/2017 09:43:00 AM Eastern Daylight Time	08/06/2017 09:43:18 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	006	2	2018	Andr,Cumb,Kenn,Saga, York	Kenn,Saga, York	2	115498	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	006	3	1	02	01	H5591_006_3	5			1		08/03/2017	2018.03	08/03/2017 04:34:37 PM Eastern Daylight Time	08/06/2017 09:43:36 AM Eastern Daylight Time	08/06/2017 09:43:48 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	006	3	2018	Andr,Cumb,Kenn,Saga, York	Androscoggin	2	59511	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	007	0	1	01	01	H5591_007_0	5		1	1		08/03/2017	2018.03	08/03/2017 04:34:59 PM Eastern Daylight Time	08/06/2017 09:44:01 AM Eastern Daylight Time	08/06/2017 09:44:11 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Focus DC (HMO SNP)	01	01		1			H5591	007	0	2018	Cumberland		2	2139	2			1	4			00000010000000000000		www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(888)423-9320		(888)423-9320		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	008	0	1	01	01	H5591_008_0	5			1		08/03/2017	2018.03	08/03/2017 04:35:05 PM Eastern Daylight Time	08/06/2017 09:44:29 AM Eastern Daylight Time	08/06/2017 09:44:36 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value Plus (HMO)	01	01		1			H5591	008	0	2018	Androscoggin,Kennebec,Sagadahoc,York		2	13891	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	009	0	1	01	01	H5591_009_0	6			1		08/03/2017	2018.03	08/03/2017 04:35:13 PM Eastern Daylight Time	08/06/2017 09:44:48 AM Eastern Daylight Time	08/06/2017 09:44:56 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value Plus (HMO)	01	01		1			H5591	009	0	2018	Penobscot,Piscatiquis,Somerset		2	10694	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	011	0	1	01	01	H5591_011_0	4			1		08/03/2017	2018.03	08/03/2017 04:35:18 PM Eastern Daylight Time	08/06/2017 09:45:09 AM Eastern Daylight Time	08/06/2017 09:45:17 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value Plus (HMO)	01	01		1			H5591	011	0	2018	Aroos,Franklin,Han,Knox,Lincoln,Oxford,Waldo,Wash		2	5134	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	013	0	1	01	01	H5591_013_0	5			1		08/03/2017	2018.03	08/03/2017 04:35:25 PM Eastern Daylight Time	08/06/2017 09:45:51 AM Eastern Daylight Time	08/06/2017 09:45:58 AM Eastern Daylight Time			08/06/2017 10:02:07 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value Plus (HMO)	01	01		1			H5591	013	0	2018	Hillsborough, Strafford		2	2872	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	801	0	1	02	01	H5591_801_0	3			1		06/30/2017	2018.03	06/30/2017 10:21:59 AM Eastern Daylight Time					06/30/2017 11:15:14 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime Group (HMO-POS)	01	02		1			H5591	801	0	2018	National		1	0	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5591	802	0	1	02	01	H5591_802_0	3			1		06/30/2017	2018.03	06/30/2017 10:22:10 AM Eastern Daylight Time					06/30/2017 11:15:14 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime Group (HMO-POS)	01	02		1			H5591	802	0	2018	National		1	0	2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(866)544-7504		(866)544-7504		(877)542-2654		(877)542-2654		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	001	0	1	01	01	H5594_001_0	5			1		05/25/2017	2018.03	05/25/2017 11:36:12 AM Eastern Daylight Time	08/04/2017 07:19:32 PM Eastern Daylight Time	08/03/2017 01:08:08 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO)	01	01		1			H5594	001	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	002	0	1	01	01	H5594_002_0	5			1		05/25/2017	2018.03	05/25/2017 11:36:21 AM Eastern Daylight Time	08/04/2017 07:20:41 PM Eastern Daylight Time	08/03/2017 01:09:01 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO)	01	01		1			H5594	002	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	016	0	1	01	01	H5594_016_0	5		1	1	2	05/25/2017	2018.03	05/25/2017 11:36:30 AM Eastern Daylight Time	08/04/2017 07:21:54 PM Eastern Daylight Time	08/03/2017 01:09:53 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Emerald Partial (HMO SNP)	01	01		1			H5594	016	0	2018	Select Counties in Florida		2	0	2			1	3		2		2	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	017	0	1	01	01	H5594_017_0	5		1	1	2	05/25/2017	2018.03	05/25/2017 11:36:40 AM Eastern Daylight Time	08/04/2017 07:23:01 PM Eastern Daylight Time	08/03/2017 01:10:46 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Emerald Full (HMO SNP)	01	01		1			H5594	017	0	2018	Select Counties in Florida		2	0	2			1	3		1		1	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	019	0	1	01	01	H5594_019_0	5			1		05/25/2017	2018.03	05/25/2017 11:36:52 AM Eastern Daylight Time	08/04/2017 07:24:21 PM Eastern Daylight Time	08/03/2017 01:11:37 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO)	01	01		1			H5594	019	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	022	0	1	01	01	H5594_022_0	5			1		05/25/2017	2018.03	05/25/2017 11:37:02 AM Eastern Daylight Time	08/04/2017 07:26:30 PM Eastern Daylight Time	08/03/2017 01:12:29 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO)	01	01		1			H5594	022	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	026	0	1	01	01	H5594_026_0	5			1		05/25/2017	2018.03	05/25/2017 11:37:12 AM Eastern Daylight Time	08/04/2017 07:27:49 PM Eastern Daylight Time	08/03/2017 01:13:21 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO)	01	01		1			H5594	026	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	028	0	1	01	01	H5594_028_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:37:22 AM Eastern Daylight Time	08/04/2017 07:29:09 PM Eastern Daylight Time	08/03/2017 01:14:13 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards (HMO SNP)	01	01		1			H5594	028	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000000000010		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	029	0	1	01	01	H5594_029_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:37:33 AM Eastern Daylight Time	08/04/2017 07:30:18 PM Eastern Daylight Time	08/03/2017 01:15:07 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards COPD (HMO SNP)	01	01		1			H5594	029	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000100000000		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	030	0	1	01	01	H5594_030_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:37:45 AM Eastern Daylight Time	08/04/2017 07:31:25 PM Eastern Daylight Time	08/03/2017 01:16:02 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards (HMO SNP)	01	01		1			H5594	030	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000000000010		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	031	0	1	01	01	H5594_031_0	5		1	1		05/25/2017	2018.03	05/25/2017 11:37:55 AM Eastern Daylight Time	08/04/2017 07:32:33 PM Eastern Daylight Time	08/03/2017 01:16:55 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards COPD (HMO SNP)	01	01		1			H5594	031	0	2018	Select Counties in Florida		2	0	2			1	4			00000000000100000000		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	032	0	1	01	01	H5594_032_0	5			1		05/25/2017	2018.03	05/25/2017 11:38:03 AM Eastern Daylight Time	08/04/2017 07:33:44 PM Eastern Daylight Time	08/03/2017 01:17:52 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Plus Plan (HMO)	01	01		1			H5594	032	0	2018	Select Counties in Florida		2	0	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	034	0	1	01	01	H5594_034_0	4		1	1		08/04/2017	2018.03	08/04/2017 08:53:30 PM Eastern Daylight Time	08/04/2017 07:34:55 PM Eastern Daylight Time	08/03/2017 01:18:53 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards (HMO SNP)	01	01		1			H5594	034	0	2018	select counties in FL		2	0	2			1	4			00000000000000000010		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5594	035	0	1	01	01	H5594_035_0	4		1	1		05/25/2017	2018.03	05/25/2017 11:38:22 AM Eastern Daylight Time	08/04/2017 07:36:02 PM Eastern Daylight Time	08/03/2017 01:19:50 PM Eastern Daylight Time			08/06/2017 09:45:39 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards COPD (HMO SNP)	01	01		1			H5594	035	0	2018	select counties in FL		2	0	2			1	4			00000000000100000000		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(866)245-5360		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5608	001	0	1	01	01	H5608_001_0	5		1	1	2	08/07/2017	2018.03	08/07/2017 10:01:12 AM Mountain Daylight Time	08/07/2017 12:35:28 PM Mountain Daylight Time	08/07/2017 12:35:30 PM Mountain Daylight Time			08/07/2017 01:33:00 PM Mountain Daylight Time	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan, Inc.	http://www.denverhealthmedicalplan.org	Denver Health Medicare Choice (HMO SNP)	01	01		1			H5608	001	0	2018	Denver County		2	19907	2			1	3		1		1	http://www.denverhealthmedicalplan.org	http://www.denverhealthmedicalplan.org	https://www.viiad.com/dhmp/provider_main.asp	(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5608	002	0	1	01	01	H5608_002_0	6			1		08/02/2017	2018.03	08/02/2017 05:47:35 PM Mountain Daylight Time	08/07/2017 12:35:28 PM Mountain Daylight Time	08/07/2017 12:35:28 PM Mountain Daylight Time			08/07/2017 01:33:00 PM Mountain Daylight Time	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan, Inc.	http://www.denverhealthmedicalplan.org	Denver Health Medicare Select (HMO)	01	01		1			H5608	002	0	2018	Denver County		2	34714	2			2						http://www.denverhealthmedicalplan.org	http://www.denverhealthmedicalplan.org	https://www.viiad.com/dhmp/provider_main.asp	(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(877)956-2111		(303)602-2111		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5610	001	0	1	20	08	H5610_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:07:34 PM Eastern Daylight Time		05/24/2017 10:21:27 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	CARE RESOURCES	Care Resources	www.care-resources.org	Care Resources (PACE)	08	20		1			H5610	001	0	2018	Kent County		2		2			2						www.care-resources.org	www.care-resources.org										(800)610-6299		(616)913-2006		(800)610-6299		(616)913-2006										(800)649-3777		(616)913-2006		(800)649-3777		(616)913-2006																
H5610	003	0	1	20	08	H5610_003_0	1			1		05/24/2017	2018.03	05/24/2017 01:07:52 PM Eastern Daylight Time		05/24/2017 10:17:45 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	CARE RESOURCES	Care Resources	www.care-resources.org	Care Resources (PACE)	08	20		1			H5610	003	0	2018	Kent County		2		2			2						www.care-resources.org	www.care-resources.org										(800)610-6299		(616)913-2006		(800)610-6299		(616)913-2006										(800)649-3777		(616)913-2006		(800)649-3777		(616)913-2006																
H5613	002	0	1	07	02	H5613_002_0	4			2		06/05/2017	2018.03	06/05/2017 12:33:37 PM Eastern Daylight Time			06/05/2017 10:05:36 PM Eastern Daylight Time		06/05/2017 10:07:29 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	mvphealthcare.com	SmartFund (MSA)	02	07	2	1			H5613	002	0	2018	Eastern NY		2	2772	2			2									(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																								
H5613	801	0	1	07	02	H5613_801_0	1			2		06/04/2017	2018.03	06/04/2017 08:03:50 PM Eastern Daylight Time					06/04/2017 08:05:48 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	mvphealthcare.com	SmartFund EG (MSA)	02	07	2	1			H5613	801	0	2018	Western NY		1	300	2			2									(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																								
H5613	802	0	1	07	02	H5613_802_0	1			2		06/04/2017	2018.03	06/04/2017 08:04:35 PM Eastern Daylight Time					06/04/2017 08:05:48 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	mvphealthcare.com	SmartFund EG (MSA)	02	07	2	1			H5613	802	0	2018	Eastern NY		1	1200	2			2									(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																								
H5619	001	0	1	01	01	H5619_001_0	3			1		08/02/2017	2018.03	08/02/2017 01:59:55 PM Eastern Daylight Time	08/05/2017 10:08:49 AM Eastern Daylight Time	08/04/2017 09:54:12 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-001 (HMO)	01	01		1			H5619	001	0	2018	Southern Maine Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	003	0	1	01	01	H5619_003_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 10:00:02 AM Eastern Daylight Time	08/05/2017 10:03:35 AM Eastern Daylight Time	08/04/2017 09:54:12 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-003 (HMO SNP)	01	01		1			H5619	003	0	2018	Select Counties in Maine		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	012	0	1	01	01	H5619_012_0	2			1		08/02/2017	2018.03	08/02/2017 03:23:50 PM Eastern Daylight Time	08/05/2017 10:27:52 AM Eastern Daylight Time	08/04/2017 09:54:13 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-012 (HMO)	01	01		1			H5619	012	0	2018	Fresno County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	013	0	1	01	01	H5619_013_0	2			1		08/02/2017	2018.03	08/02/2017 03:24:09 PM Eastern Daylight Time	08/05/2017 10:31:57 AM Eastern Daylight Time	08/04/2017 09:54:14 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-013 (HMO)	01	01		1			H5619	013	0	2018	Madera County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	015	0	1	01	01	H5619_015_0	2			1		08/02/2017	2018.03	08/02/2017 03:24:22 PM Eastern Daylight Time	08/05/2017 10:28:18 AM Eastern Daylight Time	08/04/2017 09:54:14 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-015 (HMO)	01	01		1			H5619	015	0	2018	Tulare and Kings counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	016	0	1	01	01	H5619_016_0	2			1		08/02/2017	2018.03	08/02/2017 03:24:47 PM Eastern Daylight Time	08/05/2017 10:29:12 AM Eastern Daylight Time	08/04/2017 09:54:15 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-016 (HMO)	01	01		1			H5619	016	0	2018	San Diego County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	021	0	1	01	01	H5619_021_0	2			1		08/02/2017	2018.03	08/02/2017 03:25:40 PM Eastern Daylight Time	08/05/2017 10:30:35 AM Eastern Daylight Time	08/04/2017 09:54:15 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-021 (HMO)	01	01		1			H5619	021	0	2018	Los Angeles and Orange counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	023	0	1	01	01	H5619_023_0	2			1		08/02/2017	2018.03	08/02/2017 03:26:04 PM Eastern Daylight Time	08/05/2017 10:31:02 AM Eastern Daylight Time	08/04/2017 09:54:16 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-023 (HMO)	01	01		1			H5619	023	0	2018	Santa Barbara (partial) and Ventura counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	026	0	1	01	01	H5619_026_0	2			1		05/30/2017	2018.03	05/30/2017 04:30:16 PM Eastern Daylight Time	08/05/2017 10:29:38 AM Eastern Daylight Time	08/04/2017 09:54:16 AM Eastern Daylight Time			08/06/2017 09:02:00 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-026 (HMO)	01	01		1			H5619	026	0	2018	San Joaquin County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	029	0	1	01	01	H5619_029_0	2			1		08/02/2017	2018.03	08/02/2017 03:26:58 PM Eastern Daylight Time	08/05/2017 10:30:08 AM Eastern Daylight Time	08/04/2017 09:54:17 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-029 (HMO)	01	01		1			H5619	029	0	2018	Contra Costa County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	032	0	1	01	01	H5619_032_0	2			1		08/03/2017	2018.03	08/03/2017 12:50:31 PM Eastern Daylight Time	08/05/2017 10:28:45 AM Eastern Daylight Time	08/04/2017 09:54:17 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-032 (HMO)	01	01		1			H5619	032	0	2018	Stanislaus County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	037	0	1	01	01	H5619_037_0	2			1		08/04/2017	2018.03	08/04/2017 04:35:24 PM Eastern Daylight Time	08/05/2017 10:31:30 AM Eastern Daylight Time	08/04/2017 09:54:18 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Value Plus H5619-037 (HMO)	01	01		1			H5619	037	0	2018	Select Counties in California		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	038	0	1	01	01	H5619_038_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 09:38:01 AM Eastern Daylight Time	08/05/2017 10:33:18 AM Eastern Daylight Time	08/04/2017 09:54:18 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H5619-038 (HMO SNP)	01	01		1			H5619	038	0	2018	Select Counties in California		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	039	1	1	01	01	H5619_039_1	2			1		08/02/2017	2018.03	08/02/2017 03:28:15 PM Eastern Daylight Time	08/05/2017 10:32:24 AM Eastern Daylight Time	08/04/2017 09:54:19 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-039 (HMO)	01	01		1			H5619	039	1	2018	Riverside and San Bernardino counties	Riverside County	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	039	2	1	01	01	H5619_039_2	2			1		08/02/2017	2018.03	08/02/2017 03:28:28 PM Eastern Daylight Time	08/05/2017 10:32:51 AM Eastern Daylight Time	08/04/2017 09:54:19 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5619-039 (HMO)	01	01		1			H5619	039	2	2018	Riverside and San Bernardino counties	San Bernardino County	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	040	1	1	01	01	H5619_040_1	3			1		06/28/2017	2018.03	06/28/2017 10:20:41 AM Eastern Daylight Time	08/05/2017 10:11:44 AM Eastern Daylight Time	08/04/2017 09:54:20 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-040 (HMO)	01	01		1			H5619	040	1	2018	Select Counties in Maine and New Hampshire	Select Counties in Maine and New Hampshire	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	040	2	1	01	01	H5619_040_2	3			1		06/28/2017	2018.03	06/28/2017 10:20:58 AM Eastern Daylight Time	08/05/2017 10:05:16 AM Eastern Daylight Time	08/04/2017 09:54:21 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-040 (HMO)	01	01		1			H5619	040	2	2018	Select Counties in Maine and New Hampshire	Select Counties in Maine and New Hampshire	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	040	3	1	01	01	H5619_040_3	3			1		08/02/2017	2018.03	08/02/2017 02:00:28 PM Eastern Daylight Time	08/05/2017 10:12:45 AM Eastern Daylight Time	08/04/2017 09:54:21 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-040 (HMO)	01	01		1			H5619	040	3	2018	Select Counties in Maine and New Hampshire	Kennebec County	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	041	0	1	01	01	H5619_041_0	3			1		06/22/2017	2018.03	06/22/2017 08:34:13 AM Eastern Daylight Time	08/04/2017 05:20:59 PM Eastern Daylight Time	08/04/2017 09:54:22 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-041 (HMO)	01	01		1			H5619	041	0	2018	Albemarle and Charlottesville City counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	042	1	1	01	01	H5619_042_1	2			1		08/06/2017	2018.03	08/06/2017 08:49:04 AM Eastern Daylight Time	08/04/2017 05:31:11 PM Eastern Daylight Time	08/04/2017 09:54:22 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-042 (HMO)	01	01		1			H5619	042	1	2018	Roanoke Metro Area	Roanoke Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	042	2	1	01	01	H5619_042_2	2			1		08/06/2017	2018.03	08/06/2017 08:51:30 AM Eastern Daylight Time	08/04/2017 05:32:11 PM Eastern Daylight Time	08/04/2017 09:54:23 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-042 (HMO)	01	01		1			H5619	042	2	2018	Roanoke Metro Area	Roanoke Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	044	0	1	01	01	H5619_044_0	2			1		06/22/2017	2018.03	06/22/2017 11:48:34 AM Eastern Daylight Time	08/04/2017 05:17:52 PM Eastern Daylight Time	08/04/2017 09:54:23 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-044 (HMO)	01	01		1			H5619	044	0	2018	Richmond Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	045	0	1	01	01	H5619_045_0	2			1		06/22/2017	2018.03	06/22/2017 11:50:09 AM Eastern Daylight Time	08/04/2017 05:20:00 PM Eastern Daylight Time	08/04/2017 09:54:24 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-045 (HMO)	01	01		1			H5619	045	0	2018	Tidewater area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	046	0	1	01	01	H5619_046_0	3		1	1		08/03/2017	2018.03	08/03/2017 12:51:45 PM Eastern Daylight Time	08/04/2017 05:22:02 PM Eastern Daylight Time	08/04/2017 09:54:24 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H5619	046	0	2018	Richmond - Tidewater area		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	047	0	1	01	01	H5619_047_0	2			1		08/04/2017	2018.03	08/04/2017 03:15:39 PM Eastern Daylight Time	08/04/2017 05:25:09 PM Eastern Daylight Time	08/04/2017 09:54:25 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-047 (HMO)	01	01		1			H5619	047	0	2018	Northern Virginia area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;7a;7g;8a1;8b3;	
H5619	049	0	1	01	01	H5619_049_0	4			1		08/02/2017	2018.03	08/02/2017 02:49:58 PM Eastern Daylight Time	08/04/2017 01:44:09 PM Eastern Daylight Time	08/04/2017 09:54:25 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-049 (HMO)	01	01		1			H5619	049	0	2018	Indianapolis Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	050	0	1	01	01	H5619_050_0	3			1		08/02/2017	2018.03	08/02/2017 02:50:29 PM Eastern Daylight Time	08/04/2017 01:48:32 PM Eastern Daylight Time	08/04/2017 09:54:26 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-050 (HMO)	01	01		1			H5619	050	0	2018	Evansville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	051	0	1	01	01	H5619_051_0	3			1		08/02/2017	2018.03	08/02/2017 02:50:55 PM Eastern Daylight Time	08/04/2017 01:48:00 PM Eastern Daylight Time	08/04/2017 09:54:27 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-051 (HMO)	01	01		1			H5619	051	0	2018	Fort Wayne Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	052	0	1	01	01	H5619_052_0	3			1		08/02/2017	2018.03	08/02/2017 02:51:21 PM Eastern Daylight Time	08/04/2017 01:50:35 PM Eastern Daylight Time	08/04/2017 09:54:27 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-052 (HMO)	01	01		1			H5619	052	0	2018	South Bend Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	053	0	1	01	01	H5619_053_0	3			1		08/02/2017	2018.03	08/02/2017 02:51:53 PM Eastern Daylight Time	08/04/2017 01:56:23 PM Eastern Daylight Time	08/04/2017 09:54:28 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-053 (HMO)	01	01		1			H5619	053	0	2018	Lake County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	054	0	1	01	01	H5619_054_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 02:29:34 PM Eastern Daylight Time	08/04/2017 01:51:40 PM Eastern Daylight Time	08/04/2017 09:54:28 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-054 (HMO SNP)	01	01		1			H5619	054	0	2018	Select counties in Indiana		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	055	0	1	01	01	H5619_055_0	4		1	1		06/28/2017	2018.03	06/28/2017 12:30:10 PM Eastern Daylight Time	08/04/2017 01:53:50 PM Eastern Daylight Time	08/04/2017 09:54:29 AM Eastern Daylight Time			08/06/2017 11:34:07 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H5619	055	0	2018	Select counties in Kentucky and Indiana		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	056	0	1	01	01	H5619_056_0	4			1		08/02/2017	2018.03	08/02/2017 03:42:02 PM Eastern Daylight Time	08/04/2017 05:14:18 PM Eastern Daylight Time	08/04/2017 09:54:29 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-056 (HMO)	01	01		1			H5619	056	0	2018	Clark County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	057	0	1	01	01	H5619_057_0	4			1		08/02/2017	2018.03	08/02/2017 03:42:54 PM Eastern Daylight Time	08/04/2017 05:19:44 PM Eastern Daylight Time	08/04/2017 09:54:30 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-057 (HMO)	01	01		1			H5619	057	0	2018	King County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	059	0	1	01	01	H5619_059_0	4			1		06/28/2017	2018.03	06/28/2017 10:50:44 AM Eastern Daylight Time	08/04/2017 05:15:11 PM Eastern Daylight Time	08/04/2017 09:54:30 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-059 (HMO)	01	01		1			H5619	059	0	2018	Snohomish County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	060	0	1	01	01	H5619_060_0	4			1		08/02/2017	2018.03	08/02/2017 03:43:35 PM Eastern Daylight Time	08/04/2017 05:16:06 PM Eastern Daylight Time	08/04/2017 09:54:31 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-060 (HMO)	01	01		1			H5619	060	0	2018	Spokane County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	061	0	1	01	01	H5619_061_0	4			1		06/28/2017	2018.03	06/28/2017 10:53:46 AM Eastern Daylight Time	08/04/2017 05:23:24 PM Eastern Daylight Time	08/04/2017 09:54:32 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-061 (HMO)	01	01		1			H5619	061	0	2018	Pierce County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	062	0	1	01	01	H5619_062_0	4			1		06/28/2017	2018.03	06/28/2017 11:02:23 AM Eastern Daylight Time	08/04/2017 05:24:18 PM Eastern Daylight Time	08/04/2017 09:54:32 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-062 (HMO)	01	01		1			H5619	062	0	2018	Thurston County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	063	0	1	01	01	H5619_063_0	4			1		08/02/2017	2018.03	08/02/2017 03:44:28 PM Eastern Daylight Time	08/04/2017 05:25:11 PM Eastern Daylight Time	08/04/2017 09:54:33 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-063 (HMO)	01	01		1			H5619	063	0	2018	Snohomish County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	064	0	1	01	01	H5619_064_0	4			1		08/02/2017	2018.03	08/02/2017 03:45:22 PM Eastern Daylight Time	08/04/2017 05:26:56 PM Eastern Daylight Time	08/04/2017 09:54:33 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-064 (HMO)	01	01		1			H5619	064	0	2018	Thurston County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	065	0	1	01	01	H5619_065_0	2			1		05/27/2017	2018.03	05/27/2017 11:45:11 AM Eastern Daylight Time	08/05/2017 10:10:32 AM Eastern Daylight Time	08/04/2017 09:54:34 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Value Plus H5619-065 (HMO)	01	01		1			H5619	065	0	2018	Select Counties in New Hampshire		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	066	0	1	01	01	H5619_066_0	5			1		08/02/2017	2018.03	08/02/2017 02:02:03 PM Eastern Daylight Time	08/05/2017 10:13:53 AM Eastern Daylight Time	08/04/2017 09:54:34 AM Eastern Daylight Time			08/06/2017 09:14:49 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-066 (HMO)	01	01		1			H5619	066	0	2018	Select Counties in Maine		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	067	0	1	01	01	H5619_067_0	4		1	1	2	07/17/2017	2018.03	07/17/2017 03:23:19 PM Eastern Daylight Time	08/04/2017 05:21:35 PM Eastern Daylight Time	08/04/2017 09:54:35 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-067 (HMO SNP)	01	01		1			H5619	067	0	2018	King, Pierce and Snohomish Counties		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	069	0	1	01	01	H5619_069_0	3			1		05/27/2017	2018.03	05/27/2017 12:44:45 PM Eastern Daylight Time	08/04/2017 03:45:54 PM Eastern Daylight Time	08/04/2017 09:54:35 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-069 (HMO)	01	01		1			H5619	069	0	2018	Select counties in Arkansas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	070	1	1	01	01	H5619_070_1	2			1		05/27/2017	2018.03	05/27/2017 02:53:46 PM Eastern Daylight Time	08/04/2017 03:46:29 PM Eastern Daylight Time	08/04/2017 09:54:36 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-070 (HMO)	01	01		1			H5619	070	1	2018	Select counties in Arkansas	Select counties in Arkansas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	070	2	1	01	01	H5619_070_2	2			1		05/30/2017	2018.03	05/30/2017 07:34:59 PM Eastern Daylight Time	08/04/2017 03:54:55 PM Eastern Daylight Time	08/04/2017 09:54:37 AM Eastern Daylight Time			08/06/2017 10:26:27 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-070 (HMO)	01	01		1			H5619	070	2	2018	Select counties in Arkansas	Select counties in Arkansas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	071	0	1	01	01	H5619_071_0	2			1		08/03/2017	2018.03	08/03/2017 09:51:27 AM Eastern Daylight Time	08/04/2017 05:27:55 PM Eastern Daylight Time	08/04/2017 09:54:38 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-071 (HMO)	01	01		1			H5619	071	0	2018	Lexington Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	072	0	1	01	01	H5619_072_0	2			1		05/30/2017	2018.03	05/30/2017 05:24:37 PM Eastern Daylight Time	08/04/2017 04:30:08 PM Eastern Daylight Time	08/04/2017 09:54:38 AM Eastern Daylight Time			08/06/2017 09:27:36 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-072 (HMO)	01	01		1			H5619	072	0	2018	Omaha Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	073	0	1	01	01	H5619_073_0	2			1		05/27/2017	2018.03	05/27/2017 12:00:34 PM Eastern Daylight Time	08/04/2017 05:27:28 PM Eastern Daylight Time	08/04/2017 09:54:39 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-073 (HMO)	01	01		1			H5619	073	0	2018	Louisville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	074	1	1	01	01	H5619_074_1	2			1		08/02/2017	2018.03	08/02/2017 02:38:04 PM Eastern Daylight Time	08/04/2017 03:47:04 PM Eastern Daylight Time	08/04/2017 09:54:40 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-074 (HMO)	01	01		1			H5619	074	1	2018	Select counties in Arkansas	Select counties in Arkansas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	074	2	1	01	01	H5619_074_2	2			1		05/27/2017	2018.03	05/27/2017 03:15:10 PM Eastern Daylight Time	08/04/2017 03:47:38 PM Eastern Daylight Time	08/04/2017 09:54:40 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-074 (HMO)	01	01		1			H5619	074	2	2018	Select counties in Arkansas	Select counties in Arkansas	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	075	0	1	01	01	H5619_075_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 02:44:32 PM Eastern Daylight Time	08/04/2017 05:35:33 PM Eastern Daylight Time	08/04/2017 09:54:41 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-075 (HMO SNP)	01	01		1			H5619	075	0	2018	Central Kentucky Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	076	0	1	01	01	H5619_076_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 09:51:48 AM Eastern Daylight Time	08/04/2017 05:35:59 PM Eastern Daylight Time	08/04/2017 09:54:42 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-076 (HMO SNP)	01	01		1			H5619	076	0	2018	Clark and Floyd counties		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	077	0	1	01	01	H5619_077_0	4			1		08/02/2017	2018.03	08/02/2017 03:46:07 PM Eastern Daylight Time	08/04/2017 05:12:30 PM Eastern Daylight Time	08/04/2017 09:54:42 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-077 (HMO)	01	01		1			H5619	077	0	2018	Ada, Canyon and Payette counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	078	0	1	01	01	H5619_078_0	4			1		06/28/2017	2018.03	06/28/2017 11:10:11 AM Eastern Daylight Time	08/04/2017 05:13:24 PM Eastern Daylight Time	08/04/2017 09:54:43 AM Eastern Daylight Time			08/06/2017 09:28:26 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-078 (HMO)	01	01		1			H5619	078	0	2018	Bonner and Kootenai counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	079	0	1	01	01	H5619_079_0	4			1		08/02/2017	2018.03	08/02/2017 03:46:56 PM Eastern Daylight Time	08/04/2017 05:26:04 PM Eastern Daylight Time	08/04/2017 09:54:43 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-079 (HMO)	01	01		1			H5619	079	0	2018	Ada, Canyon and Payette counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	080	0	1	01	01	H5619_080_0	3			1		06/28/2017	2018.03	06/28/2017 11:23:07 AM Eastern Daylight Time	08/04/2017 03:03:48 PM Eastern Daylight Time	08/04/2017 09:54:44 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-080 (HMO)	01	01		1			H5619	080	0	2018	Richland County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	081	0	1	01	01	H5619_081_0	2			1		05/29/2017	2018.03	05/29/2017 02:29:55 PM Eastern Daylight Time	08/04/2017 03:07:42 PM Eastern Daylight Time	08/04/2017 09:54:44 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-081 (HMO)	01	01		1			H5619	081	0	2018	Richland County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	082	0	1	01	01	H5619_082_0	3		1	1	2	08/03/2017	2018.03	08/03/2017 11:30:22 AM Eastern Daylight Time	08/04/2017 03:04:17 PM Eastern Daylight Time	08/04/2017 09:54:45 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-082 (HMO SNP)	01	01		1			H5619	082	0	2018	Greater South Carolina		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	083	0	1	01	01	H5619_083_0	2			1		05/29/2017	2018.03	05/29/2017 04:41:26 PM Eastern Daylight Time	08/04/2017 03:04:46 PM Eastern Daylight Time	08/04/2017 09:54:45 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-083 (HMO)	01	01		1			H5619	083	0	2018	Charleston Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	084	0	1	01	01	H5619_084_0	2			1		08/03/2017	2018.03	08/03/2017 11:30:54 AM Eastern Daylight Time	08/04/2017 03:08:12 PM Eastern Daylight Time	08/04/2017 09:54:46 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-084 (HMO)	01	01		1			H5619	084	0	2018	Charleston Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	086	0	1	01	01	H5619_086_0	3			1		08/03/2017	2018.03	08/03/2017 11:31:22 AM Eastern Daylight Time	08/04/2017 03:10:11 PM Eastern Daylight Time	08/04/2017 09:54:46 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-086 (HMO)	01	01		1			H5619	086	0	2018	Spartanburg/Greenville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	087	0	1	01	01	H5619_087_0	4		1	1		08/03/2017	2018.03	08/03/2017 11:31:48 AM Eastern Daylight Time	08/04/2017 03:06:42 PM Eastern Daylight Time	08/04/2017 09:54:47 AM Eastern Daylight Time			08/06/2017 09:49:32 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H5619	087	0	2018	Greenville Metro Area		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	088	0	1	01	01	H5619_088_0	2			1		08/02/2017	2018.03	08/02/2017 02:39:22 PM Eastern Daylight Time	08/04/2017 02:13:15 PM Eastern Daylight Time	08/04/2017 09:54:48 AM Eastern Daylight Time			08/06/2017 09:21:38 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-088 (HMO)	01	01		1			H5619	088	0	2018	Birmingham Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	089	0	1	01	01	H5619_089_0	2			1		08/04/2017	2018.03	08/04/2017 08:47:42 AM Eastern Daylight Time	08/04/2017 02:13:41 PM Eastern Daylight Time	08/04/2017 09:54:48 AM Eastern Daylight Time			08/06/2017 09:21:38 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-089 (HMO)	01	01		1			H5619	089	0	2018	Mobile Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	090	0	1	01	01	H5619_090_0	2			1		08/06/2017	2018.03	08/06/2017 09:39:26 AM Eastern Daylight Time	08/04/2017 02:14:06 PM Eastern Daylight Time	08/04/2017 09:54:49 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-090 (HMO)	01	01		1			H5619	090	0	2018	Select VA Counties in the Tri-Cities Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	091	0	1	01	01	H5619_091_0	2			1		06/01/2017	2018.03	06/01/2017 11:02:20 AM Eastern Daylight Time	08/04/2017 02:14:33 PM Eastern Daylight Time	08/04/2017 09:54:49 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-091 (HMO)	01	01		1			H5619	091	0	2018	Select VA Counties in the Tri-Cities Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	093	0	1	01	01	H5619_093_0	5		1	1	2	07/20/2017	2018.03	07/20/2017 04:32:40 PM Eastern Daylight Time	08/04/2017 02:14:58 PM Eastern Daylight Time	08/04/2017 09:54:50 AM Eastern Daylight Time			08/06/2017 12:40:42 PM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus SNP-DE H5619-093 (HMO SNP)	01	01		1			H5619	093	0	2018	Greater Alabama		2		2			1	3		2		2	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	094	0	1	01	01	H5619_094_0	2			1		05/27/2017	2018.03	05/27/2017 12:15:03 PM Eastern Daylight Time	08/04/2017 02:15:25 PM Eastern Daylight Time	08/04/2017 09:54:50 AM Eastern Daylight Time			08/06/2017 09:57:51 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-094 (HMO)	01	01		1			H5619	094	0	2018	Huntsville Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	095	0	1	01	01	H5619_095_0	2			1		08/02/2017	2018.03	08/02/2017 02:41:24 PM Eastern Daylight Time	08/04/2017 02:18:53 PM Eastern Daylight Time	08/04/2017 09:54:51 AM Eastern Daylight Time			08/06/2017 09:21:38 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-095 (HMO)	01	01		1			H5619	095	0	2018	Select VA Counties in the Tri-Cities Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	096	1	1	01	01	H5619_096_1	2			1		06/22/2017	2018.03	06/22/2017 09:10:33 AM Eastern Daylight Time	08/04/2017 05:38:06 PM Eastern Daylight Time	08/04/2017 09:54:51 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-096 (HMO)	01	01		1			H5619	096	1	2018	Roanoke Metro Area	Roanoke Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	096	2	1	01	01	H5619_096_2	2			1		06/22/2017	2018.03	06/22/2017 09:06:50 AM Eastern Daylight Time	08/04/2017 05:39:10 PM Eastern Daylight Time	08/04/2017 09:54:52 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-096 (HMO)	01	01		1			H5619	096	2	2018	Roanoke Metro Area	Roanoke Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	097	0	1	01	01	H5619_097_0	4			1		06/28/2017	2018.03	06/28/2017 11:13:29 AM Eastern Daylight Time	08/04/2017 05:27:50 PM Eastern Daylight Time	08/04/2017 09:54:52 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-097 (HMO)	01	01		1			H5619	097	0	2018	King County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	099	0	1	01	01	H5619_099_0	4			1		06/28/2017	2018.03	06/28/2017 11:14:27 AM Eastern Daylight Time	08/04/2017 05:32:17 PM Eastern Daylight Time	08/04/2017 09:54:53 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-099 (HMO)	01	01		1			H5619	099	0	2018	Kitsap County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	100	0	1	01	01	H5619_100_0	4			1		06/28/2017	2018.03	06/28/2017 11:15:14 AM Eastern Daylight Time	08/04/2017 05:28:43 PM Eastern Daylight Time	08/04/2017 09:54:53 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-100 (HMO)	01	01		1			H5619	100	0	2018	Pierce County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	101	0	1	01	01	H5619_101_0	4			1		06/28/2017	2018.03	06/28/2017 11:16:15 AM Eastern Daylight Time	08/04/2017 05:29:36 PM Eastern Daylight Time	08/04/2017 09:54:54 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-101 (HMO)	01	01		1			H5619	101	0	2018	Clark County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	102	0	1	01	01	H5619_102_0	4			1		06/28/2017	2018.03	06/28/2017 11:17:12 AM Eastern Daylight Time	08/04/2017 05:30:29 PM Eastern Daylight Time	08/04/2017 09:54:54 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-102 (HMO)	01	01		1			H5619	102	0	2018	Spokane County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	104	0	1	01	01	H5619_104_0	4			1		06/28/2017	2018.03	06/28/2017 11:18:36 AM Eastern Daylight Time	08/04/2017 05:31:22 PM Eastern Daylight Time	08/04/2017 09:54:55 AM Eastern Daylight Time			08/06/2017 09:38:48 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Gold Plus H5619-104 (HMO)	01	01		1			H5619	104	0	2018	Kitsap County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	109	0	1	01	01	H5619_109_0	2			1		05/30/2017	2018.03	05/30/2017 03:09:21 PM Eastern Daylight Time	08/04/2017 03:54:19 PM Eastern Daylight Time	08/04/2017 09:54:56 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Value Plus H5619-109 (HMO)	01	01		1			H5619	109	0	2018	Select counties in Arkansas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5619	802	0	1	01	01	H5619_802_0	4			1		08/03/2017	2018.03	08/03/2017 05:02:55 PM Eastern Daylight Time					08/03/2017 05:03:17 PM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H5619	802	0	2018	Select Counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H5619	803	0	1	01	01	H5619_803_0	4			1		06/13/2017	2018.03	06/13/2017 10:28:16 AM Eastern Daylight Time					08/03/2017 05:03:17 PM Eastern Daylight Time	ARCADIAN HEALTH PLAN, INC.	Arcadian Health Plan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H5619	803	0	2018	Select Counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H5628	001	0	1	01	01	H5628_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:47:01 AM Pacific Daylight Time	08/03/2017 03:38:10 PM Pacific Daylight Time	08/01/2017 09:01:34 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5628	001	0	2018	Salt Lake City		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5628	006	0	1	01	01	H5628_006_0	5		1	1	2	07/05/2017	2018.03	07/05/2017 03:48:37 PM Pacific Daylight Time	08/04/2017 01:46:16 PM Pacific Daylight Time	08/01/2017 09:02:58 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.uhealthplan.utah.edu/healthy_advantage.html	Healthy Advantage (HMO SNP)	01	01		1			H5628	006	0	2018	Salt Lake City		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.uhealthplan.utah.edu/healthy_advantage.html	www.molinahealthcare.com/medicare	(877)644-0344		(877)644-0344		(866)939-5741		(866)939-5741		(877)644-0344		(877)644-0344		(866)939-5741		(866)939-5741		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5628	007	0	1	01	01	H5628_007_0	7			1		08/04/2017	2018.03	08/04/2017 08:48:46 AM Pacific Daylight Time	08/03/2017 03:46:38 PM Pacific Daylight Time	08/01/2017 09:04:10 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.healthyadvantageplus.org	Healthy Advantage Plus (HMO)	01	01		1			H5628	007	0	2018	Salt Lake City		2		2			2						www.molinahealthcare.com/medicare	www.healthyadvantageplus.org	www.molinahealthcare.com/medicare	(877)644-0344		(877)644-0344		(866)939-5741		(866)939-5741		(877)644-0344		(877)644-0344		(866)939-5741		(866)939-5741		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5628	008	0	1	01	01	H5628_008_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:53:20 AM Pacific Daylight Time	08/03/2017 03:48:52 PM Pacific Daylight Time	08/01/2017 09:05:32 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5628	008	0	2018	Idaho		2		2			1	3		1		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5628	009	0	1	01	01	H5628_009_0	5			1		08/04/2017	2018.03	08/04/2017 08:51:57 AM Pacific Daylight Time	08/03/2017 03:43:10 PM Pacific Daylight Time	08/01/2017 09:06:54 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H5628	009	0	2018	Boise		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5628	010	0	1	01	01	H5628_010_0	6			1		08/04/2017	2018.03	08/04/2017 08:52:43 AM Pacific Daylight Time	08/03/2017 03:44:38 PM Pacific Daylight Time	08/01/2017 09:08:18 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H5628	010	0	2018	Kootenai and Twin Falls		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(888)665-1328		(888)665-1328		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5629	001	0	1	20	08	H5629_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:11:35 PM Pacific Daylight Time		05/25/2017 12:50:47 PM Pacific Daylight Time			05/25/2017 01:14:25 PM Pacific Daylight Time	COMMUNITY ELDERCARE OF SAN DIEGO	St. Paul's PACE	http://www.stpaulspace.org/	St. Paul's PACE (PACE)	08	20		1			H5629	001	0	2018	San Diego County, South County, East County		2		2			2						stpaulspace.org	stpaulspace.org										(619)677-3800		(619)677-3800		(619)677-3800		(619)677-3800										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H5629	002	0	1	20	08	H5629_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:12:22 PM Pacific Daylight Time		05/25/2017 12:51:26 PM Pacific Daylight Time			05/25/2017 01:14:25 PM Pacific Daylight Time	COMMUNITY ELDERCARE OF SAN DIEGO	St. Paul's PACE	http://www.stpaulspace.org/	St. Paul's PACE (PACE)	08	20		1			H5629	002	0	2018	San Diego County, South County, East County		2		2			2						stpaulspace.org	stpaulspace.org										(619)271-7100		(619)271-7100		(619)271-7100		(619)271-7100										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H5649	001	0	1	01	01	H5649_001_0	6			1		08/04/2017	2018.03	08/04/2017 10:06:05 AM Eastern Daylight Time	08/07/2017 10:59:42 AM Eastern Daylight Time	08/02/2017 11:40:08 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Medicare Plan (HMO)	01	01		1			H5649	001	0	2018	Counties:  LA, SB, RS,  partial OC		2	18779	2			2						www.centralhealthplan.com/Benefits/PharmacyList.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5649	002	0	1	01	01	H5649_002_0	5		1	1	2	07/11/2017	2018.03	07/11/2017 09:57:44 AM Eastern Daylight Time	08/07/2017 11:04:10 AM Eastern Daylight Time	08/02/2017 11:40:57 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Medi-Medi Plan (HMO SNP)	01	01		1			H5649	002	0	2018	Counties: LA and SB		2	5529	2			1	3		1		2	www.centralhealthplan.com/Benefits/PharmacyList.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5649	004	0	1	01	01	H5649_004_0	6			1		07/14/2017	2018.03	07/14/2017 04:04:57 PM Eastern Daylight Time	08/07/2017 11:06:39 AM Eastern Daylight Time	08/02/2017 11:42:02 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Premier Plan (HMO)	01	01		1			H5649	004	0	2018	Counties:  LA, SB, RS and partial OC		2	9247	2			2						www.centralhealthplan.com/Benefits/PharmacyList.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5649	006	0	1	01	01	H5649_006_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:05:52 AM Eastern Daylight Time	08/07/2017 11:08:17 AM Eastern Daylight Time	08/02/2017 11:42:48 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Focus Plan (HMO SNP)	01	01		1			H5649	006	0	2018	Counties:  LA, SB, and partial OC		2	2475	2			1	4			00000000000000000010		www.centralhealthplan.com/Benefits/PharmacyList.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5649	008	0	1	01	01	H5649_008_0	7			1		07/14/2017	2018.03	07/14/2017 04:08:17 PM Eastern Daylight Time	08/07/2017 11:10:19 AM Eastern Daylight Time	08/02/2017 11:43:42 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Ventura Medicare Plan (HMO)	01	01		1			H5649	008	0	2018	Ventura County		2	480	2			2						www.centralhealthplan.com/Benefits/PharmacyList.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5649	009	0	1	01	01	H5649_009_0	6		1	1	2	07/11/2017	2018.03	07/11/2017 10:18:04 AM Eastern Daylight Time	08/07/2017 11:19:18 AM Eastern Daylight Time	08/02/2017 11:44:30 AM Eastern Daylight Time			08/07/2017 12:18:40 PM Eastern Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	www.centralhealthplan.com	Central Health Ventura Medi-Medi Plan (HMO SNP)	01	01		1			H5649	009	0	2018	Ventura County		2	5529	2			1	3		1		2	www.centralhealthplan.com/Benefits/Pharmacy.aspx	www.centralhealthplan.com/Benefits/Formulary.aspx	www.centralhealthplan.com/NetworkProviders/Directory.aspx	(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(866)314-2427		(626)388-2390		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		(888)205-7671		(626)388-2391		2					2					2	2			
H5652	001	0	1	02	01	H5652_001_0	3			1		06/01/2017	2018.03	06/01/2017 09:14:20 AM Central Daylight Time	08/03/2017 01:39:46 PM Central Daylight Time	08/01/2017 11:31:02 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.EricksonAdvantage.com	Erickson Advantage Signature with Drugs (HMO-POS)	01	02		1			H5652	001	0	2018	Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA		2		2			2						www.EricksonAdvantage.com	www.EricksonAdvantage.com	www.EricksonAdvantage.com	(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5652	002	0	1	02	01	H5652_002_0	2			1		05/26/2017	2018.03	05/26/2017 09:36:13 AM Central Daylight Time	06/01/2017 12:52:51 PM Central Daylight Time				07/06/2017 03:19:00 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.EricksonAdvantage.com	Erickson Advantage Signature without Drugs (HMO-POS)	01	02		1			H5652	002	0	2018	Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA		2		2			2						www.EricksonAdvantage.com	www.EricksonAdvantage.com	www.EricksonAdvantage.com	(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5652	003	0	1	02	01	H5652_003_0	3		1	1		08/02/2017	2018.03	08/02/2017 03:02:40 PM Central Daylight Time	08/03/2017 01:40:22 PM Central Daylight Time	08/01/2017 11:31:28 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.EricksonAdvantage.com	Erickson Advantage Guardian (HMO-POS SNP)	01	02		1			H5652	003	0	2018	Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA		2		2			1	1	1				www.EricksonAdvantage.com	www.EricksonAdvantage.com	www.EricksonAdvantage.com	(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5652	004	0	1	02	01	H5652_004_0	3		1	1		06/01/2017	2018.03	06/01/2017 09:15:00 AM Central Daylight Time	08/03/2017 01:40:58 PM Central Daylight Time	08/01/2017 11:31:54 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.EricksonAdvantage.com	Erickson Advantage Champion (HMO-POS SNP)	01	02		1			H5652	004	0	2018	Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA		2		2			1	4			00011010000000000000		www.EricksonAdvantage.com	www.EricksonAdvantage.com	www.EricksonAdvantage.com	(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5652	006	0	1	02	01	H5652_006_0	3			1		06/01/2017	2018.03	06/01/2017 09:15:25 AM Central Daylight Time	08/03/2017 01:41:37 PM Central Daylight Time	08/01/2017 11:32:21 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.EricksonAdvantage.com	Erickson Advantage Freedom (HMO-POS)	01	02		1			H5652	006	0	2018	Erickson Campuses - CO,KS,MA,MD,MI,NJ,PA,TX,VA		2		2			2						www.EricksonAdvantage.com	www.EricksonAdvantage.com	www.EricksonAdvantage.com	(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(866)314-8188		(866)314-8188		(866)774-9671		(866)774-9671		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5656	001	0	1	01	01	H5656_001_0	8			1		08/03/2017	2018.03	08/03/2017 08:57:34 AM Central Daylight Time	08/03/2017 09:10:13 AM Central Daylight Time	07/31/2017 03:27:53 PM Central Daylight Time			08/07/2017 12:55:33 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American Corp.	: www.TexanPlusDFW.com	TexanPlus Classic (HMO)	01	01		1			H5656	001	0	2018	Dallas-Fort Worth		2	21662	2			2						: www.TexanPlusDFW.com	: www.TexanPlusDFW.com	: www.TexanPlusDFW.com	(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5656	801	0	1	01	01	H5656_801_0	1			1		05/28/2017	2018.03	05/28/2017 12:17:36 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American Corp.	www.Universal-American-Medicare.com	Retiree - MA-PD CY (HMO)	01	01		1			H5656	801	0	2018	Employer Group--North Texas (MAPD--CY)		1	300	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.TexanPlusDFW.com	(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H5656	802	0	1	01	01	H5656_802_0	1			1		05/28/2017	2018.03	05/28/2017 12:17:39 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American Corp.	www.Universal-American-Medicare.com	Retiree - MA-PD non-CY (HMO)	01	01		1			H5656	802	0	2018	Employer Group--North Texas (MAPD--non-CY)		1	300	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.TexanPlusDFW.com	(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H5656	803	0	1	01	01	H5656_803_0	1			1		05/28/2017	2018.03	05/28/2017 12:17:42 PM Central Daylight Time					05/28/2017 05:26:16 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American Corp.	www.Universal-American-Medicare.com	Retiree - MA (HMO)	01	01		1			H5656	803	0	2018	Employer Group--North Texas (MA--CY)		1	300	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.TexanPlusDFW.com	(800)958-2707		(800)958-2707		(866)245-4143		(866)245-4143										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H5703	001	0	1	01	01	H5703_001_0	8		1	1	2	06/05/2017	2018.03	06/05/2017 10:37:13 AM Central Daylight Time	08/01/2017 10:22:23 AM Central Daylight Time	08/01/2017 10:24:52 AM Central Daylight Time			08/01/2017 10:51:11 AM Central Daylight Time	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	AbilityCare (HMO SNP)	01	01		1			H5703	001	0	2018	Select Counties in Minnesota		2	7255	1	1		1	3		1		1	www.mnscha.org	www.mnscha.org	www.mnscha.org	(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(866)567-7242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5746	016	0	1	01	01	H5746_016_0	10			1		08/07/2017	2018.03	08/07/2017 03:27:48 PM Pacific Daylight Time	08/07/2017 05:59:17 AM Pacific Daylight Time	08/06/2017 12:07:44 PM Pacific Daylight Time			08/07/2017 03:28:52 PM Pacific Daylight Time	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	Amerigroup Community Care of New Mexico	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5746	016	0	2018	Greater Albuquerque Area		2	21126	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)726-6749		(844)726-6749		(866)805-4589		(866)805-4589		(844)726-6750		(844)726-6750		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5774	003	0	1	01	01	H5774_003_0	5			1		07/13/2017	2018.03	07/13/2017 11:01:19 AM SA Western Standard Time	06/05/2017 01:45:52 PM SA Western Standard Time				07/13/2017 11:35:23 AM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Basic (HMO)	01	01		1			H5774	003	0	2018	Puerto Rico		2	4812	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777										(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520										2					2					2	1	11	7d;7f;7g;8a1;8a2;8b1;	7f;18a1;18a2;
H5774	005	0	1	01	01	H5774_005_0	7			1		08/09/2017	2018.03	08/09/2017 02:44:40 PM SA Western Standard Time	08/04/2017 07:40:37 PM SA Western Standard Time	08/04/2017 07:40:38 PM SA Western Standard Time			08/09/2017 03:03:22 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal (HMO)	01	01		1			H5774	005	0	2018	Puerto Rico		2	80251	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	1	11	7d;7f;7g;8a1;8a2;8b1;	7f;
H5774	022	0	1	01	01	H5774_022_0	7		1	1		08/09/2017	2018.03	08/09/2017 02:21:20 PM SA Western Standard Time	08/04/2017 07:40:40 PM SA Western Standard Time	08/04/2017 07:40:19 PM SA Western Standard Time			08/09/2017 03:03:22 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Vital Plus (HMO SNP)	01	01		1			H5774	022	0	2018	Puerto Rico		2	54024	2			1	4			00000000000000000010		www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	1	11	7d;7f;7g;8a1;8a2;8b1;18a;	7f;18a1;18a2;
H5774	023	0	1	02	01	H5774_023_0	6			1		08/03/2017	2018.03	08/03/2017 09:45:27 AM SA Western Standard Time	08/04/2017 07:40:20 PM SA Western Standard Time	08/04/2017 07:40:21 PM SA Western Standard Time			08/04/2017 07:48:19 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal Plus (HMO-POS)	01	02		1			H5774	023	0	2018	Puerto Rico		2	53726	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	1	11	7d;7f;7g;8a1;8a2;8b1;	7f;
H5774	024	0	1	01	01	H5774_024_0	7		1	1	1	08/09/2017	2018.03	08/09/2017 02:16:15 PM SA Western Standard Time	08/04/2017 07:40:22 PM SA Western Standard Time	08/04/2017 07:40:24 PM SA Western Standard Time			08/09/2017 03:03:22 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Platino Plus (HMO SNP)	01	01		1			H5774	024	0	2018	Puerto Rico		2	519348	2		1	1	3		2		2	www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	2			
H5774	025	0	1	01	01	H5774_025_0	7		1	1	1	08/09/2017	2018.03	08/09/2017 02:18:54 PM SA Western Standard Time	08/04/2017 07:40:25 PM SA Western Standard Time	08/04/2017 07:40:26 PM SA Western Standard Time			08/09/2017 03:03:22 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Platino Ultra (HMO SNP)	01	01		1			H5774	025	0	2018	Puerto Rico		2	171948	2		1	1	3		2		2	www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	2			
H5774	026	0	1	01	01	H5774_026_0	7		1	1	1	08/09/2017	2018.03	08/09/2017 02:20:01 PM SA Western Standard Time	08/04/2017 07:40:27 PM SA Western Standard Time	08/04/2017 07:40:28 PM SA Western Standard Time			08/09/2017 03:03:22 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Platino Advance (HMO SNP)	01	01		1			H5774	026	0	2018	Puerto Rico		2	10524	2		1	1	3		2		2	www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		2					2					2	1	01	7d;7f;8a1;8a2;8b1;8b2;8b3;	
H5774	802	0	1	01	01	H5774_802_0	5			1		06/13/2017	2018.03	06/13/2017 10:47:59 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal A (HMO)	01	01		1			H5774	802	0	2018	Puerto Rico		1	1085	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777										(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520										1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1					1				
H5774	806	0	1	01	01	H5774_806_0	5			1		06/13/2017	2018.03	06/13/2017 10:47:31 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal B (HMO)	01	01		1			H5774	806	0	2018	Puerto Rico		1	48319	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;11a;11b;15;16b;	2		1					1				
H5774	808	0	1	01	01	H5774_808_0	5			1		06/13/2017	2018.03	06/13/2017 10:47:13 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal C (HMO)	01	01		1			H5774	808	0	2018	Puerto Rico		1	40572	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1					1				
H5774	809	0	1	02	01	H5774_809_0	5			1		06/13/2017	2018.03	06/13/2017 10:46:57 AM SA Western Standard Time					06/13/2017 02:48:06 PM SA Western Standard Time	TRIPLE S ADVANTAGE, INC.	Triple S Advantage	www.sssadvantage.com	Royal D (HMO-POS)	01	02		1			H5774	809	0	2018	Puerto Rico		1	5928	2			2						www.sssadvantage.com	www.sssadvantage.com	www.sssadvantage.com	(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(888)620-1919		(888)620-1919		(877)207-8777		(877)207-8777		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		(866)620-2520		1	1	2;3-1;3-2;3-3;5;6;7c;7i;8a;8b1;8b2;9a;9b;10a;11a;11b;15;16b;	2		1	2		2		1				
H5779	002	0	1	01	01	H5779_002_0	8			1		08/02/2017	2018.03	08/02/2017 06:28:59 PM Eastern Daylight Time	08/02/2017 04:23:30 PM Eastern Daylight Time	07/31/2017 06:18:48 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5779	002	0	2018	KN, MER, PEO, RI, TA, WAR Counties		2	24816	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5779	003	0	1	01	01	H5779_003_0	8			1		08/03/2017	2018.03	08/03/2017 07:59:14 AM Eastern Daylight Time	08/04/2017 12:46:34 PM Eastern Daylight Time	07/31/2017 06:19:54 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Elite (HMO)	01	01		1			H5779	003	0	2018	BOO, COO, KNE, MCH, WIL, WIN Counties		2	5118	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5779	005	0	1	01	01	H5779_005_0	8			1		08/02/2017	2018.03	08/02/2017 08:09:06 PM Eastern Daylight Time	08/02/2017 04:25:06 PM Eastern Daylight Time	07/31/2017 06:21:02 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Essential (HMO)	01	01		1			H5779	005	0	2018	BOO, COO, KNE, MCH, WIL, WIN Counties		2	13460	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5779	006	0	1	01	01	H5779_006_0	9			1		08/02/2017	2018.03	08/02/2017 08:04:47 PM Eastern Daylight Time	08/02/2017 04:25:56 PM Eastern Daylight Time	07/31/2017 06:22:12 PM Eastern Daylight Time			08/07/2017 05:10:04 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	MeridianCare	www.mymeridiancare.com	MeridianCare Edge (HMO)	01	01		1			H5779	006	0	2018	Greater Chicago and Central Illinois		2	9088	2			2						www.mymeridiancare.com	www.mymeridiancare.com	www.mymeridiancare.com	(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(877)902-6784		(877)902-6784		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5793	001	0	1	01	01	H5793_001_0	5			1		08/02/2017	2018.03	08/02/2017 11:43:37 AM Central Daylight Time	08/02/2017 03:10:08 PM Central Daylight Time	07/31/2017 04:53:23 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5793	001	0	2018	Inland CT		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5793	008	0	1	01	01	H5793_008_0	3			1		06/27/2017	2018.03	06/27/2017 08:59:14 PM Eastern Daylight Time	08/02/2017 03:12:06 PM Central Daylight Time	07/31/2017 04:53:50 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H5793	008	0	2018	Connecticut		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5793	010	0	1	01	01	H5793_010_0	3			1		08/01/2017	2018.03	08/01/2017 07:45:02 PM Central Daylight Time	08/02/2017 03:13:02 PM Central Daylight Time	07/31/2017 04:54:17 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (HMO)	01	01		1			H5793	010	0	2018	Shoreline CT		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5793	011	0	1	01	01	H5793_011_0	3			1		08/01/2017	2018.03	08/01/2017 07:35:45 PM Central Daylight Time	08/02/2017 03:13:52 PM Central Daylight Time	07/31/2017 04:54:44 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Elite Plan (HMO)	01	01		1			H5793	011	0	2018	Inland CT		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5793	801	0	1	01	01	H5793_801_0	2			1		05/30/2017	2018.03	05/30/2017 11:32:27 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5793	801	0	2018	Connecticut		1	170	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H5793	802	0	1	01	01	H5793_802_0	2			1		05/30/2017	2018.03	05/30/2017 11:32:38 AM Eastern Daylight Time					06/02/2017 01:39:40 PM Eastern Daylight Time	AETNA HEALTH INC. (CT)	Aetna Medicare	https://www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5793	802	0	2018	Connecticut		1	610	2			2						https://www.aetnamedicare.com/findpharmacy	https://www.aetnaretireeplans.com	www.aetnamedicaredocfind.com	(888)267-1637		(888)267-1637		(800)307-4830		(800)307-4830		(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H5810	001	0	1	01	01	H5810_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:41:23 AM Pacific Daylight Time	08/04/2017 08:24:32 AM Pacific Daylight Time	08/01/2017 09:09:20 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5810	001	0	2018	Southern California		2		2			1	3		1		1	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(800)665-0898		(800)665-0898		(866)403-8293		(866)403-8293		(800)665-0898		(800)665-0898		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	018	0	1	01	01	H5817_018_0	9			1		08/04/2017	2018.03	08/04/2017 02:25:14 PM Pacific Daylight Time	08/07/2017 05:59:18 AM Pacific Daylight Time	08/06/2017 12:09:13 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Select (HMO)	01	01		1			H5817	018	0	2018	Bexar County		2	33622	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	019	0	1	01	01	H5817_019_0	10			1		08/04/2017	2018.03	08/04/2017 02:29:40 PM Pacific Daylight Time	08/07/2017 05:59:18 AM Pacific Daylight Time	08/06/2017 12:09:13 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Select (HMO)	01	01		1			H5817	019	0	2018	El Paso County		2	17739	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	1	1	01	01	H5817_020_1	9			1		08/04/2017	2018.03	08/04/2017 02:29:26 PM Pacific Daylight Time	08/07/2017 05:59:19 AM Pacific Daylight Time	08/06/2017 12:09:13 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	1	2018	Select Counties in Texas	Houston Metro Area	2	36720	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	2	1	01	01	H5817_020_2	9			1		08/05/2017	2018.03	08/05/2017 09:04:12 AM Pacific Daylight Time	08/07/2017 05:59:19 AM Pacific Daylight Time	08/06/2017 12:09:13 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	2	2018	Select Counties in Texas	Dallas-Fort Worth Area	2	20417	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	3	1	01	01	H5817_020_3	9			1		08/04/2017	2018.03	08/04/2017 03:00:54 PM Pacific Daylight Time	08/07/2017 05:59:20 AM Pacific Daylight Time	08/06/2017 12:09:13 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	3	2018	Select Counties in Texas	San Antonio Area	2	8580	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	4	1	01	01	H5817_020_4	9			1		08/04/2017	2018.03	08/04/2017 03:05:29 PM Pacific Daylight Time	08/07/2017 05:59:20 AM Pacific Daylight Time	08/06/2017 12:09:14 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	4	2018	Select Counties in Texas	El Paso Area	2	16639	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	5	1	01	01	H5817_020_5	9			1		08/04/2017	2018.03	08/04/2017 06:26:06 PM Pacific Daylight Time	08/07/2017 05:59:21 AM Pacific Daylight Time	08/06/2017 12:09:14 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	5	2018	Select Counties in Texas	Lubbock County	2	27268	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	020	6	1	01	01	H5817_020_6	9			1		08/04/2017	2018.03	08/04/2017 03:34:17 PM Pacific Daylight Time	08/07/2017 05:59:21 AM Pacific Daylight Time	08/06/2017 12:09:14 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H5817	020	6	2018	Select Counties in Texas	Austin Area	2	2880	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	022	0	1	01	01	H5817_022_0	8			1		08/04/2017	2018.03	08/04/2017 03:55:16 PM Pacific Daylight Time	08/07/2017 05:59:21 AM Pacific Daylight Time	08/06/2017 12:09:15 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Select (HMO)	01	01		1			H5817	022	0	2018	Travis County		2	3842	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	023	0	1	01	01	H5817_023_0	9			1		08/04/2017	2018.03	08/04/2017 03:57:44 PM Pacific Daylight Time	08/07/2017 05:59:22 AM Pacific Daylight Time	08/06/2017 12:09:15 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Select (HMO)	01	01		1			H5817	023	0	2018	Harris, Montgomery, Fort Bend, Jefferson Counties		2	56174	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)326-8142		(844)326-8142		(866)805-4589		(866)805-4589		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	1	1	01	01	H5817_024_1	9		1	1	2	08/04/2017	2018.03	08/04/2017 03:59:16 PM Pacific Daylight Time	08/07/2017 05:59:22 AM Pacific Daylight Time	08/06/2017 12:09:15 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	1	2018	Select Counties in Texas	Houston Area	2	87674	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	2	1	01	01	H5817_024_2	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:01:41 PM Pacific Daylight Time	08/07/2017 05:59:22 AM Pacific Daylight Time	08/06/2017 12:09:15 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	2	2018	Select Counties in Texas	Dallas Area	2	36629	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	3	1	01	01	H5817_024_3	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:02:15 PM Pacific Daylight Time	08/07/2017 05:59:23 AM Pacific Daylight Time	08/06/2017 12:09:15 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	3	2018	Select Counties in Texas	San Antonio Area	2	49235	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	5	1	01	01	H5817_024_5	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:02:48 PM Pacific Daylight Time	08/07/2017 05:59:23 AM Pacific Daylight Time	08/06/2017 12:09:16 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	5	2018	Select Counties in Texas	El Paso Area	2	49374	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	6	1	01	01	H5817_024_6	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:04:26 PM Pacific Daylight Time	08/07/2017 05:59:23 AM Pacific Daylight Time	08/06/2017 12:09:16 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	6	2018	Select Counties in Texas	Lubbock Area	2	19417	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	024	7	1	01	01	H5817_024_7	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:05:32 PM Pacific Daylight Time	08/07/2017 05:59:24 AM Pacific Daylight Time	08/06/2017 12:09:16 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H5817	024	7	2018	Select Counties in Texas	Austin Area	2	19373	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	025	0	1	02	01	H5817_025_0	9		1	1		08/04/2017	2018.03	08/04/2017 04:07:09 PM Pacific Daylight Time		08/06/2017 12:09:17 PM Pacific Daylight Time		08/07/2017 05:59:24 AM Pacific Daylight Time	08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage ESRD (HMO-POS SNP)	01	02		1			H5817	025	0	2018	Bexar, Comal, El Paso, Hays, Travis, Williamson		2	5024	2			1	4			00000000100000000000		www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(877)269-5660		(877)269-5660		(844)326-8142		(844)326-8142		(877)269-5660		(877)269-5660		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5817	026	0	1	01	01	H5817_026_0	9		1	1	2	08/04/2017	2018.03	08/04/2017 04:06:25 PM Pacific Daylight Time	08/07/2017 05:59:25 AM Pacific Daylight Time	08/06/2017 12:09:17 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Premier (HMO SNP)	01	01		1			H5817	026	0	2018	Houston Area		2	53121	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(844)765-5165		(844)765-5165		(844)326-8142		(844)326-8142		(844)765-5165		(844)765-5165		(844)326-8215		(844)326-8215		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5822	001	0	1	20	08	H5822_001_0	2			1		05/24/2017	2018.03	05/24/2017 12:23:24 PM Central Daylight Time		07/18/2017 12:38:47 PM Central Daylight Time			07/18/2017 12:40:12 PM Central Daylight Time	MIDLAND CARE CONNECTION	Midland Care PACE	www.midlandcc.org	Midland Care Connection - Dual Eligibles (PACE)	08	20		1			H5822	001	0	2018	DG, JA, JF, LY, MS, NM, OS, PT, SN, WB counties		2		2			2						N/A	N/A										(800)726-7450		(785)232-2044		(800)726-7450		(785)232-2044										(711)-		(711)-		(711)-		(711)-																
H5822	002	0	1	20	08	H5822_002_0	2			1		05/24/2017	2018.03	05/24/2017 12:24:04 PM Central Daylight Time		07/18/2017 12:38:57 PM Central Daylight Time			07/18/2017 12:40:12 PM Central Daylight Time	MIDLAND CARE CONNECTION	Midland Care PACE	www.midlandcc.org	Midland Care Connection - Medicare Only (PACE)	08	20		1			H5822	002	0	2018	DG, JA, JF, LY, MS, NM, OS, PT, SN, WB counties		2		2			2						N/A	N/A										(800)491-3691		(785)232-2044		(800)491-3691		(785)232-2044										(711)-		(711)-		(711)-		(711)-																
H5823	006	0	1	01	01	H5823_006_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:49:29 AM Pacific Daylight Time	08/04/2017 08:26:02 AM Pacific Daylight Time	08/01/2017 09:12:50 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5823	006	0	2018	Seattle, Tacoma, Spokane		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5823	007	0	1	01	01	H5823_007_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:49:57 AM Pacific Daylight Time	08/04/2017 08:27:18 AM Pacific Daylight Time	08/01/2017 09:14:18 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Choice (HMO SNP)	01	01		1			H5823	007	0	2018	Pierce, Snohomish		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5823	008	0	1	01	01	H5823_008_0	5			1		08/04/2017	2018.03	08/04/2017 08:55:37 AM Pacific Daylight Time	08/04/2017 01:48:16 PM Pacific Daylight Time	08/01/2017 09:15:24 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H5823	008	0	2018	Pierce County		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(800)665-1029		(800)665-1029		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5826	006	0	1	01	01	H5826_006_0	2			1		07/07/2017	2018.03	07/07/2017 09:59:26 AM Pacific Daylight Time	06/01/2017 03:30:52 PM Pacific Daylight Time				07/11/2017 04:10:55 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	http://healthfirst.chpw.org/	Community HealthFirst MA Plan (HMO)	01	01		1			H5826	006	0	2018	Western Washington and Spokane Counties		2	1344	2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	http://healthfirst.chpw.org/	(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5826	008	0	1	01	01	H5826_008_0	4			1		08/02/2017	2018.03	08/02/2017 10:45:46 AM Pacific Daylight Time	08/02/2017 04:01:01 PM Pacific Daylight Time	08/02/2017 04:00:56 PM Pacific Daylight Time			08/03/2017 04:11:06 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	http://healthfirst.chpw.org/	Community HealthFirst MA Pharmacy Plan (HMO)	01	01		1			H5826	008	0	2018	Western Washington and Spokane Counties		2	16728	2			2						http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5826	009	0	1	01	01	H5826_009_0	3			1		07/07/2017	2018.03	07/07/2017 09:55:49 AM Pacific Daylight Time	08/02/2017 04:00:57 PM Pacific Daylight Time	08/02/2017 04:00:57 PM Pacific Daylight Time			08/03/2017 04:11:06 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	http://healthfirst.chpw.org/	Community HealthFirst MA Pharmacy Plan (HMO)	01	01		1			H5826	009	0	2018	Eastern and Western Washington State		2	8592	2			2						http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5826	010	0	1	01	01	H5826_010_0	5			1		07/07/2017	2018.03	07/07/2017 09:57:00 AM Pacific Daylight Time	08/02/2017 04:00:58 PM Pacific Daylight Time	08/02/2017 04:00:58 PM Pacific Daylight Time			08/03/2017 04:11:06 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	http://healthfirst.chpw.org/	Community HealthFirst MA Extra Plan (HMO)	01	01		1			H5826	010	0	2018	Western Washington, Spokane and Yakima Counties		2	27372	2			2						http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5826	014	0	1	01	01	H5826_014_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 10:46:53 AM Pacific Daylight Time	08/02/2017 04:00:59 PM Pacific Daylight Time	08/02/2017 04:00:59 PM Pacific Daylight Time			08/03/2017 04:11:06 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	http://healthfirst.chpw.org/	Community HealthFirst MA Special Needs Plan (HMO SNP)	01	01		1			H5826	014	0	2018	Eastern and Western Washington State		2	7200	2			1	3		1		1	http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	http://healthfirst.chpw.org/	(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(800)942-0247		(800)942-0247		(800)944-1247		(800)944-1247		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5852	001	0	1	01	01	H5852_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 11:12:15 AM Pacific Daylight Time	08/04/2017 11:07:36 AM Pacific Daylight Time	08/04/2017 11:07:36 AM Pacific Daylight Time			08/04/2017 12:53:19 PM Pacific Daylight Time	AIDS HEALTHCARE FOUNDATION	AHF	www.php-ca.org	PHP (HMO SNP)	01	01		1			H5852	001	0	2018	Los Angeles County, California		2	9562	2			1	4			00000000001000000000		www.php-ca.org/provider-find	www.php-ca.org/for-members/drug-benefit/formulary	www.php-ca.org/provider-find	(800)263-0067		(800)263-0067		(800)263-0067		(800)263-0067		(888)436-5018		(888)436-5018		(800)263-0067		(800)263-0067		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5854	007	0	1	01	01	H5854_007_0	6			1		06/05/2017	2018.03	06/05/2017 04:48:33 PM Eastern Daylight Time	08/07/2017 08:59:25 AM Eastern Daylight Time	08/06/2017 03:09:17 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H5854	007	0	2018	Hartford County		2	15368	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(866)673-4157		(866)673-4157		(844)364-2128		(844)364-2128		(866)673-4157		(866)673-4157		(844)364-2123		(844)364-2123		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5854	008	0	1	01	01	H5854_008_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 10:26:54 AM Eastern Daylight Time	08/07/2017 08:59:26 AM Eastern Daylight Time	08/06/2017 03:09:17 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H5854	008	0	2018	Select Counties in Connecticut		2	266360	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(844)533-2091		(844)533-2091		(844)834-6071		(844)834-6071		(844)533-2091		(844)533-2091		(844)834-6072		(844)834-6072		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5854	009	0	1	01	01	H5854_009_0	6			1		06/05/2017	2018.03	06/05/2017 04:49:33 PM Eastern Daylight Time	08/07/2017 08:59:26 AM Eastern Daylight Time	08/06/2017 03:09:18 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H5854	009	0	2018	Select Counties in Connecticut		2	29828	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(866)673-4157		(866)673-4157		(844)364-2128		(844)364-2128		(866)673-4157		(866)673-4157		(844)364-2123		(844)364-2123		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5854	010	0	1	01	01	H5854_010_0	6			1		08/04/2017	2018.03	08/04/2017 10:31:50 AM Eastern Daylight Time	08/07/2017 08:59:26 AM Eastern Daylight Time	08/06/2017 03:09:18 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Select (HMO)	01	01		1			H5854	010	0	2018	Select Counties in Connecticut		2	88678	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com/medicare	(866)673-4157		(866)673-4157		(844)364-2128		(844)364-2128		(866)673-4157		(866)673-4157		(844)364-2123		(844)364-2123		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5854	801	0	1	01	01	H5854_801_0	7			1		06/03/2017	2018.03	06/03/2017 01:10:15 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/ct/medicare	Anthem MediBlue (HMO)	01	01		1			H5854	801	0	2018	Connecticut - Select Counties		1	600	2			2						www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	(866)220-9827		(866)220-9827		(800)409-7056		(800)409-7056		(866)220-9827		(866)220-9827		(800)409-7056		(800)409-7056		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H5854	803	0	1	01	01	H5854_803_0	7			1		06/03/2017	2018.03	06/03/2017 01:10:22 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/ct/medicare	Anthem MediBlue (HMO)	01	01		1			H5854	803	0	2018	Connecticut - Select Counties		1	600	2			2						www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	(866)220-9827		(866)220-9827		(800)409-7056		(800)409-7056										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H5854	806	0	1	02	01	H5854_806_0	7			1		06/03/2017	2018.03	06/03/2017 01:10:29 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/ct/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H5854	806	0	2018	Conneticut - Select Counties		1	600	2			2						www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	www.anthem.com/ct/medicare	(844)533-2091		(844)533-2091		(800)409-7056		(800)409-7056		(866)220-9827		(866)220-9827		(800)409-7056		(800)409-7056		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H5859	001	0	1	02	01	H5859_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:11:50 AM Pacific Daylight Time	08/07/2017 02:41:34 PM Pacific Daylight Time	08/07/2017 02:41:36 PM Pacific Daylight Time			08/07/2017 02:42:41 PM Pacific Daylight Time	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	www.careoregonadvantage.org	CareOregon Advantage Plus (HMO-POS SNP)	01	02		1			H5859	001	0	2018	Portland Metro Area, Southern Oregon, Northwest		2	127920	2			1	3		2		2	http://www.careoregonadvantage.org/member-resources/find-a-provider	http://www.careoregonadvantage.org/member-resources/rx-and-drug-information/are-my-drugs-covered-	http://www.careoregonadvantage.org/member-resources/find-a-provider	(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H5859	003	0	1	01	01	H5859_003_0	6			1		08/04/2017	2018.03	08/04/2017 10:13:22 AM Pacific Daylight Time	08/07/2017 02:41:41 PM Pacific Daylight Time	08/07/2017 02:41:45 PM Pacific Daylight Time			08/07/2017 02:42:41 PM Pacific Daylight Time	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	www.careoregonadvantage.org	CareOregon Advantage Star (HMO)	01	01		1			H5859	003	0	2018	Greater Portland Metro Area, Columbia County		2	7458	2			2						http://www.careoregonadvantage.org/member-resources/find-a-provider	http://www.careoregonadvantage.org/member-resources/rx-and-drug-information/are-my-drugs-covered-	http://www.careoregonadvantage.org/member-resources/find-a-provider	(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(888)712-3258		(503)416-4279		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		(800)735-2900		2					2					2	2			
H5883	001	1	1	02	01	H5883_001_1	3	2		1		06/01/2017	2018.03	06/01/2017 11:09:58 AM Eastern Daylight Time	06/05/2017 09:09:21 AM Eastern Daylight Time				06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	1	2018	Michigan	Region 1	2	4314	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5883	001	2	1	02	01	H5883_001_2	3	2		1		06/01/2017	2018.03	06/01/2017 11:10:07 AM Eastern Daylight Time	06/05/2017 09:09:22 AM Eastern Daylight Time				06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	2	2018	Michigan	Region 2	2	1788	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5883	001	3	1	02	01	H5883_001_3	3	2		1		06/01/2017	2018.03	06/01/2017 11:10:15 AM Eastern Daylight Time	06/05/2017 09:09:22 AM Eastern Daylight Time				06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	3	2018	Michigan	Region 3	2	888	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5883	001	4	1	02	01	H5883_001_4	3	2		1		06/01/2017	2018.03	06/01/2017 11:10:26 AM Eastern Daylight Time	06/05/2017 09:09:22 AM Eastern Daylight Time				06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	4	2018	Michigan	Region 4	2	2689	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5883	001	5	1	02	01	H5883_001_5	3	2		1		06/01/2017	2018.03	06/01/2017 11:10:44 AM Eastern Daylight Time	06/05/2017 09:09:23 AM Eastern Daylight Time				06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	5	2018	Michigan	Region 5	2	3864	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5883	002	1	1	02	01	H5883_002_1	4	2		1		06/02/2017	2018.03	06/02/2017 12:55:55 PM Eastern Daylight Time	08/04/2017 04:40:46 PM Eastern Daylight Time	08/04/2017 04:41:02 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	1	2018	Michigan	Region 1	2	58016	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	002	2	1	02	01	H5883_002_2	4	2		1		06/02/2017	2018.03	06/02/2017 02:02:40 PM Eastern Daylight Time	08/04/2017 04:40:46 PM Eastern Daylight Time	08/04/2017 04:41:02 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	2	2018	Michigan	Region 2	2	32803	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	002	3	1	02	01	H5883_002_3	4	2		1		06/02/2017	2018.03	06/02/2017 02:08:00 PM Eastern Daylight Time	08/04/2017 04:40:46 PM Eastern Daylight Time	08/04/2017 04:41:02 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	3	2018	Michigan	Region 3	2	17191	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	002	4	1	02	01	H5883_002_4	4	2		1		06/02/2017	2018.03	06/02/2017 02:00:42 PM Eastern Daylight Time	08/04/2017 04:40:48 PM Eastern Daylight Time	08/04/2017 04:41:02 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	4	2018	Michigan	Region 4	2	47573	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	002	7	1	02	01	H5883_002_7	4	2		1		06/02/2017	2018.03	06/02/2017 02:03:28 PM Eastern Daylight Time	08/04/2017 04:40:48 PM Eastern Daylight Time	08/04/2017 04:41:03 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	7	2018	Michigan	Region 5	2	87053	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	003	1	1	02	01	H5883_003_1	4	1		1		06/01/2017	2018.03	06/01/2017 11:24:02 AM Eastern Daylight Time	08/04/2017 04:40:49 PM Eastern Daylight Time	08/04/2017 04:41:03 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	1	2018	Michigan	Region 1	2	3705	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	003	2	1	02	01	H5883_003_2	4	1		1		06/01/2017	2018.03	06/01/2017 11:24:57 AM Eastern Daylight Time	08/04/2017 04:40:49 PM Eastern Daylight Time	08/04/2017 04:41:03 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	2	2018	Michigan	Region 2	2	2627	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	003	3	1	02	01	H5883_003_3	4	1		1		06/01/2017	2018.03	06/01/2017 11:25:15 AM Eastern Daylight Time	08/04/2017 04:40:49 PM Eastern Daylight Time	08/04/2017 04:41:03 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	3	2018	Michigan	Region 3	2	950	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	003	4	1	02	01	H5883_003_4	4	1		1		06/01/2017	2018.03	06/01/2017 11:25:35 AM Eastern Daylight Time	08/04/2017 04:40:50 PM Eastern Daylight Time	08/04/2017 04:41:04 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	4	2018	Michigan	Region 4	2	4004	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	003	5	1	02	01	H5883_003_5	4	1		1		06/01/2017	2018.03	06/01/2017 11:26:00 AM Eastern Daylight Time	08/04/2017 04:40:50 PM Eastern Daylight Time	08/04/2017 04:41:04 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	5	2018	Michigan	Region 5	2	13935	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	004	1	1	02	01	H5883_004_1	4	2		1		06/01/2017	2018.03	06/01/2017 11:26:28 AM Eastern Daylight Time	08/04/2017 04:40:51 PM Eastern Daylight Time	08/04/2017 04:41:04 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	1	2018	Michigan	Region 1	2	40404	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	004	2	1	02	01	H5883_004_2	4	2		1		06/01/2017	2018.03	06/01/2017 11:26:53 AM Eastern Daylight Time	08/04/2017 04:40:51 PM Eastern Daylight Time	08/04/2017 04:41:04 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	2	2018	Michigan	Region 2	2	39649	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	004	3	1	02	01	H5883_004_3	4	2		1		06/01/2017	2018.03	06/01/2017 11:27:12 AM Eastern Daylight Time	08/04/2017 04:40:51 PM Eastern Daylight Time	08/04/2017 04:41:04 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	3	2018	Michigan	Region 3	2	29402	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	004	4	1	02	01	H5883_004_4	4	2		1		06/01/2017	2018.03	06/01/2017 11:27:40 AM Eastern Daylight Time	08/04/2017 04:40:52 PM Eastern Daylight Time	08/04/2017 04:41:05 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	4	2018	Michigan	Region 4	2	53179	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	004	5	1	02	01	H5883_004_5	4	2		1		06/01/2017	2018.03	06/01/2017 11:28:10 AM Eastern Daylight Time	08/04/2017 04:40:52 PM Eastern Daylight Time	08/04/2017 04:41:05 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	5	2018	Michigan	Region 5	2	112645	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	007	0	1	01	01	H5883_007_0	5	2		1		06/01/2017	2018.03	06/01/2017 11:28:49 AM Eastern Daylight Time	08/04/2017 04:40:52 PM Eastern Daylight Time	08/04/2017 04:41:05 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO ConnectedCare (HMO)	01	01		1			H5883	007	0	2018	Gen,Kzoo,Liv,Mac,Oak,StClair,Wash,Wyn,Sag,Ios,Are		2	65126	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	008	1	1	01	01	H5883_008_1	4	2		1		06/01/2017	2018.03	06/01/2017 11:29:06 AM Eastern Daylight Time	08/04/2017 04:40:53 PM Eastern Daylight Time	08/04/2017 04:41:05 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO MyChoice Wellness (HMO)	01	01		1			H5883	008	1	2018	West Michigan	Region 1	2	36087	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	008	2	1	01	01	H5883_008_2	4	2		1		06/01/2017	2018.03	06/01/2017 11:29:23 AM Eastern Daylight Time	08/04/2017 04:40:53 PM Eastern Daylight Time	08/04/2017 04:41:06 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO MyChoice Wellness (HMO)	01	01		1			H5883	008	2	2018	West Michigan	Region 2	2	15908	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	009	1	1	01	01	H5883_009_1	5	2		1		06/01/2017	2018.03	06/01/2017 11:29:51 AM Eastern Daylight Time	08/04/2017 04:40:53 PM Eastern Daylight Time	08/04/2017 04:41:06 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthySaver (HMO)	01	01		1			H5883	009	1	2018	Grand Rapids and Detroit Metro areas	Region 1	2	7653	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	009	2	1	01	01	H5883_009_2	5	2		1		06/01/2017	2018.03	06/01/2017 11:30:06 AM Eastern Daylight Time	08/04/2017 04:40:54 PM Eastern Daylight Time	08/04/2017 04:41:06 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthySaver (HMO)	01	01		1			H5883	009	2	2018	Grand Rapids and Detroit Metro areas	Region 2	2	2729	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	009	3	1	01	01	H5883_009_3	5	2		1		06/01/2017	2018.03	06/01/2017 11:31:55 AM Eastern Daylight Time	08/04/2017 04:40:54 PM Eastern Daylight Time	08/04/2017 04:41:06 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthySaver (HMO)	01	01		1			H5883	009	3	2018	Grand Rapids and Detroit Metro areas	Region 3	2	21700	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	011	1	1	01	01	H5883_011_1	5	2		1		08/03/2017	2018.03	08/03/2017 10:34:35 AM Eastern Daylight Time	08/04/2017 04:40:55 PM Eastern Daylight Time	08/04/2017 04:41:07 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthyValue (HMO)	01	01		1			H5883	011	1	2018	Grand Rapids and Detroit Metro areas	Region 1	2	4721	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	011	2	1	01	01	H5883_011_2	5	2		1		08/03/2017	2018.03	08/03/2017 10:36:55 AM Eastern Daylight Time	08/04/2017 04:40:55 PM Eastern Daylight Time	08/04/2017 04:41:07 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthyValue (HMO)	01	01		1			H5883	011	2	2018	Grand Rapids and Detroit Metro areas	Region 2	2	1683	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	011	3	1	01	01	H5883_011_3	5	2		1		08/03/2017	2018.03	08/03/2017 10:38:36 AM Eastern Daylight Time	08/04/2017 04:40:55 PM Eastern Daylight Time	08/04/2017 04:41:07 PM Eastern Daylight Time			08/04/2017 05:13:42 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage HMO HealthyValue (HMO)	01	01		1			H5883	011	3	2018	Grand Rapids and Detroit Metro areas	Region 3	2	13386	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(800)450-3680		(800)450-3680		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5883	801	0	1	02	01	H5883_801_0	3			1		06/01/2017	2018.03	06/01/2017 11:32:57 AM Eastern Daylight Time					06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage (HMO-POS)	01	02		1			H5883	801	0	2018	Employer Group		1	287341	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(866)966-2583		(866)966-2583										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	1	6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;17a;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;14d;15;16b;18a;	2		1				
H5883	805	0	1	02	01	H5883_805_0	3			1		06/01/2017	2018.03	06/01/2017 11:33:08 AM Eastern Daylight Time					06/06/2017 12:56:09 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.bcbsm.com/medicare	BCN Advantage (HMO-POS)	01	02		1			H5883	805	0	2018	Employer Group		1	81152	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(800)450-3680		(800)450-3680		(866)966-2583		(866)966-2583		(800)450-3680		(800)450-3680		(866)966-2583		(866)966-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	1	6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9d;12;17a;18a;	1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14a;14d;15;16b;18a;	2		1				
H5902	001	0	1	20	08	H5902_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:44 AM Eastern Daylight Time		05/24/2017 08:18:56 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE ALTOONA, INC.	Senior LIFE Ebensburg	www.seniorlifepa.com	Senior LIFE Altoona Dual Eligible (PACE)	08	20		1			H5902	001	0	2018	Senior LIFE Blair Indiana Cambria County Dual		2	3350	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H5902	002	0	1	20	08	H5902_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:48 AM Eastern Daylight Time		05/24/2017 08:18:49 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE ALTOONA, INC.	Senior LIFE Ebensburg	www.seniorlifepa.com	Senior LIFE Altoona Medicare Only (PACE)	08	20		1			H5902	002	0	2018	Senior LIFE Balir Indiana Cambria County MC Only		2	12	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H5926	001	0	1	01	01	H5926_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:43:25 AM Pacific Daylight Time	08/04/2017 08:30:04 AM Pacific Daylight Time	08/01/2017 09:16:34 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF MICHIGAN, INC.	Molina Healthcare of Michigan	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5926	001	0	2018	Grand Rapids, Flint, Saginaw, Detroit		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(800)665-3072		(800)665-3072		(866)403-8293		(866)403-8293		(800)665-3072		(800)665-3072		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	001	0	1	01	01	H5928_001_0	9		1	1	2	08/03/2017	2018.03	08/03/2017 12:09:49 PM Pacific Daylight Time	08/02/2017 08:03:29 AM Pacific Daylight Time	08/02/2017 06:57:21 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	001	0	2018	Los Angeles County		2	780	2			1	3		2		1	www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	004	0	1	01	01	H5928_004_0	5			1		08/03/2017	2018.03	08/03/2017 11:38:18 AM Pacific Daylight Time	08/02/2017 08:04:47 AM Pacific Daylight Time	08/02/2017 07:05:05 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	004	0	2018	Los Angeles and Orange Counties		2	14200	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	005	0	1	01	01	H5928_005_0	9		1	1	2	08/03/2017	2018.03	08/03/2017 12:11:16 PM Pacific Daylight Time	08/02/2017 08:06:14 AM Pacific Daylight Time	08/02/2017 07:06:50 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	005	0	2018	Orange and San Bernardino Counties		2	485	2			1	3		2		1	www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	009	0	1	01	01	H5928_009_0	9		1	1	2	08/03/2017	2018.03	08/03/2017 12:13:04 PM Pacific Daylight Time	08/02/2017 08:07:32 AM Pacific Daylight Time	08/02/2017 07:07:35 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	009	0	2018	San Diego County		2	400	2			1	3		2		1	www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	010	0	1	01	01	H5928_010_0	5			1		08/03/2017	2018.03	08/03/2017 11:42:27 AM Pacific Daylight Time	08/02/2017 08:09:10 AM Pacific Daylight Time	08/02/2017 07:08:16 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	010	0	2018	San Diego County		2	7150	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	016	0	1	01	01	H5928_016_0	5			1		08/03/2017	2018.03	08/03/2017 12:04:06 PM Pacific Daylight Time	08/02/2017 01:13:08 PM Pacific Daylight Time	08/02/2017 07:08:46 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	016	0	2018	Santa Clara County		2	3500	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	037	0	1	01	01	H5928_037_0	5			1		08/03/2017	2018.03	08/03/2017 12:06:14 PM Pacific Daylight Time	08/02/2017 08:10:39 AM Pacific Daylight Time	08/02/2017 07:09:17 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Coordinated Choice Plan (HMO)	01	01		1			H5928	037	0	2018	Counties: LA, OR, SD, SB, RV, SC, FR, ME, SJ, ST		2	19640	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	038	0	1	01	01	H5928_038_0	7			1		08/03/2017	2018.03	08/03/2017 12:07:52 PM Pacific Daylight Time	08/02/2017 08:11:08 AM Pacific Daylight Time	08/02/2017 07:11:14 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	038	0	2018	El Paso County		2	5700	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5928	044	0	1	01	01	H5928_044_0	9			1		08/03/2017	2018.03	08/03/2017 11:58:49 AM Pacific Daylight Time	08/02/2017 08:11:41 AM Pacific Daylight Time	08/02/2017 07:11:59 AM Pacific Daylight Time			08/03/2017 12:18:28 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Health Plan	www.care1stmedicare.com	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	044	0	2018	Fresno County		2	795	2			2						www.care1stmedicare.com	www.care1stmedicare.com	www.care1stmedicare.com	(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(800)544-0088		(800)544-0088		(800)847-1222		(800)847-1222		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5932	001	0	1	01	01	H5932_001_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 01:48:08 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:31:25 PM Eastern Daylight Time	GATEWAY HEALTH PLAN, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Diamond (HMO SNP)	01	01		1			H5932	001	0	2018	Pennsylvania Counties		2	504705	2			1	3		1		1	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5932	009	0	1	01	01	H5932_009_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 01:30:27 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:34:16 PM Eastern Daylight Time	GATEWAY HEALTH PLAN, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Ruby (HMO SNP)	01	01		1			H5932	009	0	2018	Pennsylvania Counties		2	89660	2			1	3		2		2	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5932	010	0	1	01	01	H5932_010_0	9			1		08/04/2017	2018.03	08/04/2017 01:31:16 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:36:34 PM Eastern Daylight Time	GATEWAY HEALTH PLAN, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Select (HMO)	01	01		1			H5932	010	0	2018	Bucks, Delaware and Philadelphia, PA counties		2	5410	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5932	011	0	1	02	01	H5932_011_0	5			1		08/04/2017	2018.03	08/04/2017 01:32:01 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:39:06 PM Eastern Daylight Time	GATEWAY HEALTH PLAN, INC.	Gateway Health Medicare Assured	www.MedicareAssured.com	Gateway Health Medicare Assured Value (HMO-POS)	01	02		1			H5932	011	0	2018	Bucks, Delaware and Philadelphia, PA Counties		2	4800	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(800)685-5209		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5934	001	0	1	20	08	H5934_001_0	1			1		05/23/2017	2018.03	05/23/2017 12:25:41 PM Eastern Daylight Time		05/22/2017 04:36:42 PM Eastern Daylight Time			05/23/2017 12:29:28 PM Eastern Daylight Time	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope PACE	www.hopepace.org	Hope PACE (PACE)	08	20		1			H5934	001	0	2018	Lee, Charlotte and Collier Counties Florida		2		2			2						carekinesis.com	hopehcs.org/pace										(866)659-7223		(239)985-6400		(866)659-7223		(239)985-6400										(866)659-7223		(239)985-6400		(866)659-7223		(239)985-6400																
H5934	002	0	1	20	08	H5934_002_0	1			1		05/22/2017	2018.03	05/22/2017 04:48:52 PM Eastern Daylight Time		05/22/2017 04:38:20 PM Eastern Daylight Time			05/23/2017 12:29:28 PM Eastern Daylight Time	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope PACE	www.hopepace.org	Hope PACE (PACE)	08	20		1			H5934	002	0	2018	Lee, Charlotte and Collier Counties Florida		2		2			2						carekinesis.com	hopehcs.org/pace										(866)659-7223		(239)985-6400		(866)659-7223		(239)985-6400										(866)659-7223		(239)985-6400		(866)659-7223		(239)985-6400																
H5937	001	0	1	01	01	H5937_001_0	8		1	1	2	06/19/2017	2018.03	06/19/2017 04:18:19 PM Central Daylight Time	08/02/2017 11:25:49 AM Central Daylight Time	08/02/2017 12:49:39 PM Central Daylight Time			08/02/2017 03:52:45 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare Connect + Medicare (HMO SNP)	01	01		1			H5937	001	0	2018	Twin Cities Metro Area, Rochester, St. Cloud		2		2			1	3		1		1	www.ucare.org	www.ucare.org	www.ucare.org/Pages/FindADoctor	(855)260-9707		(612)676-3310		(800)707-1711		(612)676-3554		(855)260-9707		(612)676-3310		(800)707-1711		(612)676-3554		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		(800)688-2534		(612)676-6810		2					2					2	2			
H5938	001	0	1	01	01	H5938_001_0	12			1		07/19/2017	2018.03	07/19/2017 10:46:09 AM Eastern Daylight Time	08/07/2017 08:28:13 AM Eastern Daylight Time	08/07/2017 08:28:27 AM Eastern Daylight Time			08/07/2017 09:33:49 AM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Advantage Plus (HMO)	01	01		1			H5938	001	0	2018	Leon and surrounding counties		2	110255	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		2					2					2	2			
H5938	006	0	1	01	01	H5938_006_0	12			1		07/19/2017	2018.03	07/19/2017 10:46:53 AM Eastern Daylight Time	08/07/2017 08:28:18 AM Eastern Daylight Time	08/07/2017 08:28:34 AM Eastern Daylight Time			08/07/2017 09:33:49 AM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Preferred Advantage (HMO)	01	01		1			H5938	006	0	2018	Leon and surrounding counties		2	31319	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		2					2					2	2			
H5938	802	0	1	01	01	H5938_802_0	7			1		05/16/2017	2018.03	05/16/2017 03:42:28 PM Eastern Daylight Time					06/05/2017 09:43:42 AM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	802	0	2018	Leon and surrounding counties		1	98887	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7e;7i;8a;8b1;8b2;8b3;9a;9b;9c;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7d;7g;8a;8b1;8b2;8b3;9a;9b;9c;14a;14d;14e2;16b;	1					1				
H5938	803	0	1	01	01	H5938_803_0	7			1		05/30/2017	2018.03	05/30/2017 04:20:14 PM Eastern Daylight Time					06/05/2017 09:43:42 AM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	803	0	2018	Leon and surrounding counties		1	11913	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441										(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7e;7i;8a;8b1;8b2;8b3;9a;9b;9c;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7d;7g;8a;8b1;8b2;8b3;9a;9b;9c;14a;14d;14e2;16b;	1					1				
H5938	804	0	1	01	01	H5938_804_0	7			1		05/25/2017	2018.03	05/25/2017 10:29:28 AM Eastern Daylight Time					06/05/2017 09:43:42 AM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	804	0	2018	Leon and surrounding counties		1	20247	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)247-6512		(850)523-7441		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		(877)870-8943		(850)383-3534		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7e;7i;8a;8b1;8b2;8b3;9a;9b;9c;11a;11b;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7d;7g;8a;8b1;8b2;8b3;9a;9b;9c;14a;14d;14e2;16b;	1					1				
H5943	001	0	1	02	01	H5943_001_0	7		1	1		08/04/2017	2018.03	08/04/2017 10:13:14 AM Pacific Daylight Time		07/31/2017 04:02:50 PM Pacific Daylight Time		08/03/2017 04:11:00 PM Pacific Daylight Time	08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	VillageHealth	www.villagehealthca.com	VillageHealth (HMO-POS SNP)	01	02		1			H5943	001	0	2018	Riverside and  San Bernardino Counties		2		2			1	4			00000000100000000000		www.villagehealthca.com	www.villagehealthca.com	www.villagehealthca.com	(800)399-7226		(800)399-7226		(877)916-1234		(877)916-1234		(800)399-7226		(800)399-7226		(877)916-1234		(877)916-1234		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5943	002	0	1	02	01	H5943_002_0	6		1	1		08/04/2017	2018.03	08/04/2017 10:13:35 AM Pacific Daylight Time		07/31/2017 04:03:20 PM Pacific Daylight Time		08/03/2017 04:12:02 PM Pacific Daylight Time	08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	VillageHealth	www.villagehealthca.com	VillageHealth (HMO-POS SNP)	01	02		1			H5943	002	0	2018	Los Angeles and Orange Counties		2		2			1	4			00000000100000000000		www.villagehealthca.com	www.villagehealthca.com	www.villagehealthca.com	(800)399-7226		(800)399-7226		(877)916-1234		(877)916-1234		(800)399-7226		(800)399-7226		(877)916-1234		(877)916-1234		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	001	0	1	01	01	H5945_001_0	18			1		08/04/2017	2018.03	08/04/2017 04:40:30 PM Pacific Daylight Time	08/06/2017 08:18:12 AM Pacific Daylight Time	08/06/2017 08:18:14 AM Pacific Daylight Time			08/06/2017 12:07:01 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Plus (HMO)	01	01		1			H5945	001	0	2018	Northern Nevada		2	16002	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	002	0	1	01	01	H5945_002_0	14			1		08/04/2017	2018.03	08/04/2017 02:44:00 PM Pacific Daylight Time	08/06/2017 08:18:15 AM Pacific Daylight Time	08/06/2017 08:18:15 AM Pacific Daylight Time			08/06/2017 12:16:46 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Plus (HMO)	01	01		1			H5945	002	0	2018	Washoe County		2	35640	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	005	0	1	01	01	H5945_005_0	12			1		06/30/2017	2018.03	06/30/2017 09:42:38 AM Pacific Daylight Time	08/06/2017 08:18:16 AM Pacific Daylight Time	08/06/2017 08:18:16 AM Pacific Daylight Time			08/06/2017 12:19:35 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Enhanced (HMO)	01	01		1			H5945	005	0	2018	Washoe County		2	18360	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	006	0	1	01	01	H5945_006_0	12			1		08/04/2017	2018.03	08/04/2017 11:31:38 AM Pacific Daylight Time	08/06/2017 08:18:16 AM Pacific Daylight Time	08/06/2017 08:18:16 AM Pacific Daylight Time			08/06/2017 12:21:50 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Enhanced (HMO)	01	01		1			H5945	006	0	2018	Northern Nevada		2	9702	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	801	0	1	01	01	H5945_801_0	3			1		05/25/2017	2018.03	05/25/2017 10:15:37 AM Pacific Daylight Time					06/02/2017 06:58:51 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H5945	801	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H5945	802	0	1	01	01	H5945_802_0	3			1		05/19/2017	2018.03	05/19/2017 03:50:47 PM Pacific Daylight Time					06/02/2017 03:01:50 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H5945	802	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5945	803	0	1	01	01	H5945_803_0	3			1		05/19/2017	2018.03	05/19/2017 03:54:20 PM Pacific Daylight Time					06/02/2017 04:49:13 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H5945	803	0	2018	National		1	1	1	1		2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5959	001	0	1	04	01	H5959_001_0	6			1		07/13/2017	2018.03	07/13/2017 09:17:23 AM Central Daylight Time	08/03/2017 12:35:52 PM Central Daylight Time	08/03/2017 12:33:50 PM Central Daylight Time			08/04/2017 11:53:38 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross Blue Shield of Minnesota	www.bluecrossmnonline.com	Blue Cross Medicare Advantage Core (PPO)	01	04		1			H5959	001	0	2018	55 Counties		2	3008	2			2						www.myprime.com	www.myprime.com	www.bluecrossmnonline.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5959	003	0	1	04	01	H5959_003_0	6			1		07/13/2017	2018.03	07/13/2017 09:24:52 AM Central Daylight Time	08/03/2017 12:39:08 PM Central Daylight Time	08/03/2017 12:33:50 PM Central Daylight Time			08/04/2017 11:57:44 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	Blue Cross Blue Shield of Minnesota	www.bluecrossmnonline.com	Blue Cross Medicare Advantage Choice (PPO)	01	04		1			H5959	003	0	2018	55 Counties		2	34406	2			2						www.myprime.com	www.myprime.com	www.bluecrossmnonline.com	(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(866)340-8654		(651)662-5654		(877)662-2583		(651)662-2583		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5969	002	0	1	01	01	H5969_002_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 02:26:10 PM Hawaiian Standard Time	08/04/2017 03:12:46 PM Hawaiian Standard Time	07/31/2017 01:40:46 PM Hawaiian Standard Time			08/07/2017 12:48:13 PM Hawaiian Standard Time	ALOHACARE	AlohaCare	AlohaCare.org	AlohaCare Advantage Plus (HMO SNP)	01	01		1			H5969	002	0	2018	State of Hawaii		2	18304	2			1	3		2		2	AlohaCare.org	AlohaCare.org	AlohaCare.org	(866)973-6395		(808)973-6395		(866)973-6395		(808)973-6395		(866)973-6395		(808)973-6395		(866)973-6395		(808)973-6395		(877)447-5990		(877)447-5990		(877)447-5990		(877)447-5990		(877)447-5990		(877)447-5990		(877)447-5990		(877)447-5990		2					2					2	2			
H5970	001	0	1	04	01	H5970_001_0	3			1		06/28/2017	2018.03	06/28/2017 10:21:50 AM Eastern Daylight Time	08/05/2017 10:07:33 AM Eastern Daylight Time	08/04/2017 09:54:56 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-001 (PPO)	01	04		1			H5970	001	0	2018	Southern Tier Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	008	0	1	04	01	H5970_008_0	4			1		07/10/2017	2018.03	07/10/2017 09:10:08 AM Eastern Daylight Time	08/05/2017 10:06:59 AM Eastern Daylight Time	08/04/2017 09:54:57 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-008 (PPO)	01	04		1			H5970	008	0	2018	Capital Region		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	015	0	1	04	01	H5970_015_0	3			1		08/02/2017	2018.03	08/02/2017 03:39:28 PM Eastern Daylight Time	08/05/2017 10:16:07 AM Eastern Daylight Time	08/04/2017 09:54:57 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-015 (PPO)	01	04		1			H5970	015	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	016	0	1	04	01	H5970_016_0	2			1		06/28/2017	2018.03	06/28/2017 10:23:17 AM Eastern Daylight Time	06/01/2017 07:49:02 PM Eastern Daylight Time				06/29/2017 11:18:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	HumanaChoice H5970-016 (PPO)	01	04		1			H5970	016	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
H5970	017	0	1	04	01	H5970_017_0	3			1		08/02/2017	2018.03	08/02/2017 03:39:46 PM Eastern Daylight Time	08/05/2017 10:15:33 AM Eastern Daylight Time	08/04/2017 09:54:58 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-017 (PPO)	01	04		1			H5970	017	0	2018	Southern Tier Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	018	0	1	04	01	H5970_018_0	5			1		08/02/2017	2018.03	08/02/2017 02:11:03 PM Eastern Daylight Time	08/05/2017 10:16:41 AM Eastern Daylight Time	08/04/2017 09:54:58 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-018 (PPO)	01	04		1			H5970	018	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	019	0	1	04	01	H5970_019_0	3			1		06/28/2017	2018.03	06/28/2017 10:24:08 AM Eastern Daylight Time	08/05/2017 10:13:20 AM Eastern Daylight Time	08/04/2017 09:54:59 AM Eastern Daylight Time			08/06/2017 09:19:43 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	HumanaChoice H5970-019 (PPO)	01	04		1			H5970	019	0	2018	Select Counties in New York		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H5970	801	0	1	04	01	H5970_801_0	5			1		06/13/2017	2018.03	06/13/2017 10:19:54 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5970	801	0	2018	State of New York		1	21468	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5970	802	0	1	04	01	H5970_802_0	5			1		06/13/2017	2018.03	06/13/2017 10:20:47 AM Eastern Daylight Time					06/13/2017 10:39:51 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		1			H5970	802	0	2018	State of New York		1	60600	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5970	803	0	1	04	01	H5970_803_0	4			1		06/13/2017	2018.03	06/13/2017 10:22:22 AM Eastern Daylight Time					06/13/2017 10:47:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		1			H5970	803	0	2018	State of New York		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5970	805	0	2	04	01	H5970_805_0	4			1		06/13/2017	2018.03	06/13/2017 10:23:04 AM Eastern Daylight Time					06/13/2017 10:47:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5970	805	0	2018	State of New York		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5970	806	0	2	04	01	H5970_806_0	4			1		06/13/2017	2018.03	06/13/2017 10:24:37 AM Eastern Daylight Time					06/13/2017 10:47:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer (PPO)	01	04		2	1		H5970	806	0	2018	State of New York		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5970	807	0	2	04	01	H5970_807_0	4			1		06/13/2017	2018.03	06/13/2017 10:26:24 AM Eastern Daylight Time					06/13/2017 10:47:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer Non-CY (PPO)	01	04		2	1		H5970	807	0	2018	State of New York		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
H5978	001	0	1	20	08	H5978_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:55:57 AM Eastern Daylight Time		05/24/2017 08:17:56 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE LEHIGH VALLEY, INC.	PHI LIFE dba everyday LIFE	www.seniorlifepa.com	Senior LIFE Lehigh Valley Dual Eligible (PACE)	08	20		1			H5978	001	0	2018	Senior LIFE Northampton Lehigh County Dual		2	3400	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H5978	002	0	1	20	08	H5978_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:56:02 AM Eastern Daylight Time		05/24/2017 08:17:49 AM Eastern Daylight Time			05/25/2017 12:08:44 PM Eastern Daylight Time	SENIOR LIFE LEHIGH VALLEY, INC.	PHI LIFE dba everyday LIFE	www.everydaylifecenters.org	Senior LIFE Lehigh Valley MC Only (PACE)	08	20		1			H5978	002	0	2018	Senior LIFE Lehigh and Northampton County MC Only		2	12	2			2						http://granerx.com/	NA										(877)998-5433	22102	(814)535-6000	22102	(877)998-5433	22102	(814)535-6000	22102									(877)998-5433		(814)535-6000		(877)998-5433		(814)535-6000																
H5989	002	0	1	01	01	H5989_002_0	8		1	1		06/23/2017	2018.03	06/23/2017 11:20:27 AM Central Daylight Time	08/02/2017 09:26:09 AM Central Daylight Time	08/02/2017 09:19:09 AM Central Daylight Time			08/04/2017 03:38:18 PM Central Daylight Time	CENTERLIGHT HEALTHCARE, INC.	CenterLight Healthcare	www.centerlighthealthcare.org	CenterLight Healthcare Direct Complete Plan (HMO SNP)	01	01		1			H5989	002	0	2018	NYC, LI, Westchester and Rockland Counties		2	10020	2			1	1	3				www.centerlighthealthcare.org	www.centerlighthealthcare.org	www.centerlighthealthcare.org	(877)226-8500		(347)640-6000		(877)226-8500		(347)640-6000		(877)226-8500		(877)226-8500		(877)226-8500		(347)640-6280		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5991	001	0	1	01	01	H5991_001_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 03:29:27 PM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time			08/07/2017 09:55:36 AM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinitymedicareplan.org	Affinity Medicare Ultimate (HMO SNP)	01	01		1			H5991	001	0	2018	NYC, Nassau ,Orange, Rockland, Suffolk,Westchester		2	87475	2			1	3		1		1	www.affinitymedicareplan.org	www.affinitymedicareplan.org	www.affinitymedicareplan.org	(877)234-4499		(877)234-4499		(877)234-4499		(877)234-4499		(866)362-4002		(866)362-4002		(877)234-4499		(877)234-4499		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5991	002	0	1	01	01	H5991_002_0	5		1	1	2	08/09/2017	2018.03	08/09/2017 11:47:14 AM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time			08/09/2017 11:47:43 AM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinitymedicareplan.org	Affinity Medicare Solutions (HMO SNP)	01	01		1			H5991	002	0	2018	NYC, Nassau ,Orange, Rockland, Suffolk,Westchester		2	22069	2			1	3		2		1	www.affinitymedicareplan.org	www.affinitymedicareplan.org	www.affinitymedicareplan.org	(877)234-4499		(877)234-4499		(877)234-4499		(877)234-4499		(866)362-4002		(866)362-4002		(877)234-4499		(877)234-4499		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5991	003	0	1	01	01	H5991_003_0	3			1		08/04/2017	2018.03	08/04/2017 03:30:42 PM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time			08/07/2017 09:55:36 AM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinitymedicareplan.org	Affinity Medicare Passport Essentials (HMO)	01	01		1			H5991	003	0	2018	Nassau,Orange, Rockland, Westchester		2	39845	2			2						www.affinitymedicareplan.org	www.affinitymedicareplan.org	www.affinitymedicareplan.org	(877)234-4499		(877)234-4499		(877)234-4499		(877)234-4499		(866)362-4002		(866)362-4002		(877)234-4499		(877)234-4499		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5991	006	0	1	01	01	H5991_006_0	3			1		08/04/2017	2018.03	08/04/2017 03:31:00 PM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time	08/07/2017 09:53:47 AM Eastern Daylight Time			08/07/2017 09:55:36 AM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinitymedicareplan.org	Affinity Medicare Passport Essentials NYC (HMO)	01	01		1			H5991	006	0	2018	NY, Bronx, Queens, Kings, Richmond		2	28532	2			2						www.affinitymedicareplan.org	www.affinitymedicareplan.org	www.affinitymedicareplan.org	(877)234-4499		(877)234-4499		(877)234-4499		(877)234-4499		(866)362-4002		(866)362-4002		(877)234-4499		(877)234-4499		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5992	007	0	1	01	01	H5992_007_0	3		1	1	2	08/04/2017	2018.03	08/04/2017 09:51:36 AM Eastern Daylight Time	08/03/2017 12:32:32 PM Eastern Daylight Time	08/03/2017 12:37:30 PM Eastern Daylight Time			08/06/2017 12:42:55 AM Eastern Daylight Time	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Senior Whole Health of New York	www.seniorwholehealth.com	Senior Whole Health of New York NHC (HMO SNP)	01	01		1			H5992	007	0	2018	Counties: Ki, Qu, Brx, NY, Wes, and Na		2	1656	2			1	3		2		1	www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(877)353-0185		(877)353-0185		(877)353-0188		(877)353-0188		(877)353-0185		(877)353-0185		(877)353-0188		(877)353-0188		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H5995	001	0	1	01	01	H5995_001_0	7		1	1	2	08/05/2017	2018.03	08/05/2017 08:33:34 AM Pacific Daylight Time	08/04/2017 11:32:06 AM Pacific Daylight Time	07/31/2017 05:33:16 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Special Needs Plan (Willamette) (HMO SNP)	01	01		1			H5995	001	0	2018	Marion and Polk Counties		2	39900	2			1	3		2		2	atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2					2	2			
H6059	001	0	1	20	08	H6059_001_0	3			1		05/24/2017	2018.03	05/24/2017 02:31:11 PM Eastern Daylight Time		07/19/2017 10:31:44 AM Eastern Daylight Time			07/19/2017 10:35:10 AM Eastern Daylight Time	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	PACE OF THE TRIAD	www.pacetriad.org	PACE of The Triad - Dual (PACE)	08	20		1			H6059	001	0	2018	PACE of The Triad - Dual		2		2			2						www.pacetriad.org	www.pacetriad.org										(336)550-4040		(336)550-4040		(336)550-4040		(336)550-4040										(800)735-2962		(800)735-2962		(800)735-2962		(800)735-2962																
H6059	002	0	1	20	08	H6059_002_0	2			1		05/24/2017	2018.03	05/24/2017 02:32:05 PM Eastern Daylight Time		07/19/2017 09:30:38 AM Eastern Daylight Time			07/19/2017 09:48:41 AM Eastern Daylight Time	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	PACE OF THE TRIAD	www.pacetriad.org	PACE of The Triad - Medicare only (PACE)	08	20		1			H6059	002	0	2018	PACE of The Triad - Medicare only		2		2			2						www.pacetriad.org	www.pacetriad.org										(336)550-4040		(336)550-4040		(336)550-4040		(336)550-4040										(800)735-2962		(800)735-2962		(800)735-2962		(800)735-2962																
H6079	001	0	1	20	08	H6079_001_0	2			1		05/19/2017	2018.03	05/19/2017 03:32:39 PM Mountain Daylight Time		05/19/2017 03:25:49 PM Mountain Daylight Time			05/19/2017 03:35:51 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	InnovAge Greater California PACE	www.myinnovage.org	InnovAge Greater California PACE (PACE)	08	20		1			H6079	001	0	2018	San Bernardino and Riverside counties		2		2			2						www.pharmerica.com	www.totallongtermcare.org										(877)653-0015		(909)890-2800		(877)653-0015		(909)890-2800										(877)653-0015		(877)653-0015		(877)653-0015		(877)653-0015																
H6079	002	0	1	20	08	H6079_002_0	2			1		05/19/2017	2018.03	05/19/2017 03:33:04 PM Mountain Daylight Time		05/19/2017 03:26:21 PM Mountain Daylight Time			05/19/2017 03:35:51 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	InnovAge Greater California PACE	www.myinnovage.org	InnovAge Greater California PACE (PACE)	08	20		1			H6079	002	0	2018	San Bernardino and Riverside counties		2		2			2						www.pharmerica.com	www.totallongtermcare.org										(877)653-0015		(909)890-2800		(877)653-0015		(909)890-2800										(877)653-0015		(877)653-0015		(877)653-0015		(877)653-0015																
H6080	001	0	1	48	05	H6080_001_0	4			1		09/18/2017	2018.03	09/18/2017 09:44:09 PM Eastern Daylight Time					09/18/2017 09:44:53 PM Eastern Daylight Time	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Meridian Complete	www.mhplan.com	Meridian Complete (Medicare-Medicaid Plan)	05	48		1			H6080	001	0	2018	Greater Chicago		2	82008	2			2						www.mhplan.com	www.mhplan.com	www.mhplan.com	(855)580-1689		(855)580-1689		(855)647-0075		(855)647-0075		(855)580-1689		(855)580-1689		(855)647-0075		(855)647-0075		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H6154	001	0	1	02	01	H6154_001_0	7			1		06/23/2017	2018.03	06/23/2017 02:09:13 PM Central Daylight Time	08/02/2017 04:29:31 PM Central Daylight Time	08/02/2017 04:26:38 PM Central Daylight Time			08/02/2017 04:48:29 PM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	medica.com	Medica Advantage Solution Edge (HMO-POS)	01	02		1			H6154	001	0	2018	Minneapolis/St. Paul Metro Area		2	12005	2			2						medica.com/Members	medica.com/Members	medica.com/Members	(866)269-6804		(952)992-2134		(800)906-5432		(952)992-2345		(866)269-6804		(952)992-2134		(800)906-5432		(952)992-2345		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6188	001	0	1	20	08	H6188_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:05:29 PM Eastern Daylight Time		05/24/2017 04:23:31 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE ARMSTRONG, LLC	LIFE Armstrong	www.lutheranseniorlife.org	VieCare Armstrong, LLC dba LIFE Armstrong County (PACE)	08	20		1			H6188	001	0	2018	Armstrong County		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)545-8000		(724)545-8000		(724)545-8000		(724)545-8000										(711)-		(711)-		(724)545-8000		(724)545-8000																
H6188	002	0	1	20	08	H6188_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:06:16 PM Eastern Daylight Time		05/24/2017 04:23:32 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE ARMSTRONG, LLC	LIFE Armstrong	www.lutheranseniorlife.org	VieCare Armstrong, LLC dba LIFE Armstrong County (PACE)	08	20		1			H6188	002	0	2018	Armstrong County		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)545-8000		(724)545-8000		(724)545-8000		(724)545-8000										(711)-		(711)-		(724)545-8000		(724)545-8000																
H6229	005	0	1	48	05	H6229_005_0	6			1		09/18/2017	2018.03	09/18/2017 09:44:56 AM Pacific Daylight Time					09/18/2017 09:49:19 AM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Anthem Blue Cross Cal MediConnect	duals.caremore.com	CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)	05	48		1			H6229	005	0	2018	Los Angeles County (Partial)		2	42250	2			2						duals.caremore.com	duals.caremore.com	duals.caremore.com	(888)350-3447		(888)350-3447		(888)350-3447		(888)350-3447		(888)350-3447		(888)350-3447		(888)350-3447		(888)350-3447		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H6229	006	0	1	48	05	H6229_006_0	7			1		09/18/2017	2018.03	09/18/2017 10:06:55 AM Pacific Daylight Time					09/18/2017 10:09:59 AM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Anthem Blue Cross Cal MediConnect	mss.anthem.com/cammp	Anthem Blue Cross Cal MediConnect (Medicare-Medicaid Plan)	05	48		1			H6229	006	0	2018	Santa Clara County		2	37686	2			2						mss.anthem.com/cammp	mss.anthem.com/cammp	mss.anthem.com/cammp	(855)817-5785		(855)817-5785		(855)817-5785		(855)817-5785		(855)817-5785		(855)817-5785		(855)817-5785		(855)817-5785		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H6231	001	0	1	20	08	H6231_001_0	1			1		05/24/2017	2018.03	05/24/2017 12:08:13 PM Central Daylight Time		05/24/2017 07:12:00 AM Central Daylight Time			05/24/2017 12:12:54 PM Central Daylight Time	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.ololrmc.com	Franciscan PACE, Inc. (PACE)	08	20		1			H6231	001	0	2018	PACE Baton Rouge		2		2			2						www.ololrmc.com	www.ololrmc.com										(800)789-2863		(225)490-0604		(800)789-2863		(225)490-0604										(800)789-2863		(225)490-0604		(800)789-2863		(225)490-0604																
H6231	002	0	1	20	08	H6231_002_0	1			1		05/24/2017	2018.03	05/24/2017 12:09:41 PM Central Daylight Time		05/24/2017 07:11:50 AM Central Daylight Time			05/24/2017 12:12:54 PM Central Daylight Time	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.fmolhs.org	Franciscan PACE, Inc. (PACE)	08	20		1			H6231	002	0	2018	PACE Baton Rouge		2		2			2						www.ololrmc.com	www.ololrmc.com										(800)789-2863		(225)490-0604		(800)789-2863		(225)490-0604										(800)789-2863		(225)490-0604		(800)789-2863		(225)490-0604																
H6237	004	0	1	01	01	H6237_004_0	8			1		08/03/2017	2018.03	08/03/2017 03:42:48 PM Mountain Daylight Time	08/04/2017 05:10:55 PM Mountain Daylight Time	08/01/2017 06:57:42 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence BlueAdvantage HMO (HMO)	01	01		1			H6237	004	0	2018	Portland Metro Area and Clark County, WA		2	31163	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6237	005	0	1	01	01	H6237_005_0	9			1		07/07/2017	2018.03	07/07/2017 02:10:07 PM Mountain Daylight Time	08/04/2017 05:12:36 PM Mountain Daylight Time	08/01/2017 06:58:41 PM Mountain Daylight Time			08/05/2017 11:42:08 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence BlueAdvantage HMO Plus (HMO)	01	01		1			H6237	005	0	2018	Portland Metro Area and Clark County, WA		2	39097	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(855)522-8896		(855)522-8896		(888)369-3171		(888)369-3171		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6237	803	0	1	01	01	H6237_803_0	3			1		05/22/2017	2018.03	05/22/2017 02:10:14 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OREGON	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence BlueAdvantage HMO (HMO)	01	01		1			H6237	803	0	2018	Portland Metro Area and Clark County, WA		1	12	2			2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare	(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;7c;7e;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	1	7d;7f;7g;	1					1				
H6306	002	0	1	01	01	H6306_002_0	5			1		07/27/2017	2018.03	07/27/2017 03:37:22 PM Pacific Daylight Time	08/05/2017 01:48:03 PM Pacific Daylight Time	08/03/2017 12:26:56 PM Pacific Daylight Time			08/07/2017 11:27:42 AM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct HMO Plus (HMO)	01	01		1			H6306	002	0	2018	South Central North Carolina		2	70560	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6306	003	0	1	01	01	H6306_003_0	5			1		08/03/2017	2018.03	08/03/2017 01:37:08 PM Pacific Daylight Time	08/05/2017 01:50:50 PM Pacific Daylight Time	08/03/2017 12:29:41 PM Pacific Daylight Time			08/07/2017 11:27:42 AM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct HMO Standard (HMO)	01	01		1			H6306	003	0	2018	South Central North Carolina		2	6000	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6306	005	0	1	02	01	H6306_005_0	8			1		08/03/2017	2018.03	08/03/2017 03:56:15 PM Pacific Daylight Time	08/02/2017 08:39:36 AM Pacific Daylight Time	07/31/2017 03:09:47 PM Pacific Daylight Time			08/03/2017 04:29:55 PM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct smartHMO (HMO-POS)	01	02		1			H6306	005	0	2018	Wake County		2	8400	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)499-5630		(844)499-5630		(855)903-5154		(855)903-5154		(844)499-5630		(844)499-5630		(844)499-5630		(844)499-5630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6306	006	0	1	01	01	H6306_006_0	5			1		07/19/2017	2018.03	07/19/2017 10:02:09 AM Pacific Daylight Time	08/02/2017 08:40:24 AM Pacific Daylight Time	07/31/2017 03:10:08 PM Pacific Daylight Time			08/03/2017 04:29:55 PM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct preferredPLUS (HMO)	01	01		1			H6306	006	0	2018	Wake County		2	3600	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)499-5630		(844)499-5630		(855)903-5154		(855)903-5154		(844)499-5630		(844)499-5630		(844)499-5630		(844)499-5630		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6306	007	0	1	01	01	H6306_007_0	4			1		07/10/2017	2018.03	07/10/2017 05:41:30 PM Pacific Daylight Time	08/05/2017 01:58:08 PM Pacific Daylight Time	08/03/2017 12:30:20 PM Pacific Daylight Time			08/07/2017 11:27:42 AM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct Healthy State HMO Plus (HMO)	01	01		1			H6306	007	0	2018	Western North Carolina		2	7337	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6306	010	0	1	01	01	H6306_010_0	4			1		07/10/2017	2018.03	07/10/2017 05:42:35 PM Pacific Daylight Time	08/05/2017 02:00:48 PM Pacific Daylight Time	08/03/2017 12:31:00 PM Pacific Daylight Time			08/07/2017 11:27:42 AM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct Healthy State HMO Prime (HMO)	01	01		1			H6306	010	0	2018	Western North Carolina		2	4891	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6308	001	0	1	48	05	H6308_001_0	4			1		07/17/2017	2018.03	07/17/2017 10:32:05 AM Eastern Daylight Time					07/17/2017 10:33:01 AM Eastern Daylight Time	AGEWELL NEW YORK, LLC	AgeWell New York FIDA Plan	www.agewellnewyork.com	AgeWell New York FIDA Plan (Medicare-Medicaid Plan)	05	48		1			H6308	001	0	2018	Ki, Qu, Brx, NY, Wes, Suf, Na		2	900	2			2						www.agewellnewyork.com	www.agewellnewyork.com	www.agewellnewyork.com	(866)586-8044		(866)586-8044		(866)586-8044		(866)586-8044		(855)889-0046		(855)889-0046		(866)586-8044		(866)586-8044		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220																
H6310	001	0	1	20	08	H6310_001_0	2			1		06/02/2017	2018.03	06/02/2017 05:13:11 PM Eastern Daylight Time		07/28/2017 10:40:17 AM Eastern Daylight Time			07/28/2017 10:43:26 AM Eastern Daylight Time	INOVACARES	InovaCares for Seniors	www.Inova.org	InovaCares for Seniors Dual Eligible (PACE)	08	20		1			H6310	001	0	2018	Northern Virginia		2		2			2						www.carekinesis.com	www.inova.org										(877)409-2811		(703)239-5888		(877)409-2811		(703)239-5888										(888)206-8041		(703)776-4815		(888)206-8041		(703)776-4815																
H6310	002	0	1	20	08	H6310_002_0	2			1		06/02/2017	2018.03	06/02/2017 05:13:35 PM Eastern Daylight Time		07/28/2017 10:40:36 AM Eastern Daylight Time			07/28/2017 10:43:26 AM Eastern Daylight Time	INOVACARES	InovaCares for Seniors	www.Inova.org	InovaCares for Seniors Medicare Only (PACE)	08	20		1			H6310	002	0	2018	Northern Virginia		2		2			2						www.carekinesis.com	www.inova.org										(877)409-2811		(703)239-5888		(877)409-2811		(703)239-5888										(888)206-8041		(703)776-4815		(888)206-8041		(703)776-4815																
H6320	001	0	1	01	01	H6320_001_0	6		1	1		08/01/2017	2018.03	08/01/2017 03:47:54 PM Central Daylight Time		08/03/2017 04:28:25 PM Central Daylight Time		08/03/2017 04:28:22 PM Central Daylight Time	08/03/2017 04:34:28 PM Central Daylight Time	FRESENIUS HEALTH PLANS OF NORTH CAROLINA, INC.	Fresenius Health Plans	www.esrdplans.com	Fresenius Total Health (HMO SNP)	01	01		1			H6320	001	0	2018	Durham, Orange, and Wake Counties		2	2032	2			1	4			00000000100000000000		www.esrdplans.com	www.esrdplans.com	www.esrdplans.com	(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		2					2					2	2			
H6328	001	0	1	04	01	H6328_001_0	5			1		08/07/2017	2018.03	08/07/2017 02:23:40 PM Eastern Daylight Time	08/07/2017 02:28:02 PM Eastern Daylight Time	08/04/2017 02:42:27 PM Eastern Daylight Time			08/07/2017 04:46:30 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice Premium (PPO)	01	04		1			H6328	001	0	2018	Dallas/Fort Worth Metro Area		2	16000	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6328	002	0	1	04	01	H6328_002_0	4			1		08/04/2017	2018.03	08/04/2017 02:06:20 PM Eastern Daylight Time	08/07/2017 02:29:17 PM Eastern Daylight Time	08/04/2017 02:43:28 PM Eastern Daylight Time			08/07/2017 04:46:30 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice Plus (PPO)	01	04		1			H6328	002	0	2018	Dallas/Fort Worth Metro Area		2	46000	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6328	003	0	1	04	01	H6328_003_0	4			1		08/07/2017	2018.03	08/07/2017 02:27:57 PM Eastern Daylight Time	08/07/2017 02:31:43 PM Eastern Daylight Time	08/04/2017 02:44:35 PM Eastern Daylight Time			08/07/2017 04:46:30 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice (PPO)	01	04		1			H6328	003	0	2018	Dallas/Fort Worth Metro Area		2	75000	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6328	005	0	1	04	01	H6328_005_0	3			1		07/11/2017	2018.03	07/11/2017 10:12:51 AM Eastern Daylight Time	06/04/2017 03:51:29 PM Eastern Daylight Time				07/11/2017 03:39:00 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice MA-Only (PPO)	01	04		1			H6328	005	0	2018	Dallas/Fort Worth Metro Area		2	3600	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622										(711)-		(711)-		(711)-		(711)-										2					2						2			
H6328	801	0	1	04	01	H6328_801_0	1			1		05/03/2017	2018.03	05/03/2017 09:29:14 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice CY - MAPD (PPO)	01	04		1			H6328	801	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6328	802	0	1	04	01	H6328_802_0	1			1		05/03/2017	2018.03	05/03/2017 09:29:24 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice NCY - MAPD (PPO)	01	04		1			H6328	802	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622		(855)791-5302		(855)791-5302		(877)665-2622		(877)665-2622		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6328	803	0	1	04	01	H6328_803_0	1			1		05/03/2017	2018.03	05/03/2017 09:29:31 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice CY - MA-Only (PPO)	01	04		1			H6328	803	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622										(711)-		(711)-		(711)-		(711)-										2					2						2			
H6328	804	0	1	04	01	H6328_804_0	1			1		05/03/2017	2018.03	05/03/2017 09:29:39 AM Eastern Daylight Time					06/04/2017 09:24:12 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N Care Insurance Company	www.cnchealthplan.com	Care N' Care Choice NCY - MA-Only (PPO)	01	04		1			H6328	804	0	2018	Nationwide		1	1	2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)374-7993		(877)374-7993		(877)665-2622		(877)665-2622										(711)-		(711)-		(711)-		(711)-										2					2						2			
H6342	001	0	1	20	08	H6342_001_0	1			1		05/23/2017	2018.03	05/23/2017 03:44:38 PM Central Daylight Time		05/23/2017 03:33:10 PM Central Daylight Time			05/23/2017 03:47:50 PM Central Daylight Time	COMPLETE HEALTH WITH PACE	Complete Health with PACE	www.completehealthwithpace.org	Complete Health with PACE (PACE)	08	20		1			H6342	001	0	2018	Central Arkansas		2		2			2						www.CareKinesis.com	https://www.completehealthwithpace.org												(501)376-8852				(501)376-8852												(501)688-7462				(501)688-7462																
H6342	002	0	1	20	08	H6342_002_0	1			1		05/23/2017	2018.03	05/23/2017 03:45:28 PM Central Daylight Time		05/23/2017 03:35:24 PM Central Daylight Time			05/23/2017 03:47:50 PM Central Daylight Time	COMPLETE HEALTH WITH PACE	Complete Health with PACE	www.completehealthwithpace.org	Complete Health with PACE (PACE)	08	20		1			H6342	002	0	2018	Central Arkansas		2		2			2						www.CareKinesis.com	https://www.completehealthwithpace.org												(501)376-8852				(501)376-8852												(501)688-7462				(501)688-7462																
H6348	001	0	1	04	01	H6348_001_0	2			1		08/03/2017	2018.03	08/03/2017 09:03:04 AM Eastern Daylight Time	08/04/2017 04:35:02 PM Pacific Daylight Time	08/04/2017 04:35:26 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.mhsindiana.com	Allwell Medicare (PPO)	01	04		1			H6348	001	0	2018	Central Indiana		2		2			2						www.centene.com	www.centene.com	https://allwell.mhsindiana.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H6348	002	0	1	04	01	H6348_002_0	2			1		08/03/2017	2018.03	08/03/2017 09:02:54 AM Eastern Daylight Time	08/04/2017 04:35:02 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.mhsindiana.com	Allwell Medicare (PPO)	01	04		1			H6348	002	0	2018	North East Indiana		2		2			2						www.centene.com	www.centene.com	https://allwell.mhsindiana.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H6348	003	0	1	04	01	H6348_003_0	2			1		08/03/2017	2018.03	08/03/2017 09:02:44 AM Eastern Daylight Time	08/04/2017 04:35:02 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	COORDINATED CARE CORPORATION	Allwell	www.allwell.mhsindiana.com	Allwell Medicare (PPO)	01	04		1			H6348	003	0	2018	South West Indiana		2		2			2						www.centene.com	www.centene.com	https://allwell.mhsindiana.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2						2			
H6351	001	0	1	01	01	H6351_001_0	4		1	1		08/04/2017	2018.03	08/04/2017 05:43:38 PM Central Daylight Time	08/07/2017 10:57:53 AM Central Daylight Time	08/07/2017 10:58:04 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	LIBERTY ADVANTAGE, LLC	Liberty Advantage (HMO SNP)	www.libertyadvantageplan.com	Liberty Advantage (HMO SNP)	01	01		1			H6351	001	0	2018	North Carolina (partial)		2	5760	2			1	1	3				www.libertyadvantageplan.com	www.libertyadvantageplan.com	www.libertyadvantageplan.com	(888)854-6884		(888)854-6884		(888)854-6884		(888)854-6884		(888)854-6884		(888)854-6884		(888)854-6884		(888)854-6884		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6371	001	0	1	20	08	H6371_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:07:28 PM Eastern Daylight Time		05/23/2017 04:57:50 PM Eastern Daylight Time			05/24/2017 01:42:59 PM Eastern Daylight Time	LUTHERAN SENIOR HEALTHCARE, INC.	Lutheran Senior LIFE	www.lifelsmnj.org	Lutheran Senior Healthcare (PACE)	08	20		1			H6371	001	0	2018	Lutheran Senior LIFE Hudson County		2		2			2						www.lifelsmnj.org	www.lifelsmnj.org										(877)543-3188		(201)706-2091		(877)543-3188		(201)706-2091										(877)543-3188		(201)706-2091		(877)543-3188		(201)706-2091																
H6371	002	0	1	20	08	H6371_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:20 PM Eastern Daylight Time		05/23/2017 04:57:37 PM Eastern Daylight Time			05/24/2017 01:42:59 PM Eastern Daylight Time	LUTHERAN SENIOR HEALTHCARE, INC.	Lutheran Senior LIFE	www.lifelsmnj.org	Lutheran Senior Healthcare (PACE)	08	20		1			H6371	002	0	2018	Lutheran Senior LIFE Hudson County		2		2			2						www.lifelsmnj.org	www.lifelsmnj.org										(877)543-3188		(201)706-2091		(877)543-3188		(201)706-2091										(877)543-3188		(201)706-2091		(877)543-3188		(201)706-2091																
H6396	001	0	1	01	01	H6396_001_0	8			1		07/21/2017	2018.03	07/21/2017 02:26:32 PM Eastern Daylight Time	08/03/2017 04:15:44 PM Eastern Daylight Time	08/02/2017 03:36:30 PM Eastern Daylight Time			08/07/2017 01:57:19 PM Eastern Daylight Time	CARESOURCE	CareSource	www.caresource.com/medicare	CareSource Advantage (HMO)	01	01		1			H6396	001	0	2018	Ohio		2	10909	2			2						http:\\caresource.com	www.caresource.com/medicare	https://memberportal.caresource.com/App/OH/FindADoctor/MA	(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H6396	002	0	1	01	01	H6396_002_0	8			1		07/21/2017	2018.03	07/21/2017 02:26:02 PM Eastern Daylight Time	08/03/2017 04:15:32 PM Eastern Daylight Time	08/02/2017 03:37:06 PM Eastern Daylight Time			08/07/2017 01:57:19 PM Eastern Daylight Time	CARESOURCE	CareSource	www.caresource.com/medicare	CareSource Advantage Plus (HMO)	01	01		1			H6396	002	0	2018	Ohio		2	8262	2			2						http:\\caresource.com	www.caresource.com/medicare	https://memberportal.caresource.com/App/OH/FindADoctor/MA	(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H6396	004	0	1	01	01	H6396_004_0	8			1		08/03/2017	2018.03	08/03/2017 04:50:26 PM Eastern Daylight Time	08/03/2017 04:17:10 PM Eastern Daylight Time	08/02/2017 03:37:44 PM Eastern Daylight Time			08/07/2017 01:57:19 PM Eastern Daylight Time	CARESOURCE	CareSource	www.caresource.com/medicare	CareSource Advantage Zero Premium (HMO)	01	01		1			H6396	004	0	2018	Ohio		2	9503	2			2						http:\\caresource.com	www.caresource.com/medicare	https://memberportal.caresource.com/App/OH/FindADoctor/MA	(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(844)607-2827		(844)607-2827		(844)607-2830		(844)607-2830		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		2					2					2	2			
H6435	001	0	1	48	05	H6435_001_0	3			1		07/07/2017	2018.03	07/07/2017 10:24:15 AM Eastern Daylight Time					07/07/2017 02:23:41 PM Eastern Daylight Time	ELDERSERVE HEALTH, INC.	RiverSpring FIDA Plan	www.riverspringFIDA.org	RiverSpring FIDA Plan (Medicare-Medicaid Plan)	05	48		1			H6435	001	0	2018	Brx, Ki, Na, NY, Qu, Ri, Wes		2	144	2			2						www.riverspringFIDA.org	www.riverspringFIDA.org	www.riverspringFIDA.org	(800)950-9000		(800)950-9000		(800)950-9000		(800)950-9000		(855)898-1482		(855)898-1482		(855)898-1482		(855)898-1482		(711)-		(711)-		(711)-		(711)-		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																
H6453	001	0	1	01	01	H6453_001_0	6			1		08/07/2017	2018.03	08/07/2017 12:17:53 PM Central Daylight Time	08/07/2017 11:27:33 AM Central Daylight Time	08/07/2017 11:27:25 AM Central Daylight Time			08/07/2017 01:42:18 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	001	0	2018	Baton Rouge		2	25032	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6453	002	0	1	01	01	H6453_002_0	6			1		08/07/2017	2018.03	08/07/2017 12:18:09 PM Central Daylight Time	08/07/2017 11:27:27 AM Central Daylight Time	08/07/2017 11:27:27 AM Central Daylight Time			08/07/2017 01:42:18 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	002	0	2018	Greater New Orleans		2	25788	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6453	003	0	1	01	01	H6453_003_0	6			1		08/07/2017	2018.03	08/07/2017 12:18:23 PM Central Daylight Time	08/07/2017 11:27:29 AM Central Daylight Time	08/07/2017 11:27:30 AM Central Daylight Time			08/07/2017 01:42:18 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	003	0	2018	North Shore		2	24180	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6453	004	0	1	01	01	H6453_004_0	6			1		08/07/2017	2018.03	08/07/2017 12:18:37 PM Central Daylight Time	08/07/2017 11:27:31 AM Central Daylight Time	08/07/2017 11:27:32 AM Central Daylight Time			08/07/2017 01:42:18 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	004	0	2018	Acadiana		2	17712	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6453	801	0	1	01	01	H6453_801_0	1			1		05/30/2017	2018.03	05/30/2017 03:55:52 PM Central Daylight Time					05/31/2017 02:56:56 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	801	0	2018	Parts of Southeast Louisiana		1	2352	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;15;	2		1					1				
H6453	802	0	1	01	01	H6453_802_0	1			1		05/30/2017	2018.03	05/30/2017 03:59:17 PM Central Daylight Time					05/31/2017 02:56:56 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	802	0	2018	Parts of Southeast Louisiana		1	24	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;15;	2		1					1				
H6453	803	0	1	01	01	H6453_803_0	1			1		05/30/2017	2018.03	05/30/2017 03:59:37 PM Central Daylight Time					05/31/2017 02:56:56 PM Central Daylight Time	HMO LOUISIANA, INC.	HMO Louisiana	www.bcbsla.com/blueadvantage	Blue Advantage (HMO)	01	01		1			H6453	803	0	2018	Parts of Southeast Louisiana		1	24	2			2						www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	www.bcbsla.com/blueadvantage	(866)508-7145		(866)508-7145		(800)363-9152		(800)363-9152										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;15;	2		1					1				
H6502	001	0	1	04	01	H6502_001_0	7			1		08/07/2017	2018.03	08/07/2017 07:28:06 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time	08/07/2017 07:24:40 AM Central Daylight Time			08/07/2017 07:29:13 AM Central Daylight Time	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Access (PPO)	01	04		1			H6502	001	0	2018	Kansas City Area		2	12000	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6502	801	0	1	04	01	H6502_801_0	3			1		06/01/2017	2018.03	06/01/2017 01:52:07 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group MA-CY (PPO)	01	04		1			H6502	801	0	2018	Kansas City Area		1	2400	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H6502	802	0	1	04	01	H6502_802_0	3			1		06/01/2017	2018.03	06/01/2017 01:55:09 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group MAPD - CY (PPO)	01	04		1			H6502	802	0	2018	Kansas City Area		1	12000	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H6502	803	0	1	04	01	H6502_803_0	3			1		06/01/2017	2018.03	06/01/2017 01:54:46 PM Central Daylight Time					06/05/2017 02:34:52 PM Central Daylight Time	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	Blue Cross and Blue Shield of Kansas City (Blue KC	www.BlueKCMA.com	Blue Medicare Advantage Employer Group MAPD - BY (PPO)	01	04		1			H6502	803	0	2018	Kansas City Area		1	2400	2			2						www.BlueKCMA.com	www.BlueKCMA.com	www.BlueKCMA.com	(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(866)508-7140		(866)508-7140		(855)208-8246		(816)395-3152		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H6526	001	0	1	01	01	H6526_001_0	4			1		08/02/2017	2018.03	08/02/2017 01:46:00 PM Central Daylight Time	08/03/2017 01:42:13 PM Central Daylight Time	08/01/2017 11:32:47 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW MEXICO, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H6526	001	0	2018	Bernalillo, Sandoval, and Valencia counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6526	002	0	1	01	01	H6526_002_0	4			1		08/02/2017	2018.03	08/02/2017 01:46:26 PM Central Daylight Time	08/03/2017 01:42:50 PM Central Daylight Time	08/01/2017 11:33:13 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW MEXICO, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H6526	002	0	2018	Santa Fe Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6528	006	0	1	04	01	H6528_006_0	3			1		06/28/2017	2018.03	06/28/2017 09:47:51 AM Central Daylight Time	08/03/2017 01:43:24 PM Central Daylight Time	08/01/2017 11:33:40 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H6528	006	0	2018	Various Counties in Georgia		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6550	001	0	1	01	01	H6550_001_0	2			1		08/01/2017	2018.03	08/01/2017 05:13:54 PM Pacific Daylight Time	08/04/2017 04:35:03 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/04/2017 07:54:28 PM Pacific Daylight Time	SUNFLOWER STATE HEALTH PLAN, INC.	Allwell	www.allwell.sunflowerhealthplan.com	Allwell Medicare (HMO)	01	01		1			H6550	001	0	2018	Johnson, Wyandotte		2		2			2						www.centene.com	www.centene.com	https://allwell.sunflowerhealthplan.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H6551	001	0	1	20	08	H6551_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:08:09 PM Eastern Daylight Time		05/24/2017 01:58:27 PM Eastern Daylight Time			05/24/2017 02:53:48 PM Eastern Daylight Time	LIFE ST. MARY	LIFE St. Mary	http://www.lifestmary.org/	LIFE St. Mary (PACE)	08	20		1			H6551	001	0	2018	LIFE St. Mary		2		2			2						stmaryhealthcare.org	stmaryhealthcare.org										(267)991-7601		(267)991-7601		(267)991-7601		(267)991-7601										(267)991-7601		(267)991-7601		(267)991-7601		(267)991-7601																
H6551	002	0	1	20	08	H6551_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:42 PM Eastern Daylight Time		05/24/2017 02:27:13 PM Eastern Daylight Time			05/24/2017 02:53:48 PM Eastern Daylight Time	LIFE ST. MARY	LIFE St. Mary	www.lifestmary.org	LIFE St. Mary (PACE)	08	20		1			H6551	002	0	2018	LIFE St. Mary		2		2			2						stmaryhealthcare.org	stmaryhealthcare.org										(267)991-7601		(267)991-7601		(267)991-7601		(267)991-7601										(267)991-7601		(267)991-7601		(267)991-7601		(267)991-7601																
H6596	001	0	1	20	08	H6596_001_0	2			1		07/26/2017	2018.03	07/26/2017 04:42:10 PM Eastern Daylight Time		07/26/2017 04:39:51 PM Eastern Daylight Time			07/26/2017 04:42:49 PM Eastern Daylight Time	FALLON HEALTH WEINBERG, INC.	Fallon Health Weinberg-PACE	fallonweinberg.org	Fallon Health Weinberg-PACE (PACE)	08	20		1			H6596	001	0	2018	Erie County		2	1861	2			2						Not applicable	Not applicable										(855)665-1113		(716)810-1895		(855)665-1113		(716)810-1895										(711)-		(711)-		(711)-		(711)-																
H6596	002	0	1	20	08	H6596_002_0	2			1		07/26/2017	2018.03	07/26/2017 04:42:16 PM Eastern Daylight Time		07/26/2017 04:39:26 PM Eastern Daylight Time			07/26/2017 04:42:49 PM Eastern Daylight Time	FALLON HEALTH WEINBERG, INC.	Fallon Health Weinberg-PACE	fallonweinberg.org	Fallon Health Weinberg-PACE (PACE)	08	20		1			H6596	002	0	2018	Erie County		2	0	2			2						Not applicable	Not applicable										(855)665-1113		(716)810-1895		(855)665-1113		(716)810-1895										(711)-		(711)-		(711)-		(711)-																
H6622	001	0	1	01	01	H6622_001_0	3			1		08/02/2017	2018.03	08/02/2017 03:08:38 PM Eastern Daylight Time	08/04/2017 02:42:56 PM Eastern Daylight Time	08/04/2017 09:54:59 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-001 (HMO)	01	01		1			H6622	001	0	2018	Green Bay area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	002	0	1	01	01	H6622_002_0	2			1		05/27/2017	2018.03	05/27/2017 01:15:12 PM Eastern Daylight Time	08/04/2017 02:43:25 PM Eastern Daylight Time	08/04/2017 09:55:00 AM Eastern Daylight Time			08/06/2017 09:07:53 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-002 (HMO)	01	01		1			H6622	002	0	2018	Milwaukee area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	004	0	1	01	01	H6622_004_0	2			1		08/03/2017	2018.03	08/03/2017 12:59:46 PM Eastern Daylight Time	08/04/2017 05:28:11 PM Eastern Daylight Time	08/04/2017 09:55:00 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-004 (HMO)	01	01		1			H6622	004	0	2018	Richmond Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	005	0	1	01	01	H6622_005_0	2			1		08/03/2017	2018.03	08/03/2017 01:00:15 PM Eastern Daylight Time	08/04/2017 05:29:13 PM Eastern Daylight Time	08/04/2017 09:55:01 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-005 (HMO)	01	01		1			H6622	005	0	2018	Tidewater Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	007	0	1	01	01	H6622_007_0	2			1		05/30/2017	2018.03	05/30/2017 05:24:46 PM Eastern Daylight Time	08/04/2017 04:31:28 PM Eastern Daylight Time	08/04/2017 09:55:01 AM Eastern Daylight Time			08/06/2017 09:30:02 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-007 (HMO)	01	01		1			H6622	007	0	2018	Select Counties in Montana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	008	0	1	01	01	H6622_008_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 01:49:10 PM Eastern Daylight Time	08/04/2017 04:33:18 PM Eastern Daylight Time	08/04/2017 09:55:02 AM Eastern Daylight Time			08/06/2017 09:30:02 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-008 (HMO SNP)	01	01		1			H6622	008	0	2018	Select Counties in Montana		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	010	0	1	01	01	H6622_010_0	2			1		08/04/2017	2018.03	08/04/2017 03:41:39 PM Eastern Daylight Time	08/04/2017 05:30:12 PM Eastern Daylight Time	08/04/2017 09:55:02 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-010 (HMO)	01	01		1			H6622	010	0	2018	Kent, New Castle and Sussex Counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	011	0	1	01	01	H6622_011_0	3			1		06/28/2017	2018.03	06/28/2017 11:08:32 AM Eastern Daylight Time	08/04/2017 01:46:02 PM Eastern Daylight Time	08/04/2017 09:55:03 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-011 (HMO)	01	01		1			H6622	011	0	2018	Cleveland Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	012	0	1	01	01	H6622_012_0	3			1		08/02/2017	2018.03	08/02/2017 02:52:27 PM Eastern Daylight Time	08/04/2017 01:46:30 PM Eastern Daylight Time	08/04/2017 09:55:03 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-012 (HMO)	01	01		1			H6622	012	0	2018	Dayton Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	013	0	1	01	01	H6622_013_0	2			1		08/02/2017	2018.03	08/02/2017 02:52:56 PM Eastern Daylight Time	08/04/2017 01:49:02 PM Eastern Daylight Time	08/04/2017 09:55:04 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-013 (HMO)	01	01		1			H6622	013	0	2018	Columbus Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	014	0	1	01	01	H6622_014_0	3			1		08/02/2017	2018.03	08/02/2017 02:53:27 PM Eastern Daylight Time	08/04/2017 01:49:32 PM Eastern Daylight Time	08/04/2017 09:55:05 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-014 (HMO)	01	01		1			H6622	014	0	2018	Canton-Akron Metro Areas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	015	0	1	01	01	H6622_015_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 12:53:13 PM Eastern Daylight Time	08/04/2017 01:50:04 PM Eastern Daylight Time	08/04/2017 09:55:05 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-015 (HMO SNP)	01	01		1			H6622	015	0	2018	Canton-Cincinnati-Columbus Areas		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	016	0	1	01	01	H6622_016_0	3			1		06/28/2017	2018.03	06/28/2017 12:33:39 PM Eastern Daylight Time	08/04/2017 01:51:04 PM Eastern Daylight Time	08/04/2017 09:55:06 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-016 (HMO)	01	01		1			H6622	016	0	2018	Select Counties in Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	017	0	1	01	01	H6622_017_0	4		1	1		08/04/2017	2018.03	08/04/2017 03:44:27 PM Eastern Daylight Time	08/04/2017 01:52:16 PM Eastern Daylight Time	08/04/2017 09:55:06 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H6622	017	0	2018	Cincinnati and Columbus area		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	018	0	1	01	01	H6622_018_0	2		1	1	2	05/29/2017	2018.03	05/29/2017 05:50:06 PM Eastern Daylight Time	08/04/2017 01:53:19 PM Eastern Daylight Time	08/04/2017 09:55:07 AM Eastern Daylight Time			08/06/2017 11:38:38 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-018 (HMO SNP)	01	01		1			H6622	018	0	2018	Northern Kentucky Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	019	0	1	01	01	H6622_019_0	3			1		06/28/2017	2018.03	06/28/2017 12:36:11 PM Eastern Daylight Time	08/04/2017 01:56:55 PM Eastern Daylight Time	08/04/2017 09:55:07 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-019 (HMO)	01	01		1			H6622	019	0	2018	Select Counties in Ohio and Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	020	0	1	01	01	H6622_020_0	3			1		06/28/2017	2018.03	06/28/2017 12:37:19 PM Eastern Daylight Time	08/04/2017 01:57:34 PM Eastern Daylight Time	08/04/2017 09:55:08 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-020 (HMO)	01	01		1			H6622	020	0	2018	Select counties in Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	021	1	1	01	01	H6622_021_1	3			1		08/02/2017	2018.03	08/02/2017 02:54:20 PM Eastern Daylight Time	08/04/2017 01:55:22 PM Eastern Daylight Time	08/04/2017 09:55:08 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-021 (HMO)	01	01		1			H6622	021	1	2018	Select KY counties in Cincinnati Metro Area	Select KY counties in Cincinnati Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	021	2	1	01	01	H6622_021_2	3			1		08/02/2017	2018.03	08/02/2017 02:54:50 PM Eastern Daylight Time	08/04/2017 01:55:53 PM Eastern Daylight Time	08/04/2017 09:55:09 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-021 (HMO)	01	01		1			H6622	021	2	2018	Select KY counties in Cincinnati Metro Area	Select OH counties in Cincinnati Metro Area	2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	022	0	1	01	01	H6622_022_0	2			1		08/02/2017	2018.03	08/02/2017 02:55:25 PM Eastern Daylight Time	08/04/2017 01:59:06 PM Eastern Daylight Time	08/04/2017 09:55:09 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-022 (HMO)	01	01		1			H6622	022	0	2018	Select counties in Cleveland		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	023	0	1	01	01	H6622_023_0	2			1		08/02/2017	2018.03	08/02/2017 02:55:51 PM Eastern Daylight Time	08/04/2017 02:03:51 PM Eastern Daylight Time	08/04/2017 09:55:10 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Cleveland Clinic Preferred (HMO)	01	01		1			H6622	023	0	2018	Cuyahoga County		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	024	0	1	01	01	H6622_024_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 02:41:33 PM Eastern Daylight Time	08/04/2017 02:04:19 PM Eastern Daylight Time	08/04/2017 09:55:11 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Cleveland Clinic Preferred SNP-DE (HMO SNP)	01	01		1			H6622	024	0	2018	Cuyahoga County		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	025	0	1	01	01	H6622_025_0	2			1		08/03/2017	2018.03	08/03/2017 11:14:09 AM Eastern Daylight Time	08/04/2017 03:18:00 PM Eastern Daylight Time	08/04/2017 09:55:11 AM Eastern Daylight Time			08/06/2017 09:22:09 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-025 (HMO)	01	01		1			H6622	025	0	2018	Western North Carolina Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	026	0	1	01	01	H6622_026_0	2			1		05/30/2017	2018.03	05/30/2017 10:45:15 AM Eastern Daylight Time	08/04/2017 03:16:05 PM Eastern Daylight Time	08/04/2017 09:55:12 AM Eastern Daylight Time			08/06/2017 09:22:09 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-026 (HMO)	01	01		1			H6622	026	0	2018	Western North Carolina Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	027	0	1	01	01	H6622_027_0	3		1	1	2	07/18/2017	2018.03	07/18/2017 12:14:07 PM Eastern Daylight Time	08/04/2017 03:16:34 PM Eastern Daylight Time	08/04/2017 09:55:12 AM Eastern Daylight Time			08/06/2017 09:22:09 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-027 (HMO SNP)	01	01		1			H6622	027	0	2018	Western North Carolina Area		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	028	0	1	01	01	H6622_028_0	2			1		08/04/2017	2018.03	08/04/2017 09:24:04 AM Eastern Daylight Time	08/04/2017 01:11:37 PM Eastern Daylight Time	08/04/2017 09:55:13 AM Eastern Daylight Time			08/06/2017 09:20:58 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-028 (HMO)	01	01		1			H6622	028	0	2018	Clark and Nye (partial) counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	029	0	1	01	01	H6622_029_0	3		1	1		08/04/2017	2018.03	08/04/2017 09:24:16 AM Eastern Daylight Time	08/04/2017 01:07:38 PM Eastern Daylight Time	08/04/2017 09:55:13 AM Eastern Daylight Time			08/06/2017 09:20:58 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus - Diabetes and Heart (HMO SNP)	01	01		1			H6622	029	0	2018	Clark and Nye (partial) counties		2		2			1	4			00000000000000000010		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	030	0	1	01	01	H6622_030_0	3		1	1		08/04/2017	2018.03	08/04/2017 09:24:29 AM Eastern Daylight Time	08/04/2017 01:08:42 PM Eastern Daylight Time	08/04/2017 09:55:14 AM Eastern Daylight Time			08/06/2017 09:20:58 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-CLD H6622-030 (HMO SNP)	01	01		1			H6622	030	0	2018	Clark and Nye (partial) counties		2		2			1	4			00000000000100000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	031	0	1	01	01	H6622_031_0	4		1	1		08/02/2017	2018.03	08/02/2017 03:19:05 PM Eastern Daylight Time		08/04/2017 09:55:14 AM Eastern Daylight Time		08/02/2017 12:13:08 PM Eastern Daylight Time	08/06/2017 09:20:58 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Kidney Care (HMO SNP)	01	01		1			H6622	031	0	2018	Clark and Nye (partial) counties		2		2			1	4			00000000100000000000		http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	032	0	1	01	01	H6622_032_0	2			1		08/02/2017	2018.03	08/02/2017 02:29:04 PM Eastern Daylight Time	08/04/2017 03:48:13 PM Eastern Daylight Time	08/04/2017 09:55:15 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-032 (HMO)	01	01		1			H6622	032	0	2018	Canadian, Cleveland and Oklahoma counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	033	0	1	01	01	H6622_033_0	2			1		05/27/2017	2018.03	05/27/2017 12:56:23 PM Eastern Daylight Time	08/04/2017 03:48:47 PM Eastern Daylight Time	08/04/2017 09:55:15 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-033 (HMO)	01	01		1			H6622	033	0	2018	Okmulgee and Tulsa counties		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	034	0	1	01	01	H6622_034_0	2			1		08/02/2017	2018.03	08/02/2017 03:03:14 PM Eastern Daylight Time	08/04/2017 02:48:35 PM Eastern Daylight Time	08/04/2017 09:55:16 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-034 (HMO)	01	01		1			H6622	034	0	2018	Milwaukee area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	035	0	1	01	01	H6622_035_0	2			1		08/03/2017	2018.03	08/03/2017 09:52:48 AM Eastern Daylight Time	08/04/2017 05:31:31 PM Eastern Daylight Time	08/04/2017 09:55:16 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-035 (HMO)	01	01		1			H6622	035	0	2018	Central-Western Pennsylvania area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	036	0	1	01	01	H6622_036_0	2			1		08/03/2017	2018.03	08/03/2017 09:53:13 AM Eastern Daylight Time	08/04/2017 05:31:58 PM Eastern Daylight Time	08/04/2017 09:55:17 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-036 (HMO)	01	01		1			H6622	036	0	2018	Northeast Pennsylvania Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	037	0	1	01	01	H6622_037_0	2			1		08/03/2017	2018.03	08/03/2017 09:53:34 AM Eastern Daylight Time	08/04/2017 05:32:25 PM Eastern Daylight Time	08/04/2017 09:55:17 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-037 (HMO)	01	01		1			H6622	037	0	2018	Greater Philadelphia Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	038	0	1	01	01	H6622_038_0	4		1	1	2	07/18/2017	2018.03	07/18/2017 02:46:53 PM Eastern Daylight Time	08/04/2017 05:36:26 PM Eastern Daylight Time	08/04/2017 09:55:18 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-038 (HMO SNP)	01	01		1			H6622	038	0	2018	Select counties in Pennsylvania		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	039	0	1	01	01	H6622_039_0	2			1		08/03/2017	2018.03	08/03/2017 09:54:10 AM Eastern Daylight Time	08/04/2017 05:39:34 PM Eastern Daylight Time	08/04/2017 09:55:18 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-039 (HMO)	01	01		1			H6622	039	0	2018	Greater Philadelphia Metro Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	040	0	1	01	01	H6622_040_0	2			1		08/02/2017	2018.03	08/02/2017 03:06:39 PM Eastern Daylight Time	08/04/2017 02:49:32 PM Eastern Daylight Time	08/04/2017 09:55:19 AM Eastern Daylight Time			08/06/2017 10:18:43 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-040 (HMO)	01	01		1			H6622	040	0	2018	Milwaukee area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	041	0	1	01	01	H6622_041_0	2			1		06/22/2017	2018.03	06/22/2017 10:18:17 AM Eastern Daylight Time	08/04/2017 05:44:52 PM Eastern Daylight Time	08/04/2017 09:55:20 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-041 (HMO)	01	01		1			H6622	041	0	2018	Eastern and Central Virginia Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	042	0	1	01	01	H6622_042_0	2			1		06/22/2017	2018.03	06/22/2017 10:13:30 AM Eastern Daylight Time	08/04/2017 05:46:06 PM Eastern Daylight Time	08/04/2017 09:55:20 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-042 (HMO)	01	01		1			H6622	042	0	2018	Charlottesville-Western Virginia Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	043	0	1	01	01	H6622_043_0	2			1		08/03/2017	2018.03	08/03/2017 09:54:55 AM Eastern Daylight Time	08/04/2017 05:41:19 PM Eastern Daylight Time	08/04/2017 09:55:21 AM Eastern Daylight Time			08/06/2017 10:15:41 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-043 (HMO)	01	01		1			H6622	043	0	2018	South Central-Northeast Pennsylvania area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	044	0	1	01	01	H6622_044_0	2			1		06/22/2017	2018.03	06/22/2017 10:10:51 AM Eastern Daylight Time	08/04/2017 05:47:11 PM Eastern Daylight Time	08/04/2017 09:55:21 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-044 (HMO)	01	01		1			H6622	044	0	2018	Roanoke- Alleghany Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	045	0	1	01	01	H6622_045_0	2			1		06/22/2017	2018.03	06/22/2017 10:06:34 AM Eastern Daylight Time	08/04/2017 05:42:38 PM Eastern Daylight Time	08/04/2017 09:55:22 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-045 (HMO)	01	01		1			H6622	045	0	2018	Richmond-Tidewater Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	046	0	1	01	01	H6622_046_0	2			1		06/22/2017	2018.03	06/22/2017 10:04:27 AM Eastern Daylight Time	08/04/2017 05:43:39 PM Eastern Daylight Time	08/04/2017 09:55:22 AM Eastern Daylight Time			08/06/2017 10:05:42 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-046 (HMO)	01	01		1			H6622	046	0	2018	Northern Virginia Area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	047	0	1	01	01	H6622_047_0	2			1		08/02/2017	2018.03	08/02/2017 02:49:25 PM Eastern Daylight Time	08/04/2017 02:14:00 PM Eastern Daylight Time	08/04/2017 09:55:23 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus H6622-047 (HMO)	01	01		1			H6622	047	0	2018	Hattiesburg		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	048	0	1	01	01	H6622_048_0	3		1	1	2	07/17/2017	2018.03	07/17/2017 03:26:21 PM Eastern Daylight Time	08/04/2017 02:13:31 PM Eastern Daylight Time	08/04/2017 09:55:23 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Gold Plus SNP-DE H6622-048 (HMO SNP)	01	01		1			H6622	048	0	2018	Hattiesburg		2		2			1	3		1		1	http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	049	0	1	01	01	H6622_049_0	2			1		05/30/2017	2018.03	05/30/2017 09:06:06 AM Eastern Daylight Time	08/04/2017 03:53:33 PM Eastern Daylight Time	08/04/2017 09:55:24 AM Eastern Daylight Time			08/06/2017 09:35:04 AM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Value Plus H6622-049 (HMO)	01	01		1			H6622	049	0	2018	Select counties in Oklahoma		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6622	801	0	1	01	01	H6622_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:29:31 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H6622	801	0	2018	Select counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H6622	802	0	1	01	01	H6622_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:29:45 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Humana WI Health Organization Insurance Corp	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H6622	802	0	2018	Select counties in Multi States		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H6672	001	0	1	01	01	H6672_001_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 01:01:52 PM Eastern Daylight Time	08/04/2017 10:20:05 AM Eastern Daylight Time	08/04/2017 08:55:40 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (GA)	Eon Health	www.eonhealthplan.com	EON DELUXE (HMO SNP)	01	01		1			H6672	001	0	2018	Select Georgia Counties		2	16171	2			1	3		1		1	www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6672	003	0	1	01	01	H6672_003_0	9		1	1		08/04/2017	2018.03	08/04/2017 11:57:51 AM Eastern Daylight Time	08/04/2017 10:28:12 AM Eastern Daylight Time	08/04/2017 08:57:59 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (GA)	Eon Health	www.eonhealthplan.com	EON SILVER (HMO SNP)	01	01		1			H6672	003	0	2018	Select Georgia Counties		2	5946	2			1	4			00000000000000000010		www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6672	004	0	1	01	01	H6672_004_0	9			1		08/04/2017	2018.03	08/04/2017 11:58:07 AM Eastern Daylight Time	08/04/2017 10:35:55 AM Eastern Daylight Time	08/04/2017 08:59:27 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (GA)	Eon Health	www.eonhealthplan.com	EON SELECT (HMO)	01	01		1			H6672	004	0	2018	Select Georgia Counties		2	5157	2			2						www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	001	1	1	01	01	H6723_001_1	7			1		08/04/2017	2018.03	08/04/2017 05:26:55 PM Eastern Daylight Time	08/04/2017 05:22:54 PM Eastern Daylight Time	08/04/2017 01:46:18 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Classic (HMO)	01	01		1			H6723	001	1	2018	Ohio Regions	Region 1	2	120108	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	001	2	1	01	01	H6723_001_2	7			1		08/04/2017	2018.03	08/04/2017 05:30:15 PM Eastern Daylight Time	08/04/2017 05:23:36 PM Eastern Daylight Time	08/04/2017 01:47:28 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Classic (HMO)	01	01		1			H6723	001	2	2018	Ohio Regions	Region 2	2	29952	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	002	1	1	01	01	H6723_002_1	7			1		08/04/2017	2018.03	08/04/2017 05:35:47 PM Eastern Daylight Time	08/04/2017 05:24:16 PM Eastern Daylight Time	08/04/2017 01:48:38 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Choice (HMO)	01	01		1			H6723	002	1	2018	Ohio Regions	Region 1	2	111684	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	002	2	1	01	01	H6723_002_2	7			1		08/04/2017	2018.03	08/04/2017 05:40:01 PM Eastern Daylight Time	08/04/2017 05:25:06 PM Eastern Daylight Time	08/04/2017 01:49:44 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Choice (HMO)	01	01		1			H6723	002	2	2018	Ohio Regions	Region 2	2	12084	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	003	1	1	01	01	H6723_003_1	7			1		08/04/2017	2018.03	08/04/2017 05:43:34 PM Eastern Daylight Time	08/04/2017 05:25:58 PM Eastern Daylight Time	08/04/2017 01:50:50 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Plus (HMO)	01	01		1			H6723	003	1	2018	Ohio Regions	Region 1	2	47448	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	003	2	1	01	01	H6723_003_2	7			1		08/04/2017	2018.03	08/04/2017 05:46:34 PM Eastern Daylight Time	08/04/2017 05:30:24 PM Eastern Daylight Time	08/04/2017 01:51:46 PM Eastern Daylight Time			08/04/2017 09:09:51 PM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MedMutual.com/medicare	MedMutual Advantage Plus (HMO)	01	01		1			H6723	003	2	2018	Ohio Regions	Region 2	2	3972	2			2						medmutual.com/medicare	MedMutual.com/medicare	MedMutual.com/medicare	(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(800)982-3117		(800)982-3117		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6723	801	0	1	01	01	H6723_801_0	2			1		05/16/2017	2018.03	05/16/2017 10:03:18 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	Medmutual.com/medicare	MedMutual Advantage EGWP (Calendar Year) (HMO)	01	01		1			H6723	801	0	2018	Ohio Regions		1	18000	2			2						medmutual.com/medicare	Medmutual.com/medicare	Medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1					1				
H6723	802	0	1	01	01	H6723_802_0	2			1		05/16/2017	2018.03	05/16/2017 10:03:29 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	medmutual.com/medicare	MedMutual Advantage EGWP (Non-Calendar Year) (HMO)	01	01		1			H6723	802	0	2018	Ohio Regions		1	1200	2			2						medmutual.com/medicare	medmutual.com/medicare	medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1					1				
H6723	803	0	1	01	01	H6723_803_0	2			1		05/16/2017	2018.03	05/16/2017 10:01:00 AM Eastern Daylight Time					06/05/2017 09:17:22 AM Eastern Daylight Time	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	medmutual.com/medicare	MedMutual Advantage EGWP (MA-Only) (HMO)	01	01		1			H6723	803	0	2018	Ohio Regions		1	1200	2			2						medmutual.com/medicare	medmutual.com/medicare	medmutual.com/medicare	(800)801-4823		(800)801-4823		(866)406-8777		(866)406-8777										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;6;8a;8b1;8b2;9a;9b;10a;11a;11b;	2		1					1				
H6743	001	0	1	04	01	H6743_001_0	10	2		1		07/10/2017	2018.03	07/10/2017 04:41:33 PM Pacific Daylight Time	08/04/2017 11:35:10 AM Pacific Daylight Time	07/31/2017 05:35:23 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Bronze Rx (Basin) (PPO)	01	04		1			H6743	001	0	2018	Klamath County		2	24087	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6743	002	0	1	04	01	H6743_002_0	6	2		1		05/31/2017	2018.03	05/31/2017 10:24:21 AM Pacific Daylight Time	07/14/2017 01:30:04 PM Pacific Daylight Time				07/15/2017 12:32:06 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Silver (PPO)	01	04		1			H6743	002	0	2018	Douglas and Klamath Counties		2	2864	2			2						www.atriohp.com	www.atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620										(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900										2					2						2			
H6743	003	0	1	04	01	H6743_003_0	10	2		1		06/01/2017	2018.03	06/01/2017 10:27:24 PM Pacific Daylight Time	08/04/2017 11:41:39 AM Pacific Daylight Time	07/31/2017 05:35:50 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Silver Rx (PPO)	01	04		1			H6743	003	0	2018	Douglas and Klamath Counties		2	15559	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6743	004	0	1	04	01	H6743_004_0	10	2		1		06/01/2017	2018.03	06/01/2017 10:27:55 PM Pacific Daylight Time	08/04/2017 11:54:25 AM Pacific Daylight Time	07/31/2017 05:36:12 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Gold Rx (PPO)	01	04		1			H6743	004	0	2018	Douglas and Klamath Counties		2	14309	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6743	006	0	1	04	01	H6743_006_0	6	2		1		05/31/2017	2018.03	05/31/2017 10:24:49 AM Pacific Daylight Time	07/14/2017 01:37:43 PM Pacific Daylight Time				07/15/2017 12:32:06 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Bronze (PPO)	01	04		1			H6743	006	0	2018	Douglas and Klamath Counties		2	5768	2			2						www.atriohp.com	www.atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620										(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900										2					2						2			
H6743	007	0	1	04	01	H6743_007_0	10	2		1		08/03/2017	2018.03	08/03/2017 09:35:45 PM Pacific Daylight Time	08/04/2017 11:55:51 AM Pacific Daylight Time	07/31/2017 05:36:39 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Bronze Rx (Umpqua) (PPO)	01	04		1			H6743	007	0	2018	Douglas County		2	44008	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6743	014	0	1	04	01	H6743_014_0	10	2		1		07/10/2017	2018.03	07/10/2017 04:46:25 PM Pacific Daylight Time	08/04/2017 11:58:48 AM Pacific Daylight Time	07/31/2017 05:37:04 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Bronze Rx (Rogue) (PPO)	01	04		1			H6743	014	0	2018	Josephine and Jackson Counties		2	12616	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6743	016	0	1	04	01	H6743_016_0	10	2		1		06/01/2017	2018.03	06/01/2017 10:29:36 PM Pacific Daylight Time	08/04/2017 12:00:15 PM Pacific Daylight Time	07/31/2017 05:37:30 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Silver Rx (Rogue) (PPO)	01	04		1			H6743	016	0	2018	Josephine and Jackson Counties		2	6549	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H6750	001	0	1	01	01	H6750_001_0	4			1		08/07/2017	2018.03	08/07/2017 02:48:32 AM Eastern Daylight Time	08/04/2017 03:37:30 PM Eastern Daylight Time	08/02/2017 02:25:46 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H6750	001	0	2018	New Hampshire		2	20187	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	002	0	1	01	01	H6750_002_0	4			1		08/07/2017	2018.03	08/07/2017 02:23:56 AM Eastern Daylight Time	08/04/2017 03:39:10 PM Eastern Daylight Time	08/02/2017 02:26:14 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H6750	002	0	2018	New Hampshire		2	50750	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	005	0	1	01	01	H6750_005_0	4			1		08/07/2017	2018.03	08/07/2017 02:46:32 PM Eastern Daylight Time	08/07/2017 02:31:52 PM Eastern Daylight Time	08/02/2017 02:26:42 PM Eastern Daylight Time			08/07/2017 07:37:11 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Basic Rx (HMO)	01	01		1			H6750	005	0	2018	Hillsborough, Merrimack and Rockingham Counties NH		2	2400	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(888)609-0692		(888)609-0692		(877)431-4742		(877)431-4742		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	801	0	1	01	01	H6750_801_0	3			1		06/02/2017	2018.03	06/02/2017 11:22:14 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.harvardpilgrim.org	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H6750	801	0	2018	New Hampshire		1	1200	2			2						www.harvardpilgrim.org	www.harvardpilgrim.org	www.harvardpilgrim.org	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	802	0	1	01	01	H6750_802_0	3			1		06/02/2017	2018.03	06/02/2017 11:18:27 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.harvardpilgrim.org/medicare	Harvard Pilgrim Stride Value Rx Plus (HMO)	01	01		1			H6750	802	0	2018	New Hampshire		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	803	0	1	01	01	H6750_803_0	3			1		06/02/2017	2018.03	06/02/2017 11:13:49 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H6750	803	0	2018	New Hampshire		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6750	804	0	1	01	01	H6750_804_0	3			1		06/02/2017	2018.03	06/02/2017 11:09:53 AM Eastern Daylight Time					06/02/2017 12:34:01 PM Eastern Daylight Time	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	Harvard Pilgrim Health Care of New England, Inc.	www.hpforlife.org	Harvard Pilgrim Stride Value Rx (HMO)	01	01		1			H6750	804	0	2018	New Hampshire		1	1200	2			2						www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	www.harvardpilgrim.org/medicare	(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(888)609-0692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6776	001	0	1	01	01	H6776_001_0	6		1	1		08/02/2017	2018.03	08/02/2017 02:14:43 PM Eastern Daylight Time	08/01/2017 08:35:00 AM Eastern Daylight Time	08/01/2017 08:32:48 AM Eastern Daylight Time			08/02/2017 02:29:22 PM Eastern Daylight Time	ELDERSERVE HEALTH, INC.	RiverSpring Health Plans	riverspringstar.org	RiverSpring Star (HMO SNP)	01	01		1			H6776	001	0	2018	Counties: Brx, Ki, Na, NY, Qu, Ri, Wes		2	6054	2			1	1	3				riverspringstar.org	riverspringstar.org	riverspringstar.org	(800)580-7000		(800)580-7000		(800)580-7000		(800)580-7000		(855)898-1482		(855)898-1482		(855)898-1482		(855)898-1482		(711)-		(711)-		(711)-		(711)-		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		2					1					1	2			
H6776	002	0	1	01	01	H6776_002_0	6		1	1	2	08/02/2017	2018.03	08/02/2017 02:15:18 PM Eastern Daylight Time	08/01/2017 08:36:14 AM Eastern Daylight Time	08/01/2017 08:33:38 AM Eastern Daylight Time			08/02/2017 02:29:22 PM Eastern Daylight Time	ELDERSERVE HEALTH, INC.	RiverSpring Health Plans	riverspringMAP.org	RiverSpring MAP (HMO SNP)	01	01		1			H6776	002	0	2018	Counties: Brx, Ki, Na, NY, Qu, Ri, Wes		2	1170	2			1	3		2		1	riverspringMAP.org	riverspringMAP.org	riverspringMAP.org	(800)580-7000		(800)580-7000		(800)580-7000		(800)580-7000		(855)898-1482		(855)898-1482		(855)898-1482		(855)898-1482		(711)-		(711)-		(711)-		(711)-		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		2					1					1	2			
H6786	002	0	1	04	01	H6786_002_0	5			1		07/13/2017	2018.03	07/13/2017 07:23:13 PM Eastern Daylight Time	08/07/2017 08:59:27 AM Eastern Daylight Time	08/06/2017 03:09:18 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H6786	002	0	2018	Androscoggin and Cumberland Counties		2	1074	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)304-1785		(855)304-1785		(800)797-6458		(800)797-6458		(855)304-1785		(855)304-1785		(844)373-7114		(844)373-7114		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H6786	801	0	1	04	01	H6786_801_0	1			1		06/03/2017	2018.03	06/03/2017 02:38:06 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H6786	801	0	2018	Maine		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6555		(855)320-6555		(877)411-1647		(877)411-1647		(855)320-6555		(855)320-6555		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H6786	802	0	1	04	01	H6786_802_0	1			1		06/03/2017	2018.03	06/03/2017 02:38:45 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H6786	802	0	2018	Maine		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6555		(855)320-6555		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H6786	803	0	1	04	01	H6786_803_0	1			1		06/03/2017	2018.03	06/03/2017 02:38:19 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H6786	803	0	2018	Maine		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6555		(855)320-6555		(877)411-1647		(877)411-1647		(855)320-6555		(855)320-6555		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H6787	001	0	1	20	08	H6787_001_0	2			1		05/24/2017	2018.03	05/24/2017 01:06:58 PM Eastern Daylight Time		07/06/2017 12:24:01 PM Eastern Daylight Time			07/06/2017 12:28:34 PM Eastern Daylight Time	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	Senior Community Care of Michigan	http://seniorcommunitycaremi.org	VOANS Senior Community Care of Michigan (PACE)	08	20		1			H6787	001	0	2018	Ingham, Eaton, and Clinton Counties		2		2			2						http://seniorcommunitycaremi.org	http://seniorcommunitycaremi.org										(517)319-0700		(517)319-0700		(517)319-0700		(517)319-0700										(000)000-0000		(000)000-0000		(000)000-0000		(000)000-0000																
H6787	002	0	1	20	08	H6787_002_0	2			1		05/24/2017	2018.03	05/24/2017 01:07:38 PM Eastern Daylight Time		07/06/2017 12:26:28 PM Eastern Daylight Time			07/06/2017 12:28:34 PM Eastern Daylight Time	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	Senior Community Care of Michigan	http://seniorcommunitycaremi.org	VOANS Senior Community Care of Michigan (PACE)	08	20		1			H6787	002	0	2018	Eaton, Ingham and Clinton County		2		2			2						http://seniorcommunitycaremi.org	http://seniorcommunitycaremi.org										(517)319-0700		(517)319-0700		(517)319-0700		(517)319-0700										(000)000-0000		(000)000-0000		(000)000-0000		(000)000-0000																
H6815	003	1	1	01	01	H6815_003_1	4			1		08/02/2017	2018.03	08/02/2017 02:17:00 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET HEALTH PLAN OF OREGON	Health Net Health Plan of Oregon, Inc.	www.healthnet.com/medicare	Health Net Ruby (HMO)	01	01		1			H6815	003	1	2018	OR Counties BE, CK, LA, LN, ML, MN, PK, WA, YM	Clackamas, Lane, Multnomah, Washington OR	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6815	003	2	1	01	01	H6815_003_2	4			1		08/02/2017	2018.03	08/02/2017 02:17:27 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET HEALTH PLAN OF OREGON	Health Net Health Plan of Oregon, Inc.	www.healthnet.com/medicare	Health Net Ruby (HMO)	01	01		1			H6815	003	2	2018	OR Counties BE, CK, LA, LN, ML, MN, PK, WA, YM	OR Counties BE, LN, MN, PK, YM	2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6815	005	0	1	01	01	H6815_005_0	3			1		06/21/2017	2018.03	06/21/2017 10:21:46 AM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time	08/04/2017 05:04:52 PM Pacific Daylight Time			08/04/2017 08:11:11 PM Pacific Daylight Time	HEALTH NET HEALTH PLAN OF OREGON	Health Net Health Plan of Oregon, Inc.	www.healthnet.com/medicare	Health Net Ruby (HMO)	01	01		1			H6815	005	0	2018	Douglas, Jackson, Josephine		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	www.healthnet.com/medicare	(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(888)445-8913		(888)445-8913		(800)949-6192		(800)949-6192		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H6846	001	0	1	20	08	H6846_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:43 PM Eastern Daylight Time		05/24/2017 08:12:01 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	COMMUNITY CAREPARTNERS, INC.	CarePartners PACE	http://www.carepartners.org/services_adult_pac.htm	Community CarePartners, Inc (PACE)	08	20		1			H6846	001	0	2018	Buncombe and Henderson Counties		2		2			2						http://www.missionpardeehealthcampus.org/services/	www.carepartners.org										(800)000-0000		(828)213-8442		(800)000-0000		(828)213-8442										(800)735-2962		(800)735-2962		(800)735-2962		(800)735-2962																
H6846	002	0	1	20	08	H6846_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:59 PM Eastern Daylight Time		05/24/2017 08:12:02 AM Eastern Daylight Time			05/24/2017 01:12:55 PM Eastern Daylight Time	COMMUNITY CAREPARTNERS, INC.	CarePartners PACE	http://www.carepartners.org/PACE	Community CarePartners, Inc (PACE)	08	20		1			H6846	002	0	2018	Buncombe and Henderson Counties		2		2			2						http://www.missionpardeehealthcampus.org/services/	www.carepartners.org										(800)000-0000		(828)213-8442		(800)000-0000		(828)213-8442										(800)735-2962		(800)735-2962		(800)735-2962		(800)735-2962																
H6864	001	0	1	01	01	H6864_001_0	11		1	1	2	08/04/2017	2018.03	08/04/2017 11:50:37 AM Eastern Daylight Time	08/04/2017 11:27:50 AM Eastern Daylight Time	08/04/2017 11:27:50 AM Eastern Daylight Time			08/04/2017 12:09:41 PM Eastern Daylight Time	GUILDNET, INC.	GuildNet	www.guildnetny.org	GuildNet Gold (HMO SNP)	01	01		1			H6864	001	0	2018	Bronx, Kings, NY, Queens, Richmond		2		2			1	3		1		1	www.guildnetny.org	www.guildnetny.org	www.guildnetny.org	(800)815-0000		(800)815-0000		(800)815-0000		(800)815-0000		(877)444-3973		(877)444-3973		(800)815-0000		(800)815-0000		(711)-		(711)-		(711)-		(711)-		(866)248-0640		(866)248-0640		(711)-		(711)-		2					2					2	2			
H6870	001	0	1	48	05	H6870_001_0	4			1		08/09/2017	2018.03	08/09/2017 01:21:01 PM Pacific Daylight Time					08/10/2017 11:16:47 AM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Superior HealthPlan	http://mmp.superiorhealthplan.com	Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)	05	48		1			H6870	001	0	2018	Bexar, Dallas and Hidalgo Counties		2	90000	2			2						http://apps.superiorhealthplan.com/findadoc/legacy/selectProduct?busLine=TX	http://mmp.superiorhealthplan.com/home/prescription-drug-part-d-benefit-information/	http://apps.superiorhealthplan.com/findadoc/legacy/selectProduct?busLine=TX	(866)896-1844		(866)896-1844		(866)896-1844		(866)896-1844		(866)896-1844		(866)896-1844		(866)896-1844		(866)896-1844		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H6887	001	0	1	20	08	H6887_001_0	1			1		05/30/2017	2018.03	05/30/2017 01:41:08 PM Eastern Daylight Time		05/30/2017 11:33:34 AM Eastern Daylight Time			05/30/2017 03:21:16 PM Eastern Daylight Time	INSPIRA HEALTH NETWORK LIFE, INC.	Inspira Health Network LIFE	http://www.inspirahealthnetwork.org/life-center	Inspira Health Network LIFE (PACE)	08	20		1			H6887	001	0	2018	Inspira Health Network LIFE		2	3732	1	1		2						http://www.inspirahealthnetwork.org/	http://www.inspirahealthnetwork.org/										(855)295-5433		(856)362-4516		(855)295-5433		(856)362-4516										(855)295-5433		(856)632-4516		(855)295-5433		(856)362-4516																
H6887	002	0	1	20	08	H6887_002_0	1			1		05/30/2017	2018.03	05/30/2017 01:44:34 PM Eastern Daylight Time		05/30/2017 11:33:04 AM Eastern Daylight Time			05/30/2017 03:25:17 PM Eastern Daylight Time	INSPIRA HEALTH NETWORK LIFE, INC.	Inspira Health Network LIFE	http://www.inspirahealthnetwork.org/life-center	Inspira Health Network LIFE (PACE)	08	20		1			H6887	002	0	2018	Inspira Health Network LIFE		2	3732	1	1		2						http://www.inspirahealthnetwork.org/	http://www.inspirahealthnetwork.org/										(855)295-5433		(856)362-4516		(855)295-5433		(856)362-4516										(855)295-5433		(856)362-4516		(855)295-5433		(856)362-4516																
H6941	001	0	1	20	08	H6941_001_0	1			1		06/02/2017	2018.03	06/02/2017 01:54:10 PM Central Daylight Time		06/02/2017 01:59:59 PM Central Daylight Time			06/02/2017 02:17:05 PM Central Daylight Time	LIFE PACE	LIFE PACE, INC.	www.lifepace.org	LIFE PACE Dual Eligible 001 (PACE)	08	20		1			H6941	001	0	2018	Tulsa County		2		2			2						www.carekinesis.com	www.lifepace.org										(844)664-4440		(918)949-9969		(844)664-4440		(918)949-9969										(844)664-4440		(918)949-9969		(844)664-4440		(918)949-9969																
H6941	002	0	1	20	08	H6941_002_0	1			1		06/02/2017	2018.03	06/02/2017 01:54:39 PM Central Daylight Time		06/02/2017 01:59:27 PM Central Daylight Time			06/02/2017 02:17:05 PM Central Daylight Time	LIFE PACE	LIFE PACE, INC.	www.lifepace.org	LIFE PACE Medicare Only 002 (PACE)	08	20		1			H6941	002	0	2018	Tulsa County		2		2			2						www.carekinesis.com	www.lifepace.org										(844)664-4440		(918)949-9969		(844)664-4440		(918)949-9969										(844)664-4440		(918)949-9969		(844)664-4440		(918)949-9969																
H6947	001	0	1	01	01	H6947_001_0	4			1		08/03/2017	2018.03	08/03/2017 07:33:58 PM Central Daylight Time	08/03/2017 03:27:16 PM Central Daylight Time	08/01/2017 02:07:12 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	QUALCHOICE ADVANTAGE	QualChoice Advantage	www.QualChoiceAdvantage.com	Classic Plus Rx (HMO)	01	01		1			H6947	001	0	2018	Little Rock - Hot Springs AR		2		2			2						www.QualChoiceAdvantage.com	www.QualChoiceAdvantage.com	www.QualChoiceAdvantage.com	(844)822-7838		(844)822-7838		(844)822-7838		(844)822-7838		(844)822-7838		(844)822-7838		(844)822-7838		(844)822-7838		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H6988	001	0	1	01	01	H6988_001_0	10			1		08/04/2017	2018.03	08/04/2017 10:18:58 AM Eastern Daylight Time	08/04/2017 10:08:52 AM Eastern Daylight Time	08/04/2017 10:09:43 AM Eastern Daylight Time			08/04/2017 10:21:01 AM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for Healthy Living	www.centersplan.com	Centers Plan for Medicare Advantage Care (HMO)	01	01		1			H6988	001	0	2018	NYC Metro Area, ERIE, NASS, NIAG, ROCK Counties		2	287	2			2						www.centersplan.com	www.centersplan.com	www.centersplan.com	(877)940-9330		(877)940-9330		(877)940-9330		(877)940-9330		(888)807-5717		(888)807-5717		(877)940-9330		(877)940-9330		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		2					2					2	2			
H6988	002	0	1	01	01	H6988_002_0	10		1	1	2	07/21/2017	2018.03	07/21/2017 12:36:33 PM Eastern Daylight Time	08/04/2017 10:08:52 AM Eastern Daylight Time	08/04/2017 10:09:43 AM Eastern Daylight Time			08/04/2017 10:21:01 AM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for Healthy Living	www.centersplan.com	Centers Plan for Dual Coverage Care (HMO SNP)	01	01		1			H6988	002	0	2018	Kings,Queens,Bronx,Manhattan and Richmond Counties		2		2			1	3		2		2	www.centersplan.com	www.centersplan.com	www.centersplan.com	(877)940-9330		(877)940-9330		(877)940-9330		(877)940-9330		(888)807-5717		(888)807-5717		(877)940-9330		(877)940-9330		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		2					2					2	2			
H6988	003	0	1	01	01	H6988_003_0	10		1	1		07/06/2017	2018.03	07/06/2017 11:48:38 AM Eastern Daylight Time	08/04/2017 10:08:52 AM Eastern Daylight Time	08/04/2017 10:09:43 AM Eastern Daylight Time			08/04/2017 10:21:01 AM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for Healthy Living	www.centersplan.com	Centers Plan for Nursing Home Care (HMO SNP)	01	01		1			H6988	003	0	2018	NYC Metro Area, Rockland, Erie, Niagara Counties		2	287	2			1	1	1				www.centersplan.com	www.centersplan.com	www.centersplan.com	(877)940-9330		(877)940-9330		(877)940-9330		(877)940-9330		(888)807-5717		(888)807-5717		(877)940-9330		(877)940-9330		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		2					2					2	2			
H6988	004	0	1	01	01	H6988_004_0	9		1	1	2	07/21/2017	2018.03	07/21/2017 12:37:49 PM Eastern Daylight Time	08/04/2017 10:08:52 AM Eastern Daylight Time	08/04/2017 10:09:43 AM Eastern Daylight Time			08/04/2017 10:21:01 AM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for Healthy Living	www.centersplan.com	Centers Plan for Medicaid Advantage Plus (HMO SNP)	01	01		1			H6988	004	0	2018	NYC Metro Area, NASS, ROCK County		2		2			1	3		1		2	www.centersplan.com	www.centersplan.com	www.centersplan.com	(877)940-9330		(877)940-9330		(877)940-9330		(877)940-9330		(888)807-5717		(888)807-5717		(877)940-9330		(877)940-9330		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		2					2					2	2			
H6988	801	0	1	01	01	H6988_801_0	4			1		06/05/2017	2018.03	06/05/2017 01:05:20 PM Eastern Daylight Time					06/05/2017 04:38:07 PM Eastern Daylight Time	CENTERS PLAN FOR HEALTHY LIVING, LLC	Centers Plan for Healthy Living	www.centersplan.com	Centers Plan for Employer Groups (HMO)	01	01		1			H6988	801	0	2018	NYC Metro Area, ERIE, NASS, NIAG, ROCK Counties		1	63	2			2						www.centersplan.com	www.centersplan.com	www.centersplan.com	(877)940-9330		(877)940-9330		(877)940-9330		(877)940-9330		(888)807-5717		(888)807-5717		(877)940-9330		(877)940-9330		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		(800)421-1220		(711)-		1	1	1a;1b;2;3-1;5;6;7b;7c;7f;7g;7i;9a;9b;9c;11a;11b;12;14d;15;	1	7b;7f;7g;7h;	1					1				
H7003	001	0	1	20	08	H7003_001_0	1			1		06/03/2017	2018.03	06/03/2017 08:55:54 AM Central Daylight Time		06/03/2017 08:29:34 AM Central Daylight Time			06/03/2017 08:57:04 AM Central Daylight Time	PACE NEBRASKA	Immanuel Pathways Omaha	immanuelpathways.org	PACE Nebraska (PACE)	08	20		1			H7003	001	0	2018	Select Zip Codes in DO, SA, and W, DG, C, and SU		2		2			2						http://www.immanuelpathways.org/	www.immanuelpathways,org										(800)000-0000		(402)991-0330		(800)000-0000		(402)991-0330										(800)829-2992		(402)991-0330		(800)829-2992		(402)991-0330																
H7003	002	0	1	20	08	H7003_002_0	1			1		06/03/2017	2018.03	06/03/2017 08:56:06 AM Central Daylight Time		06/03/2017 08:29:34 AM Central Daylight Time			06/03/2017 08:57:04 AM Central Daylight Time	PACE NEBRASKA	Immanuel Pathways Omaha	immanuelpathways.org	PACE Nebraska (PACE)	08	20		1			H7003	002	0	2018	Select Zip Codes in DO, SA, and W, DG, C, and SU		2		2			2						http://www.immanuelpathways.org/	www.immanuelpathways,org										(800)000-0000		(402)991-0330		(800)000-0000		(402)991-0330										(800)829-2992		(402)991-0330		(800)829-2992		(402)991-0330																
H7006	001	0	1	04	01	H7006_001_0	10	2		1		06/01/2017	2018.03	06/01/2017 10:24:49 PM Pacific Daylight Time	08/04/2017 12:01:43 PM Pacific Daylight Time	07/31/2017 05:37:55 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Gold Rx (Willamette) (PPO)	01	04		1			H7006	001	0	2018	Marion and Polk Counties		2	17303	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H7006	003	0	1	04	01	H7006_003_0	10	2		1		07/10/2017	2018.03	07/10/2017 04:47:01 PM Pacific Daylight Time	08/04/2017 12:03:31 PM Pacific Daylight Time	07/31/2017 05:38:20 PM Pacific Daylight Time			08/05/2017 08:37:46 AM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	atriohp.com	ATRIO Silver Rx (Willamette) (PPO)	01	04		1			H7006	003	0	2018	Marion and Polk Counties		2	27303	2			2						atriohp.com	atriohp.com	atriohp.com	(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(877)672-8620		(541)672-8620		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		(800)735-2900		(541)735-2900		2					2						2			
H7020	004	0	1	01	01	H7020_004_0	3			1		08/02/2017	2018.03	08/02/2017 02:00:31 PM Central Daylight Time	08/03/2017 10:47:31 AM Central Daylight Time	08/01/2017 02:16:03 PM Central Daylight Time			08/04/2017 09:36:31 PM Central Daylight Time	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Cigna-Healthspring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H7020	004	0	2018	South Carolina		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7020	801	0	1	01	01	H7020_801_0	2			1		05/22/2017	2018.03	05/22/2017 08:58:43 PM Central Daylight Time					05/31/2017 10:28:56 PM Central Daylight Time	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	Cigna-Healthspring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H7020	801	0	2018	South Carolina		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(888)281-7867		(888)281-7867		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H7114	001	0	1	20	08	H7114_001_0	1			1		06/05/2017	2018.03	06/05/2017 10:59:24 AM Central Daylight Time		06/05/2017 10:27:14 AM Central Daylight Time			06/05/2017 11:00:17 AM Central Daylight Time	VALIR PACE FOUNDATION	Valir PACE Foundation	www.valir.com	Dual (PACE)	08	20		1			H7114	001	0	2018	Oklahoma County		2		2			2						www.valir.com	www.valir.com										(888)898-2080		(405)609-3688		(888)898-8020		(405)609-3688										(711)-		(711)-		(711)-		(711)-																
H7114	002	0	1	20	08	H7114_002_0	1			1		06/05/2017	2018.03	06/05/2017 10:59:37 AM Central Daylight Time		06/05/2017 10:29:28 AM Central Daylight Time			06/05/2017 11:00:17 AM Central Daylight Time	VALIR PACE FOUNDATION	Valir PACE Foundation	www.valir.com	Medicare Only (PACE)	08	20		1			H7114	002	0	2018	Oklahoma County		2		2			2						www.valir.com	www.valir.com										(888)898-2080		(405)609-3688		(888)898-8020		(405)609-3688										(711)-		(711)-		(711)-		(711)-																
H7115	001	0	1	01	01	H7115_001_0	6			1		08/03/2017	2018.03	08/03/2017 03:09:47 PM Central Daylight Time	08/03/2017 08:55:20 AM Central Daylight Time	08/03/2017 09:01:51 AM Central Daylight Time			08/07/2017 05:40:39 PM Central Daylight Time	MEMORIAL HERMANN HEALTH PLAN	Memorial Hermann Health Plan	healthplan.memorialhermann.org/medicare	Memorial Hermann Advantage (HMO)	01	01		1			H7115	001	0	2018	Texas Counties - Harris, Montgomery, Fort Bend		2	6375	2			2						healthplan.memorialhermann.org/medicare	healthplan.memorialhermann.org/medicare	healthplan.memorialhermann.org/medicare	(855)645-8448		(855)645-8448		(888)801-4808		(888)801-4808		(855)645-8448		(855)645-8448		(888)801-4808		(888)801-4808		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7149	001	0	1	01	01	H7149_001_0	5			1		08/02/2017	2018.03	08/02/2017 02:21:00 PM Eastern Daylight Time	08/03/2017 04:59:47 PM Eastern Daylight Time	07/31/2017 05:56:33 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Coventry Health Care	www.coventry-medicare.com	Coventry Advantra Silver (HMO)	01	01		1			H7149	001	0	2018	Partial State of Nebraska		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7149	004	0	1	01	01	H7149_004_0	4			1		08/02/2017	2018.03	08/02/2017 07:22:02 PM Eastern Daylight Time	08/03/2017 05:01:04 PM Eastern Daylight Time	07/31/2017 05:57:04 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Coventry Health Care	www.coventry-medicare.com	Coventry Total Care (HMO)	01	01		1			H7149	004	0	2018	Douglas and Sarpy Counties Nebraska		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7149	801	0	1	01	01	H7149_801_0	1			1		06/01/2017	2018.03	06/01/2017 11:54:15 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Silver EmpGrp/NoRx/Cyear (HMO)	01	01		1			H7149	801	0	2018	Partial State of Nebraska		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H7149	802	0	1	01	01	H7149_802_0	1			1		05/31/2017	2018.03	05/31/2017 08:06:21 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH INC. (PA)	Coventry Health Care	iowa-nebraska.chcadvantra.com	Coventry Advantra Silver EmpGrp/Rx/Cyear (HMO)	01	01		1			H7149	802	0	2018	Partial State of Nebraska		1	120	2			2						PharmacyLocator.coventry-medicare.com	IANEFormulary.coventry-medicare.com	ProviderDirectory.coventry-medicare.com	(866)901-4692		(866)901-4692		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H7165	001	0	1	01	01	H7165_001_0	3			1		08/03/2017	2018.03	08/03/2017 10:14:35 AM Eastern Daylight Time	08/03/2017 10:36:16 AM Eastern Daylight Time	08/03/2017 10:36:39 AM Eastern Daylight Time			08/04/2017 11:07:20 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Secure (HMO)	01	01		1			H7165	001	0	2018	Greenville County		2	6000	2			2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7165	002	0	1	01	01	H7165_002_0	3			1		08/03/2017	2018.03	08/03/2017 10:17:19 AM Eastern Daylight Time	08/03/2017 10:37:15 AM Eastern Daylight Time	08/03/2017 10:37:39 AM Eastern Daylight Time			08/04/2017 11:07:20 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Secure (HMO)	01	01		1			H7165	002	0	2018	Richland County		2	6000	2			2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7165	801	0	1	01	01	H7165_801_0	1			1		05/11/2017	2018.03	05/11/2017 11:06:44 AM Eastern Daylight Time					06/03/2017 10:40:31 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MAPD Calendar Year Group (HMO)	01	01		1			H7165	801	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H7165	802	0	1	01	01	H7165_802_0	1			1		05/11/2017	2018.03	05/11/2017 11:13:44 AM Eastern Daylight Time					06/03/2017 10:40:31 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MAPD Non-calendar Year Group (HMO)	01	01		1			H7165	802	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1					1				
H7165	803	0	1	01	01	H7165_803_0	1			1		05/11/2017	2018.03	05/11/2017 11:18:29 AM Eastern Daylight Time					06/03/2017 10:40:31 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MA Only Calendar Year Group (HMO)	01	01		1			H7165	803	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H7165	804	0	1	01	01	H7165_804_0	1			1		05/11/2017	2018.03	05/11/2017 11:22:32 AM Eastern Daylight Time					06/03/2017 10:40:31 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MA Only Non-calendar Year Group (HMO)	01	01		1			H7165	804	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-										1	2		2		1					1				
H7172	001	0	1	48	05	H7172_001_0	4			1		08/23/2017	2018.03	08/23/2017 11:02:41 AM Central Daylight Time					08/24/2017 03:52:53 PM Central Daylight Time	AETNA BETTER HEALTH, INC. (OH)	Aetna Better Health of Ohio, MyCare Ohio	www.aetnabetterhealth.com/ohio	Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan)	05	48		1			H7172	001	0	2018	Ohio		2	249252	2			2						www.aetnabetterhealth.com/ohio	www.aetnabetterhealth.com/ohio	www.aetnabetterhealth.com/ohio	(855)364-0974		(855)364-0974		(855)364-0974		(855)364-0974		(855)364-0974		(855)364-0974		(855)364-0974		(855)364-0974		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H7173	001	0	1	01	01	H7173_001_0	4		1	1	2	07/05/2017	2018.03	07/05/2017 07:38:04 AM Pacific Daylight Time	08/04/2017 04:35:04 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/06/2017 09:35:23 AM Pacific Daylight Time	PEACH STATE HEALTH PLAN, INC.	Allwell	allwell.pshpgeorgia.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H7173	001	0	2018	Metro Atlanta, North and Central Regions		2		2			1	3		2		2	https://advantage.pshpgeorgia.com/findadoctor	https://advantage.pshpgeorgia.com/partdformulary	https://advantage.pshpgeorgia.com/findadoctor	(877)725-7748		(877)725-7748		(877)826-3693		(877)826-3693		(877)725-7748		(877)725-7748		(877)826-3693		(877)826-3693		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7173	002	0	1	01	01	H7173_002_0	3			1		08/04/2017	2018.03	08/04/2017 10:06:51 AM Eastern Daylight Time	08/04/2017 04:35:04 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	PEACH STATE HEALTH PLAN, INC.	Allwell	allwell.pshpgeorgia.com	Allwell Medicare (HMO)	01	01		1			H7173	002	0	2018	Dekalb and Fulton counties		2	233	2			2						https://advantage.pshpgeorgia.com/findadoctor	https://advantage.pshpgeorgia.com/partdformulary	https://advantage.pshpgeorgia.com/findadoctor	(844)890-2326		(844)890-2326		(877)826-3693		(877)826-3693		(844)890-2326		(844)890-2326		(877)826-3693		(877)826-3693		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7173	003	0	1	01	01	H7173_003_0	3			1		08/04/2017	2018.03	08/04/2017 10:07:37 AM Eastern Daylight Time	08/04/2017 04:35:04 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/05/2017 11:55:05 AM Pacific Daylight Time	PEACH STATE HEALTH PLAN, INC.	Allwell	allwell.pshpgeorgia.com	Allwell Medicare (HMO)	01	01		1			H7173	003	0	2018	Chattahoochee, Harris and Muscogee counties		2	1210	2			2						https://advantage.pshpgeorgia.com/findadoctor	https://advantage.pshpgeorgia.com/partdformulary	https://advantage.pshpgeorgia.com/findadoctor	(844)890-2326		(844)890-2326		(877)826-3693		(877)826-3693		(844)890-2326		(844)890-2326		(877)826-3693		(877)826-3693		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7195	001	0	1	20	08	H7195_001_0	1			1		05/31/2017	2018.03	05/31/2017 09:36:43 AM Central Daylight Time		05/31/2017 09:23:00 AM Central Daylight Time			05/31/2017 09:37:54 AM Central Daylight Time	NORTHLAND PACE PROGRAM	Northland PACE Senior Care Services	http://www.northlandpace.com	Northland PACE - Dual (PACE)	08	20		1			H7195	001	0	2018	Burleigh, Morton, Stark and Ward Counties		2		2			2						http://www.pharmastarpbm.com/	n/a										(888)883-8959		(701)751-3050		(888)883-8959		(701)751-3050										(888)838-8959		(701)751-3050		(888)838-8959		(701)751-3050																
H7195	002	0	1	20	08	H7195_002_0	1			1		05/31/2017	2018.03	05/31/2017 09:36:49 AM Central Daylight Time		05/31/2017 09:23:29 AM Central Daylight Time			05/31/2017 09:37:54 AM Central Daylight Time	NORTHLAND PACE PROGRAM	Northland PACE Senior Care Services	http://www.northlandpace.com	Northland PACE - Medicare Only (PACE)	08	20		1			H7195	002	0	2018	Burleigh, Morton, Stark and Ward Counties		2		2			2						http://www.pharmastarpbm.com/	n/a										(888)883-8959		(701)751-3050		(888)883-8959		(701)751-3050										(888)838-8959		(701)751-3050		(888)838-8959		(701)751-3050																
H7200	006	0	1	01	01	H7200_006_0	7		1	1	2	06/07/2017	2018.03	06/07/2017 10:47:20 AM Pacific Daylight Time	08/07/2017 05:59:27 AM Pacific Daylight Time	08/06/2017 12:09:18 PM Pacific Daylight Time			08/07/2017 12:38:53 PM Pacific Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Dual Coordination (HMO SNP)	01	01		1			H7200	006	0	2018	Select Counties in Tennessee		2	114696	2			1	3		1		1	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(877)411-0929		(877)411-0929		(844)316-0355		(844)316-0355		(877)411-0929		(877)411-0929		(844)600-9930		(844)600-9930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7200	007	0	1	01	01	H7200_007_0	7			1		08/04/2017	2018.03	08/04/2017 10:30:28 AM Pacific Daylight Time	08/07/2017 05:59:28 AM Pacific Daylight Time	08/06/2017 12:09:19 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H7200	007	0	2018	Select Counties in Tennessee		2	23340	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)316-0355		(844)316-0355		(866)805-4589		(866)805-4589		(844)600-9930		(844)600-9930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7200	013	0	1	01	01	H7200_013_0	7			1		06/05/2017	2018.03	06/05/2017 03:53:11 PM Pacific Daylight Time	08/07/2017 05:59:28 AM Pacific Daylight Time	08/06/2017 12:09:19 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Classic (HMO)	01	01		1			H7200	013	0	2018	Select Counties in Tennessee		2	2760	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)316-0355		(844)316-0355		(866)805-4589		(866)805-4589		(844)600-9930		(844)600-9930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7200	014	0	1	01	01	H7200_014_0	6			1		08/04/2017	2018.03	08/04/2017 10:48:05 AM Pacific Daylight Time	08/07/2017 05:59:28 AM Pacific Daylight Time	08/06/2017 12:09:11 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup	www.myamerigroup.com/medicare	Amerivantage Plus (HMO)	01	01		1			H7200	014	0	2018	Select Counties in Tennessee		2	2040	2			2						www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	www.myamerigroup.com/medicare	(866)805-4589		(866)805-4589		(844)316-0355		(844)316-0355		(866)805-4589		(866)805-4589		(844)600-9930		(844)600-9930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7220	002	0	1	01	01	H7220_002_0	4	1		1		06/23/2017	2018.03	06/23/2017 05:59:23 PM Eastern Daylight Time	07/14/2017 10:20:12 AM Eastern Daylight Time				07/14/2017 10:40:24 AM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Select (HMO)	01	01		1			H7220	002	0	2018	State of Indiana - 31 counties		2	13992	2			2						www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)455-9776		(317)963-9700		(866)327-7497		(866)327-7497										(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333										2					2					2	2			
H7220	004	0	1	02	01	H7220_004_0	6	1		1		06/23/2017	2018.03	06/23/2017 06:00:23 PM Eastern Daylight Time	08/07/2017 11:58:58 AM Eastern Daylight Time	08/07/2017 11:58:01 AM Eastern Daylight Time			08/07/2017 12:56:40 PM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Choice (HMO-POS)	01	02		1			H7220	004	0	2018	State of Indiana - 25 counties		2	55128	2			2						www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)455-9776		(317)963-9700		(866)327-7497		(866)327-7497		(844)432-0695		(844)432-0695		(866)327-7497		(866)327-7497		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		2					2					2	2			
H7220	009	1	1	01	01	H7220_009_1	6	1		1		08/03/2017	2018.03	08/03/2017 12:43:32 PM Eastern Daylight Time	08/07/2017 11:57:18 AM Eastern Daylight Time	08/07/2017 11:58:07 AM Eastern Daylight Time			08/07/2017 12:56:40 PM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Select Plus (HMO)	01	01		1			H7220	009	1	2018	Indianapolis Metro Area and Surrounding Counties	State of Indiana - 35 counties	2	54432	2			2						www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)455-9776		(317)963-9700		(866)327-7497		(866)327-7497		(844)432-0695		(844)432-0695		(866)327-7497		(866)327-7497		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		2					2					2	2			
H7220	009	2	1	01	01	H7220_009_2	6	1		1		08/03/2017	2018.03	08/03/2017 12:44:23 PM Eastern Daylight Time	08/07/2017 11:57:32 AM Eastern Daylight Time	08/07/2017 11:58:13 AM Eastern Daylight Time			08/07/2017 12:56:40 PM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Select Plus (HMO)	01	01		1			H7220	009	2	2018	Indianapolis Metro Area and Surrounding Counties	Indianapolis Metro Area	2	50604	2			2						www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)455-9776		(317)963-9700		(866)327-7497		(866)327-7497		(844)432-0695		(844)432-0695		(866)327-7497		(866)327-7497		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		2					2					2	2			
H7220	009	3	1	01	01	H7220_009_3	6	1		1		08/03/2017	2018.03	08/03/2017 12:45:08 PM Eastern Daylight Time	08/07/2017 11:58:47 AM Eastern Daylight Time	08/07/2017 11:58:19 AM Eastern Daylight Time			08/07/2017 12:56:40 PM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Select Plus (HMO)	01	01		1			H7220	009	3	2018	Indianapolis Metro Area and Surrounding Counties	Ft. Wayne Area	2	2136	2			2						www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)455-9776		(317)963-9700		(866)327-7497		(866)327-7497		(844)432-0695		(844)432-0695		(866)327-7497		(866)327-7497		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		(800)743-3333		2					2					2	2			
H7245	001	0	1	01	01	H7245_001_0	17			1		08/02/2017	2018.03	08/02/2017 09:57:26 AM Pacific Daylight Time	08/03/2017 08:52:38 AM Pacific Daylight Time	08/01/2017 10:28:47 AM Pacific Daylight Time			08/04/2017 08:21:52 AM Pacific Daylight Time	PREMERA BLUE CROSS	Premera Blue Cross Medicare Advantage	premera.com/ma	Premera Blue Cross Medicare Advantage (HMO)	01	01		1			H7245	001	0	2018	King,Snohomish,Pierce,Thurston,Spokane Counties		2		2			2						premera.com/ma	premera.com/ma	premera.com/ma	(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7245	002	0	1	01	01	H7245_002_0	15			1		08/02/2017	2018.03	08/02/2017 10:19:44 AM Pacific Daylight Time	08/03/2017 08:54:32 AM Pacific Daylight Time	08/01/2017 10:28:55 AM Pacific Daylight Time			08/04/2017 08:21:52 AM Pacific Daylight Time	PREMERA BLUE CROSS	Premera Blue Cross Medicare Advantage	premera.com/ma	Premera Blue Cross Medicare Advantage Classic (HMO)	01	01		1			H7245	002	0	2018	King, Snohomish, Pierce, Thurston Counties		2		2			2						premera.com/ma	premera.com/ma	premera.com/ma	(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7245	003	0	1	01	01	H7245_003_0	15			1		06/29/2017	2018.03	06/29/2017 09:22:32 AM Pacific Daylight Time	08/03/2017 08:56:01 AM Pacific Daylight Time	08/01/2017 10:29:02 AM Pacific Daylight Time			08/04/2017 08:21:52 AM Pacific Daylight Time	PREMERA BLUE CROSS	Premera Blue Cross Medicare Advantage	premera.com/ma	Premera Blue Cross Medicare Advantage Classic Plus (HMO)	01	01		1			H7245	003	0	2018	King, Snohomish, Pierce, Thurston Counties		2		2			2						premera.com/ma	premera.com/ma	premera.com/ma	(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7245	005	0	1	01	01	H7245_005_0	14			1		08/02/2017	2018.03	08/02/2017 10:04:00 AM Pacific Daylight Time	08/03/2017 08:58:06 AM Pacific Daylight Time	08/01/2017 10:29:08 AM Pacific Daylight Time			08/04/2017 08:21:52 AM Pacific Daylight Time	PREMERA BLUE CROSS	Premera Blue Cross Medicare Advantage	premera.com/ma	Premera Blue Cross Medicare Advantage Total Health (HMO)	01	01		1			H7245	005	0	2018	Spokane County		2		2			2						premera.com/ma	premera.com/ma	premera.com/ma	(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(888)850-8526		(888)850-8526		(888)868-7767		(888)868-7767		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7262	001	0	1	20	08	H7262_001_0	2			1		06/05/2017	2018.03	06/05/2017 08:49:39 AM Mountain Daylight Time		06/05/2017 08:43:31 AM Mountain Daylight Time			06/05/2017 08:50:55 AM Mountain Daylight Time	TRU COMMUNITY CARE	TRU PACE	www.pace.trucare.org	TRU Community Care (PACE)	08	20		1			H7262	001	0	2018	Boulder and Parts of Weld Counties		2		2			2						TBD	www.trucare.org												(303)665-0115				(303)665-0115												(800)659-2656				(800)659-2656																
H7262	002	0	1	20	08	H7262_002_0	2			1		06/05/2017	2018.03	06/05/2017 08:49:49 AM Mountain Daylight Time		06/05/2017 08:43:32 AM Mountain Daylight Time			06/05/2017 08:50:55 AM Mountain Daylight Time	TRU COMMUNITY CARE	TRU PACE	www.pace.trucare.org	TRU Community Care (PACE)	08	20		1			H7262	002	0	2018	Boulder and Parts of Weld Counties		2		2			2						TBD	www.trucare.org												(303)665-0115				(303)665-0115												(800)659-2656				(800)659-2656																
H7301	002	0	1	04	01	H7301_002_0	6			1		08/02/2017	2018.03	08/02/2017 05:00:41 PM Eastern Daylight Time	08/03/2017 04:35:20 PM Eastern Daylight Time	07/31/2017 05:57:36 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra (PPO)	01	04		1			H7301	002	0	2018	Central and Northern Illinois		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7301	006	0	1	04	01	H7301_006_0	3			1		08/02/2017	2018.03	08/02/2017 03:04:06 PM Eastern Daylight Time	08/03/2017 04:36:49 PM Eastern Daylight Time	07/31/2017 05:58:06 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra Value (PPO)	01	04		1			H7301	006	0	2018	Illinois		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7301	007	0	1	04	01	H7301_007_0	4			1		08/03/2017	2018.03	08/03/2017 09:11:57 AM Central Daylight Time	08/03/2017 09:08:34 AM Central Daylight Time	07/31/2017 04:55:12 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Coventry Health Care	www.coventry-medicare.com	Advantra Value (PPO)	01	04		1			H7301	007	0	2018	Illinois		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4916		(866)784-4916		(855)338-9551		(855)338-9551		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7301	801	0	1	04	01	H7301_801_0	1			1		05/31/2017	2018.03	05/31/2017 07:29:24 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Coventry Health Care	www.chcillinoismedicare.com	Advantra MA Integrated Calendar (PPO)	01	04		1			H7301	801	0	2018	Central and Northern Illinois		1	120	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	https://coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(866)557-8753		(866)557-8753		(844)741-8423		(844)741-8423		(855)338-9551		(855)338-9551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H7301	803	0	1	04	01	H7301_803_0	1			1		05/31/2017	2018.03	05/31/2017 07:29:19 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Coventry Health Care	www.chcillinoismedicare.com	Advantra MA Only (PPO)	01	04		1			H7301	803	0	2018	Central and Northern Illinois		1	120	2			2						http://pharmacylocator.coventry-medicare.com	http://www.formulary.coventry-medicare.com	https://coventry-medicare.com/findprovider	(855)275-5888		(855)275-5888		(866)557-8753		(866)557-8753										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	2		1									
H7317	001	0	1	01	01	H7317_001_0	8			1		08/05/2017	2018.03	08/05/2017 05:24:38 PM Hawaiian Standard Time	08/04/2017 04:56:24 AM Hawaiian Standard Time	07/31/2017 10:50:56 AM Hawaiian Standard Time			08/07/2017 10:12:09 AM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA	www.hmsa.com/advantage	Essential Advantage (HMO)	01	01		1			H7317	001	0	2018	Honolulu County		2	11040	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7317	801	0	1	01	01	H7317_801_0	2			1		05/23/2017	2018.03	05/23/2017 02:28:01 PM Hawaiian Standard Time					06/03/2017 02:53:12 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA	www.hmsa.com/advantage	Essential Advantage EGWP with Drug CY (HMO)	01	01		1			H7317	801	0	2018	Honolulu County		1	0	2			2						www.hmsa.com/advantage	www.hmsa.com/advantage	www.hmsa.com/advantage	(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(800)660-4672		(808)948-6000		(800)693-4672		(808)948-6235		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					1					2	2			
H7326	001	0	1	04	01	H7326_001_0	3			1		08/04/2017	2018.03	08/04/2017 10:17:41 AM Eastern Daylight Time	08/03/2017 04:55:38 PM Eastern Daylight Time	07/31/2017 07:19:07 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF SOUTH CAROLINA, INC.	WellCare	www.wellcare.com/medicare	WellCare Premier (PPO)	01	04		1			H7326	001	0	2018	Select Counties in SC		2	9263	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fab_search	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H7326	002	0	1	04	01	H7326_002_0	3			1		08/04/2017	2018.03	08/04/2017 10:20:41 AM Eastern Daylight Time	08/03/2017 04:56:49 PM Eastern Daylight Time	07/31/2017 07:19:33 PM Eastern Daylight Time			08/04/2017 04:51:45 PM Eastern Daylight Time	WELLCARE OF SOUTH CAROLINA, INC.	WellCare	www.wellcare.com/medicare	WellCare Prime (PPO)	01	04		1			H7326	002	0	2018	Select Counties in SC		2	3235	2			2						www.WellCare.com/our_pharmacies/default	www.WellCare.com/medicare/medication_guide	www.wellcare.com/fab_search	(855)292-0237		(855)292-0237		(866)527-0056		(866)527-0056		(800)316-2273		(800)316-2273		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2						2			
H7419	001	0	1	48	05	H7419_001_0	5			1		08/11/2017	2018.03	08/11/2017 04:34:23 PM Eastern Daylight Time					08/11/2017 04:35:17 PM Eastern Daylight Time	TUFTS HEALTH PUBLIC PLANS, INC.	Tufts Health Plan	www.ChooseUnify.org	Tufts Health Unify (Medicare-Medicaid Plan)	05	48		1			H7419	001	0	2018	Middlesex*, Worcester and Suffolk counties		2	36000	2			2						www.TuftsHealthUnify.org	www.TuftsHealthUnify.org	www.TuftsHealthUnify.org	(855)393-3154		(855)393-3154		(855)393-3154		(855)393-3154		(855)393-3154		(855)393-3154		(855)393-3154		(855)393-3154		(888)391-5535		(888)391-5535		(888)391-5535		(888)391-5535		(888)391-5535		(888)391-5535		(888)391-5535		(888)391-5535																
H7445	004	0	1	01	01	H7445_004_0	5			1		05/30/2017	2018.03	05/30/2017 04:23:01 PM Central Daylight Time	08/03/2017 01:16:07 PM Central Daylight Time	08/01/2017 11:34:06 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE OF ILLINOIS, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare MedicareComplete (HMO)	01	01		1			H7445	004	0	2018	Carroll county		2		2			2						www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7464	001	0	1	01	01	H7464_001_0	4		1	1	2	06/28/2017	2018.03	06/28/2017 10:50:48 AM Central Daylight Time	08/03/2017 01:16:37 PM Central Daylight Time	08/01/2017 11:34:33 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H7464	001	0	2018	Select Counties in VA		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(800)690-1606		(800)690-1606		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7501	001	0	1	20	08	H7501_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:41:45 PM Pacific Daylight Time		05/23/2017 05:31:31 PM Pacific Daylight Time			05/24/2017 03:06:09 PM Pacific Daylight Time	ORANGE COUNTY HEALTH AUTHORITY	CalOptima PACE	https://www.caloptima.org/en/Members/PACE.aspx	CalOptima PACE (PACE)	08	20		1			H7501	001	0	2018	Orange County		2		2			2						www.caloptima.org/home/providers/pharmacy.aspx	www.caloptima.org										(855)785-2584		(714)468-1100		(855)785-2584		(714)468-1100										(800)735-2929		(714)468-1063		(800)735-2929		(714)468-1063																
H7501	002	0	1	20	08	H7501_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:42:30 PM Pacific Daylight Time		05/23/2017 05:31:54 PM Pacific Daylight Time			05/24/2017 03:06:09 PM Pacific Daylight Time	ORANGE COUNTY HEALTH AUTHORITY	CalOptima PACE	www.caloptima.org	CalOptima PACE (PACE)	08	20		1			H7501	002	0	2018	Orange County		2		2			2						www.caloptima.org/home/providers/pharmacy.aspx	www.caloptima.org										(855)785-2584		(714)468-1100		(855)785-2584		(714)468-1100										(800)735-2929		(714)468-1063		(800)735-2929		(714)468-1063																
H7511	001	0	1	01	01	H7511_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:20:49 AM Central Daylight Time	08/07/2017 10:57:54 AM Central Daylight Time	08/07/2017 10:58:04 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Good Samaritan Insurance Plan of Nebraska	www.goodsamaritaninsuranceplan.com	Good Samaritan Insurance Plan NE (HMO SNP)	01	01		1			H7511	001	0	2018	Nebraska (partial)		2	12616	2			1	1	1				www.gsipne.com	www.gsipne.com	www.goodsamaritaninsuranceplan.com	(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7522	001	0	1	04	01	H7522_001_0	14			1		08/07/2017	2018.03	08/07/2017 05:10:59 PM SA Western Standard Time	08/07/2017 01:59:52 PM SA Western Standard Time	08/07/2017 05:57:46 PM SA Western Standard Time			08/07/2017 06:54:21 PM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.firstpluspr.com	First+Plus - Advantage (PPO)	01	04		1			H7522	001	0	2018	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.firstpluspr.com	(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		2					2						1	01	7d;8a1;8b1;8b2;8b3;9a;9b;12;	
H7522	801	0	1	04	01	H7522_801_0	9			1		06/13/2017	2018.03	06/13/2017 10:06:07 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.firstpluspr.com	First+Plus - Advantage Group Non Calendar (PPO)	01	04		1			H7522	801	0	2018	Puerto Rico		1	0	2			2						www.mmm-pr.com	www.mmm-pr.com	www.firstpluspr.com	(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		1	1	1a;1b;2;5;6;7c;7i;8b1;8b2;9a;9b;9c;11a;11b;11c;	2		1									
H7522	802	0	1	04	01	H7522_802_0	9			1		06/13/2017	2018.03	06/13/2017 10:06:35 AM SA Western Standard Time					06/13/2017 10:17:29 AM SA Western Standard Time	MMM HEALTHCARE, LLC	Medicare y Mucho Ms	www.firstpluspr.com	First+Plus - Advantage Group Calendar (PPO)	01	04		1			H7522	802	0	2018	Puerto Rico		1	12373	2			2						www.mmm-pr.com	www.mmm-pr.com	www.firstpluspr.com	(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(888)767-7717		(787)522-7800		(877)662-4242		(787)620-1282		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		(877)672-4242		(877)672-4242		(844)690-9666		(844)690-9666		1	1	1a;1b;2;5;6;7c;7i;8b1;8b2;9a;9b;9c;11a;11b;11c;	2		1									
H7660	001	0	1	20	08	H7660_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:05:50 PM Eastern Daylight Time		05/24/2017 04:23:35 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE BEAVER, LLC	LIFE Beaver and Lawrence Counties	http://www.lutheranseniorlife.org	VieCare Beaver, LLC dba LIFE Beaver and Lawrence C (PACE)	08	20		1			H7660	001	0	2018	Beaver and Lawrence Counties		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)302-2488		(724)742-2226		(724)378-5400		(724)378-5400										(711)-		(711)-		(724)378-5400		(724)378-5400																
H7660	002	0	1	20	08	H7660_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:06:49 PM Eastern Daylight Time		05/24/2017 04:23:36 PM Eastern Daylight Time			05/25/2017 01:12:35 PM Eastern Daylight Time	VIECARE BEAVER, LLC	LIFE Beaver and Lawrence Counties	www.LutheranSeniorLife.org	VieCare Beaver, LLC dba LIFE Beaver and Lawrence C (PACE)	08	20		1			H7660	002	0	2018	Beaver and Lawrence Counties		2		2			2						www.lutheranseniorlife.org	www.lutheranseniorlife.org										(724)302-2488		(724)742-2226		(724)378-5400		(724)378-5400										(711)-		(711)-		(724)378-5400		(724)378-5400																
H7678	001	0	1	01	01	H7678_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 10:21:24 AM Pacific Daylight Time	08/04/2017 08:31:30 AM Pacific Daylight Time	08/01/2017 09:17:42 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H7678	001	0	2018	Texas		2		2			1	3		1		1	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(866)440-0012		(866)440-0012		(866)403-8293		(866)403-8293		(866)440-0012		(866)440-0012		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	001	0	1	01	01	H7680_001_0	13			1		08/04/2017	2018.03	08/04/2017 02:42:51 PM Pacific Daylight Time	08/06/2017 08:18:17 AM Pacific Daylight Time	08/06/2017 08:18:17 AM Pacific Daylight Time			08/06/2017 12:24:02 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Plus (HMO)	01	01		1			H7680	001	0	2018	North Texas		2	16224	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	002	0	1	01	01	H7680_002_0	8			1		08/04/2017	2018.03	08/04/2017 04:25:19 PM Pacific Daylight Time	08/06/2017 08:18:17 AM Pacific Daylight Time	08/06/2017 08:18:18 AM Pacific Daylight Time			08/06/2017 12:26:04 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Plus (HMO)	01	01		1			H7680	002	0	2018	South Texas		2	18480	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	005	0	1	01	01	H7680_005_0	13			1		08/10/2017	2018.03	08/10/2017 08:09:48 AM Pacific Daylight Time	08/06/2017 08:18:18 AM Pacific Daylight Time	08/06/2017 08:18:18 AM Pacific Daylight Time			08/10/2017 08:11:04 AM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Enhanced (HMO)	01	01		1			H7680	005	0	2018	North Texas		2	16776	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	006	0	1	01	01	H7680_006_0	11			1		06/30/2017	2018.03	06/30/2017 09:29:08 AM Pacific Daylight Time	08/06/2017 08:18:19 AM Pacific Daylight Time	08/06/2017 08:18:19 AM Pacific Daylight Time			08/06/2017 12:30:20 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Enhanced (HMO)	01	01		1			H7680	006	0	2018	South Texas		2	18720	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	801	0	1	01	01	H7680_801_0	2			1		05/22/2017	2018.03	05/22/2017 09:24:43 AM Pacific Daylight Time					06/02/2017 04:51:33 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	801	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H7680	802	0	1	01	01	H7680_802_0	2			1		05/22/2017	2018.03	05/22/2017 09:18:37 AM Pacific Daylight Time					06/02/2017 04:53:52 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	802	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	803	0	1	01	01	H7680_803_0	2			1		05/22/2017	2018.03	05/22/2017 09:32:53 AM Pacific Daylight Time					06/02/2017 04:55:51 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	803	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	804	0	1	01	01	H7680_804_0	2			1		05/22/2017	2018.03	05/22/2017 09:35:49 AM Pacific Daylight Time					06/02/2017 04:57:06 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	804	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H7680	805	0	1	01	01	H7680_805_0	2			1		05/22/2017	2018.03	05/22/2017 09:39:27 AM Pacific Daylight Time					06/02/2017 04:58:42 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	805	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7680	806	0	1	01	01	H7680_806_0	2			1		05/22/2017	2018.03	05/22/2017 09:42:12 AM Pacific Daylight Time					06/02/2017 05:00:39 PM Pacific Daylight Time	PROMINENCE HEALTHFIRST OF TEXAS	Prominence Health Plan	www.prominencemedicare.com	Prominence Health Plan (HMO)	01	01		1			H7680	806	0	2018	National		1	1	2			2						www.prominencemedicare.com	www.prominencemedicare.com	www.prominencemedicare.com	(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(855)969-5882		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7728	002	0	1	04	01	H7728_002_0	7			1		06/05/2017	2018.03	06/05/2017 05:11:57 PM Eastern Daylight Time	08/07/2017 08:59:29 AM Eastern Daylight Time	08/06/2017 03:09:12 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H7728	002	0	2018	Select Counties in New Hampshire		2	13692	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)304-1787		(855)304-1787		(844)368-4245		(844)368-4245		(855)304-1787		(855)304-1787		(844)368-4244		(844)368-4244		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7728	004	1	1	04	01	H7728_004_1	5			1		06/03/2017	2018.03	06/03/2017 08:49:52 AM Eastern Daylight Time	08/07/2017 08:59:29 AM Eastern Daylight Time	08/06/2017 03:09:12 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H7728	004	1	2018	Select counties in KY	Lexington and Cincinnati	2	50976	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)690-7795		(855)690-7795		(844)368-4245		(844)368-4245		(855)690-7795		(855)690-7795		(844)368-4244		(844)368-4244		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7728	004	2	1	04	01	H7728_004_2	5			1		06/03/2017	2018.03	06/03/2017 08:49:58 AM Eastern Daylight Time	08/07/2017 08:59:29 AM Eastern Daylight Time	08/06/2017 03:09:12 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access (PPO)	01	04		1			H7728	004	2	2018	Select counties in KY	Louisville	2	53748	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)690-7795		(855)690-7795		(844)368-4245		(844)368-4245		(855)690-7795		(855)690-7795		(844)368-4244		(844)368-4244		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7728	005	0	1	04	01	H7728_005_0	5			1		06/29/2017	2018.03	06/29/2017 09:13:28 AM Pacific Daylight Time	08/07/2017 05:59:30 AM Pacific Daylight Time	08/06/2017 12:09:12 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.bcbsga.com/medicare	BCBSGa MediBlue Access (PPO)	01	04		1			H7728	005	0	2018	Select Counties in Georgia		2	27612	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(866)438-9968		(866)438-9968		(844)368-4245		(844)368-4245		(866)438-9968		(866)438-9968		(844)368-4244		(844)368-4244		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7728	801	0	1	04	01	H7728_801_0	1			1		06/03/2017	2018.03	06/03/2017 02:53:04 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H7728	801	0	2018	New Hampshire		1	53661	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H7728	802	0	1	04	01	H7728_802_0	1			1		06/03/2017	2018.03	06/03/2017 02:54:38 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H7728	802	0	2018	New Hampshire		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H7728	803	0	1	04	01	H7728_803_0	1			1		06/03/2017	2018.03	06/03/2017 02:53:12 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		1			H7728	803	0	2018	New Hampshire		1	600	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H7728	804	0	2	04	01	H7728_804_0	1			1		06/03/2017	2018.03	06/03/2017 02:59:25 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem Medicare Preferred (PPO)	01	04		2	1		H7728	804	0	2018	National		1	96	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(855)320-6556		(855)320-6556		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H7787	001	0	1	04	01	H7787_001_0	3			1		08/02/2017	2018.03	08/02/2017 12:29:54 PM Central Daylight Time	08/03/2017 09:13:06 AM Central Daylight Time	08/01/2017 02:16:24 PM Central Daylight Time			08/05/2017 09:13:34 AM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (PPO)	01	04		1			H7787	001	0	2018	North Texas		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7787	002	0	1	04	01	H7787_002_0	3			1		06/28/2017	2018.03	06/28/2017 09:33:55 PM Central Daylight Time	05/28/2017 10:55:24 PM Central Daylight Time				06/29/2017 05:24:38 PM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (PPO)	01	04		1			H7787	002	0	2018	North Texas		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(800)846-2098		(800)846-2098										(711)-		(711)-		(711)-		(711)-										2					2						2			
H7802	001	0	1	01	01	H7802_001_0	3		1	1		08/04/2017	2018.03	08/04/2017 05:49:27 PM Central Daylight Time	08/07/2017 10:57:55 AM Central Daylight Time	08/07/2017 10:58:04 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN VA, INC.	Spartan Plan VA, Inc.	www.sunriseadvantage.com	Spartan Plan VA I-SNP (HMO SNP)	01	01		1			H7802	001	0	2018	Virginia (partial)		2	1380	2			1	1	3				www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7802	002	0	1	01	01	H7802_002_0	3		1	1		08/04/2017	2018.03	08/04/2017 05:49:41 PM Central Daylight Time	08/07/2017 10:57:55 AM Central Daylight Time	08/07/2017 10:58:05 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN VA, INC.	Spartan Plan VA, Inc.	www.sunriseadvantage.com	Spartan Plan VA C-SNP (HMO SNP)	01	01		1			H7802	002	0	2018	Virginia (partial)		2	2760	2			1	4			00000100000000000000		www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7802	003	0	1	01	01	H7802_003_0	4			1		08/04/2017	2018.03	08/04/2017 05:49:56 PM Central Daylight Time	08/07/2017 10:57:56 AM Central Daylight Time	08/07/2017 10:58:05 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	SPARTAN PLAN VA, INC.	Spartan Plan VA, Inc.	www.sunriseadvantage.com	Spartan Plan VA (HMO)	01	01		1			H7802	003	0	2018	Virginia (partial)		2	4320	2			2						www.sunriseadvantage.com	www.sunriseadvantage.com	www.sunriseadvantage.com	(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(844)896-0628		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H7833	001	0	1	48	05	H7833_001_0	2			1		06/28/2017	2018.03	06/28/2017 11:11:42 AM US Mountain Standard Time					06/28/2017 11:19:41 AM US Mountain Standard Time	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	UnitedHealthcare	www.UHCCommunityplan.com	UnitedHealthcare Connected (Medicare-Medicaid Plan)	05	48		1			H7833	001	0	2018	Harris County		2		2			2						www.optumrx.com	www.UHCCommunityplan.com	www.UHCCommunityplan.com	(800)256-6533		(800)256-6533		(800)256-6533		(800)256-6533		(800)256-6533		(800)256-6533		(800)256-6533		(800)256-6533		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H7844	001	0	1	48	05	H7844_001_0	6			1		08/24/2017	2018.03	08/24/2017 02:05:25 PM Pacific Daylight Time					08/24/2017 02:43:42 PM Pacific Daylight Time	MOLINA HEALTHCARE OF MICHIGAN, INC.	Molina Healthcare of Michigan	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H7844	001	0	2018	Wayne and Macomb County		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(855)735-5604		(855)735-5604		(855)701-4885		(855)701-4885		(855)735-5604		(855)735-5604		(855)701-4885		(855)701-4885		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H7853	001	0	1	01	01	H7853_001_0	6			1		08/04/2017	2018.03	08/04/2017 02:22:04 PM Central Daylight Time	08/03/2017 11:54:56 AM Central Daylight Time	08/03/2017 11:32:14 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH INSURANCE COMPANY	Bright Health	http://www.brighthealthplan.com/	Bright Advantage (HMO)	01	01		1			H7853	001	0	2018	Greater Denver Area		2	50400	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		2					2					2	2			
H7853	002	0	1	01	01	H7853_002_0	6			1		07/20/2017	2018.03	07/20/2017 06:47:26 PM Central Daylight Time	08/03/2017 11:55:01 AM Central Daylight Time	08/03/2017 11:32:17 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH INSURANCE COMPANY	Bright Health	http://www.brighthealthplan.com/	Bright Advantage Plus (HMO)	01	01		1			H7853	002	0	2018	Greater Denver Area		2	21600	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		(844)202-4793		(844)202-4793		(844)679-2029		(844)679-2029		2					2					2	2			
H7855	001	0	1	20	08	H7855_001_0	1			1		05/24/2017	2018.03	05/24/2017 10:11:25 AM Pacific Daylight Time		05/24/2017 09:34:17 AM Pacific Daylight Time			05/24/2017 10:15:12 AM Pacific Daylight Time	BRANDMAN CENTERS FOR SENIOR CARE, INC.	Brandman Centers for Senior Care	www.brandmanseniorcare.org	Brandman Centers for Senior Care-Dual (PACE)	08	20		1			H7855	001	0	2018	Brandman Centers for Senior Care-Dual		2		2			2						www.carekinesis.com	Not applicable										(855)744-8444	3033	(818)774-8444	3033	(855)774-8444		(818)774-8444										(818)774-3194		(818)774-3194		(818)774-3194		(818)774-3194																
H7855	002	0	1	20	08	H7855_002_0	2			1		05/24/2017	2018.03	05/24/2017 10:12:15 AM Pacific Daylight Time		05/24/2017 11:07:03 AM Pacific Daylight Time			05/24/2017 11:10:43 AM Pacific Daylight Time	BRANDMAN CENTERS FOR SENIOR CARE, INC.	Brandman Centers for Senior Care	www.brandmanseniorcare.org	Brandman Centers for Senior Care-Medicare Only (PACE)	08	20		1			H7855	002	0	2018	Brandman Centers for Senior Care-Medicare Only		2		2			2						www.carekinesis.com	Not applicable										(855)774-8444		(818)774-8444		(855)774-8444		(818)774-8444										(818)774-3194		(818)774-3194		(818)774-3194		(818)774-3194																
H7885	001	0	1	48	05	H7885_001_0	7			1		09/18/2017	2018.03	09/18/2017 02:59:48 PM Pacific Daylight Time					09/18/2017 02:59:55 PM Pacific Daylight Time	SAN MATEO HEALTH COMMISSION	Health Plan of San Mateo	www.hpsm.org	CareAdvantage Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H7885	001	0	2018	San Mateo County		2	109450	2			2						https://www.hpsm.org/providers/pharmacy.aspx	https://www.hpsm.org/search/formularies.aspx	https://www.hpsm.org/search/formularies.aspx	(866)880-0606		(650)616-2174		(888)252-3153		(650)616-1500		(866)880-0606		(650)616-2174		(888)252-3153		(650)616-1500		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929																
H7890	001	0	1	48	05	H7890_001_0	5			1		09/18/2017	2018.03	09/18/2017 02:06:46 PM Pacific Daylight Time					09/18/2017 02:31:33 PM Pacific Daylight Time	SANTA CLARA COUNTY HEALTH AUTHORITY	Santa Clara Family Health Plan Cal MediConnect	www.scfhp.com	Santa Clara Family Health Plan (Medicare-Medicaid Plan)	05	48		1			H7890	001	0	2018	Santa Clara County		2	96000	2			2						www.scfhp.com/healthcareplans/calmediconnect	www.scfhp.com	www.scfhp.com/healthcareplans/calmediconnect	(877)723-4795		(408)376-2000		(888)202-3353		(408)376-2000		(877)723-4795		(408)376-2000		(888)202-3353		(408)376-2000		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929																
H7917	008	0	1	04	01	H7917_008_0	5			1		07/06/2017	2018.03	07/06/2017 04:51:09 PM Eastern Daylight Time	08/03/2017 01:13:32 PM Eastern Daylight Time	08/03/2017 01:14:04 PM Eastern Daylight Time			08/04/2017 09:12:31 AM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	008	0	2018	West Tennessee		2	4330	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	009	0	1	04	01	H7917_009_0	7			1		08/04/2017	2018.03	08/04/2017 09:31:37 AM Eastern Daylight Time	08/03/2017 01:56:36 PM Eastern Daylight Time	08/03/2017 01:57:06 PM Eastern Daylight Time			08/04/2017 09:32:56 AM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	009	0	2018	Middle Tennessee		2	12231	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	010	0	1	04	01	H7917_010_0	7			1		08/04/2017	2018.03	08/04/2017 09:31:48 AM Eastern Daylight Time	08/03/2017 01:57:52 PM Eastern Daylight Time	08/03/2017 01:58:22 PM Eastern Daylight Time			08/04/2017 09:32:56 AM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	010	0	2018	Southeast Tennessee		2	15861	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	011	0	1	04	01	H7917_011_0	8			1		08/04/2017	2018.03	08/04/2017 09:31:57 AM Eastern Daylight Time	08/03/2017 01:16:54 PM Eastern Daylight Time	08/03/2017 01:17:24 PM Eastern Daylight Time			08/04/2017 09:32:56 AM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	011	0	2018	Northeast Tennessee		2	42566	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	012	0	1	04	01	H7917_012_0	8			1		08/11/2017	2018.03	08/11/2017 03:41:35 PM Eastern Daylight Time	08/03/2017 01:18:14 PM Eastern Daylight Time	08/03/2017 01:18:42 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	012	0	2018	West Tennessee		2	14136	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	013	0	1	04	01	H7917_013_0	8			1		08/11/2017	2018.03	08/11/2017 03:41:19 PM Eastern Daylight Time	08/03/2017 01:19:28 PM Eastern Daylight Time	08/03/2017 01:19:56 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	013	0	2018	Middle Tennessee		2	26982	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	014	0	1	04	01	H7917_014_0	8			1		08/11/2017	2018.03	08/11/2017 03:41:03 PM Eastern Daylight Time	08/03/2017 01:20:42 PM Eastern Daylight Time	08/03/2017 01:21:10 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	014	0	2018	Southeast Tennessee		2	75277	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	015	0	1	04	01	H7917_015_0	8			1		08/11/2017	2018.03	08/11/2017 03:40:45 PM Eastern Daylight Time	08/03/2017 01:22:04 PM Eastern Daylight Time	08/03/2017 01:22:34 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	015	0	2018	Northeast Tennessee		2	30347	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	030	0	1	04	01	H7917_030_0	8			1		08/11/2017	2018.03	08/11/2017 03:43:55 PM Eastern Daylight Time	08/03/2017 01:23:22 PM Eastern Daylight Time	08/03/2017 01:23:52 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Sapphire (PPO)	01	04		1			H7917	030	0	2018	Southeast Tennessee		2	206267	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	031	0	1	04	01	H7917_031_0	8			1		08/11/2017	2018.03	08/11/2017 03:44:14 PM Eastern Daylight Time	08/03/2017 01:24:38 PM Eastern Daylight Time	08/03/2017 01:25:06 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Sapphire (PPO)	01	04		1			H7917	031	0	2018	Northeast Tennessee		2	425572	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	032	0	1	04	01	H7917_032_0	8			1		08/11/2017	2018.03	08/11/2017 03:44:28 PM Eastern Daylight Time	08/03/2017 01:25:58 PM Eastern Daylight Time	08/03/2017 01:26:32 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Garnet (PPO)	01	04		1			H7917	032	0	2018	Middle Tennessee		2	431036	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	033	0	1	04	01	H7917_033_0	8			1		08/11/2017	2018.03	08/11/2017 03:44:43 PM Eastern Daylight Time	08/03/2017 01:27:26 PM Eastern Daylight Time	08/03/2017 01:28:00 PM Eastern Daylight Time			08/11/2017 03:46:32 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Garnet (PPO)	01	04		1			H7917	033	0	2018	West Tennessee		2	146899	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(800)831-2583		(800)831-2583		(800)292-5146		(800)292-5146		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7917	801	0	1	04	01	H7917_801_0	3			1		06/14/2017	2018.03	06/14/2017 03:00:00 PM Eastern Daylight Time					06/14/2017 03:08:11 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Plus (PPO)	01	04		1			H7917	801	0	2018	22 County Region		1	37200	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072		(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7i;8b1;8b2;9b;11a;15;	2		1									
H7917	802	0	1	04	01	H7917_802_0	3			1		06/14/2017	2018.03	06/14/2017 03:00:43 PM Eastern Daylight Time					06/14/2017 03:08:11 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage Plus (PPO)	01	04		1			H7917	802	0	2018	22 County Region		1	1200	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072		(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7i;8b1;8b2;9b;11a;15;	2		1									
H7917	803	0	1	04	01	H7917_803_0	3			1		06/14/2017	2018.03	06/14/2017 03:01:10 PM Eastern Daylight Time					06/14/2017 03:08:11 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	bcbstmedicare.com	BlueAdvantage (PPO)	01	04		1			H7917	803	0	2018	22 County Region		1	2400	2			2						bcbstmedicare.com	bcbstmedicare.com	bcbstmedicare.com	(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7c;7i;8b1;8b2;9b;11a;15;	2		1									
H7971	001	0	1	04	01	H7971_001_0	7			1		07/07/2017	2018.03	07/07/2017 07:19:25 AM Eastern Daylight Time	08/03/2017 11:05:24 AM Eastern Daylight Time	08/03/2017 11:04:46 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com/Medicare	Horizon Medicare Blue (PPO)	01	04		1			H7971	001	0	2018	Sussex County		2	284	2			2						www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://directory.horizonblue.com	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H7971	801	0	1	04	01	H7971_801_0	1			1		05/30/2017	2018.03	05/30/2017 10:22:01 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Blue Group (PPO)	01	04		1			H7971	801	0	2018	National		1	175	2			2						medicare.horizonblue.com/medicare-advantage-health-insurance-plans-new-jersey-introduction	medicare.horizonblue.com/medicare-advantage-health-insurance-new-jersey-formulary-drug-search	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H7971	802	0	1	04	01	H7971_802_0	1			1		05/30/2017	2018.03	05/30/2017 10:22:36 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Blue Group w/rx (PPO)	01	04		1			H7971	802	0	2018	National		1	2539	2			2						https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPPOG/en.html	https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPPOG/en/find-medicine.html	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134		(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H7971	805	0	1	04	01	H7971_805_0	2			1		05/30/2017	2018.03	05/30/2017 10:23:26 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Advantage NJ DIRECT10 (PPO)	01	04		1			H7971	805	0	2018	National		1	396433	2			2						medicare.horizonblue.com/medicare-advantage-health-insurance-plans-new-jersey-introduction	medicare.horizonblue.com/medicare-advantage-health-insurance-new-jersey-formulary-drug-search	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H7971	806	0	1	04	01	H7971_806_0	1			1		05/30/2017	2018.03	05/30/2017 10:24:05 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.HorizonBlue.com	Horizon Medicare Advantage NJ DIRECT15 (PPO)	01	04		1			H7971	806	0	2018	National		1	339869	2			2						medicare.horizonblue.com/medicare-advantage-health-insurance-plans-new-jersey-introduction	medicare.horizonblue.com/medicare-advantage-health-insurance-new-jersey-formulary-drug-search	http://directory.horizonblue.com/	(800)365-2223		(800)365-2223		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7d;7e;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;15;	2		1									
H8003	001	0	1	04	01	H8003_001_0	3			1		08/03/2017	2018.03	08/03/2017 09:55:45 AM Eastern Daylight Time	08/03/2017 10:38:13 AM Eastern Daylight Time	08/03/2017 10:38:36 AM Eastern Daylight Time			08/04/2017 11:07:20 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Total (PPO)	01	04		1			H8003	001	0	2018	Upstate		2	50000	2			2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8003	002	0	1	04	01	H8003_002_0	3			1		08/03/2017	2018.03	08/03/2017 10:01:15 AM Eastern Daylight Time	08/03/2017 10:39:10 AM Eastern Daylight Time	08/03/2017 10:39:33 AM Eastern Daylight Time			08/04/2017 11:07:20 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Total (PPO)	01	04		1			H8003	002	0	2018	Midlands/Coastal		2	40000	2			2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8003	003	0	1	04	01	H8003_003_0	3			1		08/03/2017	2018.03	08/03/2017 10:12:10 AM Eastern Daylight Time	08/03/2017 10:40:08 AM Eastern Daylight Time	08/03/2017 10:40:31 AM Eastern Daylight Time			08/04/2017 11:07:20 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Total (PPO)	01	04		1			H8003	003	0	2018	Lowcountry		2	30000	2			2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8003	801	0	1	04	01	H8003_801_0	1			1		05/26/2017	2018.03	05/26/2017 05:49:42 PM Eastern Daylight Time					06/03/2017 10:44:24 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MAPD Calendar Year Group (PPO)	01	04		1			H8003	801	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H8003	802	0	1	04	01	H8003_802_0	1			1		05/26/2017	2018.03	05/26/2017 05:50:48 PM Eastern Daylight Time					06/03/2017 10:44:24 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MAPD Non-calendar Year Group (PPO)	01	04		1			H8003	802	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
H8003	803	0	1	04	01	H8003_803_0	1			1		05/26/2017	2018.03	05/26/2017 05:54:43 PM Eastern Daylight Time					06/03/2017 10:44:24 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MA Only Calendar Year Group (PPO)	01	04		1			H8003	803	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H8003	804	0	1	04	01	H8003_804_0	1			1		05/26/2017	2018.03	05/26/2017 05:55:17 PM Eastern Daylight Time					06/03/2017 10:44:24 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.SCBluesMedAdvantage.com/retplan18	BlueCross MA Only Non-calendar Year Group (PPO)	01	04		1			H8003	804	0	2018	Nationwide		1	120	2			2						www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	www.SCBluesMedAdvantage.com/retplan18	(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
H8016	001	0	1	48	05	H8016_001_0	7			1		09/19/2017	2018.03	09/19/2017 01:42:11 PM Pacific Daylight Time					09/19/2017 01:42:16 PM Pacific Daylight Time	ORANGE COUNTY HEALTH AUTHORITY	OneCare Connect	www.caloptima.org/onecareconnect	OneCare Connect (Medicare-Medicaid Plan)	05	48		1			H8016	001	0	2018	Orange County, CA		2		2			2						http://www.caloptima.org/Home/Providers/Pharmacy.aspx	www.caloptima.org	www.caloptima.org/OneCareConnect	(855)705-8823		(855)705-8823		(855)705-8823		(855)705-8823		(855)705-8823		(855)705-8823		(855)705-8823		(855)705-8823		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929		(800)735-2929																
H8026	001	0	1	48	05	H8026_001_0	5			1		08/23/2017	2018.03	08/23/2017 01:51:48 PM Central Daylight Time					08/23/2017 01:57:14 PM Central Daylight Time	AETNA BETTER HEALTH OF MICHIGAN INC.	Aetna Better Health Premier Plan	www.aetnabetterhealth.com/michigan	Aetna Better Health Premier Plan (Medicare-Medicaid Plan)	05	48		1			H8026	001	0	2018	Wayne, Macomb and Southwest Michigan Regions		2	89796	2			2						www.aetnabetterhealth.com/michigan	www.aetnabetterhealth.com/michigan	www.aetnabetterhealth.com/michigan	(855)676-5772		(855)676-5772		(855)676-5772		(855)676-5772		(855)676-5772		(855)676-5772		(855)676-5772		(855)676-5772		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8029	001	0	1	48	05	H8029_001_0	3			1		07/06/2017	2018.03	07/06/2017 04:43:04 PM Eastern Daylight Time					07/06/2017 05:06:27 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan FIDA Total Care	www.elderplanfida.org	Elderplan FIDA Total Care (Medicare-Medicaid Plan)	05	48		1			H8029	001	0	2018	Ki, Qu, Brx, NY, Ri, and Na		2	4614	2			2						www.caremark.com	www.elderplanfida.org	www.elderplanfida.org	(855)462-3167		(718)921-7979		(866)695-8101		(866)695-8101		(855)462-3167		(718)921-7979		(866)695-8101		(866)695-8101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8046	001	0	1	48	05	H8046_001_0	5			1		09/18/2017	2018.03	09/18/2017 02:40:42 PM Pacific Daylight Time					09/18/2017 03:02:36 PM Pacific Daylight Time	MOLINA HEALTHCARE OF ILLINOIS, INC.	Molina Healthcare of Illinois	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H8046	001	0	2018	Davenport, Peoria, Champaign, Chicago		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(877)901-8181		(877)901-8181		(855)895-9987		(855)895-9987		(877)901-8181		(877)901-8181		(855)895-9987		(855)895-9987		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8064	002	0	1	04	01	H8064_002_0	4			1		07/26/2017	2018.03	07/26/2017 10:59:30 AM Pacific Daylight Time	08/05/2017 01:54:35 PM Pacific Daylight Time	08/03/2017 12:42:41 PM Pacific Daylight Time			08/07/2017 11:27:42 AM Pacific Daylight Time	FIRSTCAROLINACARE INSURANCE COMPANY	FirstMedicare Direct	www.firstmedicare.com	FirstMedicare Direct PPO Plus (PPO)	01	04		1			H8064	002	0	2018	South Central North Carolina		2	12588	2			2						www.firstmedicare.com	www.firstmedicare.com	www.firstmedicare.com	(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(844)201-4957		(844)201-4957		(877)279-1732		(877)279-1732		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8067	001	0	1	01	01	H8067_001_0	7		1	1		06/05/2017	2018.03	06/05/2017 01:20:16 PM Eastern Daylight Time	08/04/2017 12:50:43 PM Eastern Daylight Time	08/04/2017 12:50:43 PM Eastern Daylight Time			08/04/2017 12:55:51 PM Eastern Daylight Time	PROVIDER PARTNERS HEALTH PLAN, INC.	Provider Partners Maryland Advantage Plan	pphealthplan.com	Provider Partners Maryland Advantage Plan (HMO SNP)	01	01		1			H8067	001	0	2018	Western & Central Maryland		2	16932	2			1	1	1				pphealthplan.com	pphealthplan.com	pphealthplan.com	(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(800)405-9681		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H8096	001	0	1	20	08	H8096_001_0	1			1		05/24/2017	2018.03	05/24/2017 04:06:31 PM Eastern Daylight Time		05/24/2017 03:58:15 PM Eastern Daylight Time			05/24/2017 04:08:17 PM Eastern Daylight Time	CENTRA HEALTH, INC.	Centra PACE	http://www.centrahealth.com/pace-program	Centra PACE - Dual (PACE)	08	20		1			H8096	001	0	2018	Centra PACE - Lynchburg		2		2			2						www.centrahealth.com	http:\\www.centrahealth.com										(888)316-9540		(434)200-6516		(888)316-9540		(434)200-6516										(800)828-1140		(800)828-1140		(800)828-1140		(800)828-1140																
H8096	002	0	1	20	08	H8096_002_0	1			1		05/24/2017	2018.03	05/24/2017 04:06:57 PM Eastern Daylight Time		05/24/2017 03:58:12 PM Eastern Daylight Time			05/24/2017 04:08:17 PM Eastern Daylight Time	CENTRA HEALTH, INC.	Centra PACE	http://www.centrahealth.com/pace-program	Centra PACE - Medicare only (PACE)	08	20		1			H8096	002	0	2018	Centra PACE - Lynchburg		2		2			2						www.centrahealth.com	http:\\www.centrahealth.com										(888)316-9540		(434)200-6516		(888)316-9540		(434)200-6516										(800)828-1140		(800)828-1140		(800)828-1140		(800)828-1140																
H8130	001	0	1	01	01	H8130_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:42:20 AM Pacific Daylight Time	08/04/2017 08:32:42 AM Pacific Daylight Time	08/01/2017 09:18:56 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF FLORIDA, INC.	Molina Healthcare of Florida	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H8130	001	0	2018	Tampa, West Palm Beach, Miami		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(866)553-9494		(866)553-9494		(866)403-8293		(866)403-8293		(866)553-9494		(866)553-9494		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	001	0	1	01	01	H8133_001_0	8			1		08/04/2017	2018.03	08/04/2017 11:08:42 AM Central Daylight Time	08/04/2017 04:43:11 PM Central Daylight Time	08/01/2017 03:55:11 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H8133	001	0	2018	Houston Metro Area		2	27221	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	003	0	1	01	01	H8133_003_0	8			1		08/04/2017	2018.03	08/04/2017 11:08:54 AM Central Daylight Time	08/04/2017 04:46:58 PM Central Daylight Time	08/01/2017 03:55:43 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H8133	003	0	2018	El Paso		2	3155	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	004	0	1	01	01	H8133_004_0	8			1		08/04/2017	2018.03	08/04/2017 11:09:08 AM Central Daylight Time	08/07/2017 01:57:45 PM Central Daylight Time	08/01/2017 03:56:14 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Premier (HMO)	01	01		1			H8133	004	0	2018	El Paso		2	968	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	005	0	1	01	01	H8133_005_0	8			1		08/04/2017	2018.03	08/04/2017 11:09:20 AM Central Daylight Time	08/04/2017 04:54:41 PM Central Daylight Time	08/01/2017 03:56:46 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H8133	005	0	2018	South Texas		2	22731	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	006	0	1	01	01	H8133_006_0	8			1		08/04/2017	2018.03	08/04/2017 11:09:34 AM Central Daylight Time	08/07/2017 01:58:38 PM Central Daylight Time	08/01/2017 03:57:17 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Premier (HMO)	01	01		1			H8133	006	0	2018	South Texas		2	6529	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	007	0	1	01	01	H8133_007_0	8			1		08/04/2017	2018.03	08/04/2017 11:07:34 AM Central Daylight Time	08/04/2017 05:04:15 PM Central Daylight Time	08/01/2017 03:57:49 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic (HMO)	01	01		1			H8133	007	0	2018	Austin		2	5873	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	008	0	1	01	01	H8133_008_0	8			1		08/04/2017	2018.03	08/04/2017 11:08:11 AM Central Daylight Time	08/07/2017 11:47:15 AM Central Daylight Time	08/01/2017 03:58:20 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Premier (HMO)	01	01		1			H8133	008	0	2018	Austin		2	937	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	009	0	1	01	01	H8133_009_0	7		1	1	2	07/18/2017	2018.03	07/18/2017 03:14:02 PM Central Daylight Time	08/04/2017 05:07:21 PM Central Daylight Time	08/01/2017 03:58:52 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/dsnp	Blue Cross Medicare Advantage Dual Care (HMO SNP)	01	01		1			H8133	009	0	2018	Bastrp,Burnet,Caldwl,Hays,Lee,&Wilmson ctys		2	216	2			1	3		2		2	www.getbluetx.com/dsnp/pharmacies	www.getbluetx.com/dsnp/druglist	www.getbluetx.com/dsnp/providers	(877)895-6437		(877)895-6437		(877)583-8129		(877)583-8129		(877)895-6437		(877)895-6437		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	011	0	1	01	01	H8133_011_0	8			1		08/04/2017	2018.03	08/04/2017 11:09:57 AM Central Daylight Time	08/07/2017 01:59:56 PM Central Daylight Time	08/01/2017 03:59:24 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Premier (HMO)	01	01		1			H8133	011	0	2018	Houston Metro Area		2	6072	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	012	0	1	02	01	H8133_012_0	8			1		08/04/2017	2018.03	08/04/2017 12:56:43 PM Central Daylight Time	08/04/2017 05:09:52 PM Central Daylight Time	08/01/2017 03:59:55 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic Plus (HMO-POS)	01	02		1			H8133	012	0	2018	Houston Metro Area		2	1271	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	013	0	1	02	01	H8133_013_0	8			1		08/04/2017	2018.03	08/04/2017 01:13:20 PM Central Daylight Time	08/04/2017 05:10:53 PM Central Daylight Time	08/01/2017 04:00:27 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic Plus (HMO-POS)	01	02		1			H8133	013	0	2018	El Paso County		2	71	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	014	0	1	02	01	H8133_014_0	8			1		08/04/2017	2018.03	08/04/2017 01:13:43 PM Central Daylight Time	08/04/2017 05:12:00 PM Central Daylight Time	08/01/2017 04:00:58 PM Central Daylight Time			08/07/2017 04:36:26 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Basic Plus (HMO-POS)	01	02		1			H8133	014	0	2018	South Texas		2	353	2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8133	801	0	1	01	01	H8133_801_0	4			1		05/23/2017	2018.03	05/23/2017 10:56:59 AM Central Daylight Time					06/05/2017 10:23:40 AM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H8133	801	0	2018	Houston		1	127	2			2						www.getbluetx.com	www.getbluetx.com	www.getbluetx.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H8133	803	0	1	01	01	H8133_803_0	4			1		05/23/2017	2018.03	05/23/2017 10:57:13 AM Central Daylight Time					06/05/2017 10:23:40 AM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H8133	803	0	2018	Houston		1	15	2			2						www.getbluetx.com	www.getbluetx.com	www.getbluetx.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H8133	805	0	1	01	01	H8133_805_0	4			1		05/23/2017	2018.03	05/23/2017 10:57:25 AM Central Daylight Time					06/05/2017 10:23:40 AM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com	Blue Cross Medicare Advantage (HMO)	01	01		1			H8133	805	0	2018	Houston		1	7	2			2						www.getbluetx.com	www.getbluetx.com	www.getbluetx.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1					1				
H8142	001	0	1	01	01	H8142_001_0	7			1		08/03/2017	2018.03	08/03/2017 11:53:13 AM Central Daylight Time	08/03/2017 08:17:50 PM Central Daylight Time	08/01/2017 08:37:58 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Baylor Scott & White Health Plan	advantage.swhp.org	SeniorCare Advantage (HMO)	01	01		1			H8142	001	0	2018	Central Texas		2	1205	2			2						www.swhp.org	www.swhp.org	www.swhp.org	(866)334-3141		(866)334-3141		(800)782-5068		(800)782-5068		(866)334-3141		(254)298-3141		(800)782-5068		(254)298-3356		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H8145	003	0	1	09	04	H8145_003_0	5			1		05/30/2017	2018.03	05/30/2017 04:28:56 PM Eastern Daylight Time	08/04/2017 05:41:35 PM Eastern Daylight Time	08/04/2017 09:55:24 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-003 (PFFS)	04	09	1	1			H8145	003	0	2018	Select Counties in Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	004	0	1	09	04	H8145_004_0	5			1		05/30/2017	2018.03	05/30/2017 04:29:38 PM Eastern Daylight Time	08/04/2017 05:18:58 PM Eastern Daylight Time	08/04/2017 09:55:25 AM Eastern Daylight Time			08/06/2017 09:43:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-004 (PFFS)	04	09	1	1			H8145	004	0	2018	Select Counties in Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	006	0	1	09	04	H8145_006_0	4			1		05/28/2017	2018.03	05/28/2017 05:09:31 PM Eastern Daylight Time	08/04/2017 02:44:21 PM Eastern Daylight Time	08/04/2017 09:55:25 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-006 (PFFS)	04	09	1	1			H8145	006	0	2018	Select Counties in Michigan and Wisconsin		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	008	0	1	09	04	H8145_008_0	4			1		05/29/2017	2018.03	05/29/2017 10:35:35 AM Eastern Daylight Time	08/04/2017 02:41:32 PM Eastern Daylight Time	08/04/2017 09:55:26 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-008 (PFFS)	04	09	1	1			H8145	008	0	2018	Select Counties in Illinois		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	011	0	1	09	04	H8145_011_0	5			1		06/28/2017	2018.03	06/28/2017 12:20:25 PM Eastern Daylight Time	08/04/2017 01:47:25 PM Eastern Daylight Time	08/04/2017 09:55:27 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-011 (PFFS)	04	09	1	1			H8145	011	0	2018	Select Counties in Indiana		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	021	0	1	09	04	H8145_021_0	2			1		05/27/2017	2018.03	05/27/2017 12:13:12 PM Eastern Daylight Time	08/04/2017 05:29:17 PM Eastern Daylight Time	08/04/2017 09:55:27 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-021 (PFFS)	04	09	1	1			H8145	021	0	2018	Select Counties in Kentucky and West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	032	0	1	09	04	H8145_032_0	4			1		06/28/2017	2018.03	06/28/2017 12:21:56 PM Eastern Daylight Time	08/04/2017 01:52:47 PM Eastern Daylight Time	08/04/2017 09:55:28 AM Eastern Daylight Time			08/06/2017 11:40:54 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-032 (PFFS)	04	09	1	1			H8145	032	0	2018	Select Counties in Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	042	0	1	09	04	H8145_042_0	5			1		05/30/2017	2018.03	05/30/2017 04:30:43 PM Eastern Daylight Time	06/01/2017 06:31:48 PM Eastern Daylight Time				06/02/2017 09:00:16 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-042 (PFFS)	04	09	1	1			H8145	042	0	2018	Select Counties in Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	050	0	1	09	04	H8145_050_0	3			1		05/27/2017	2018.03	05/27/2017 12:14:52 PM Eastern Daylight Time	06/01/2017 09:19:19 PM Eastern Daylight Time				06/02/2017 08:39:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-050 (PFFS)	04	09	1	1			H8145	050	0	2018	Select Counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	051	0	1	09	04	H8145_051_0	2			1		08/03/2017	2018.03	08/03/2017 09:56:29 AM Eastern Daylight Time	08/04/2017 05:28:23 PM Eastern Daylight Time	08/04/2017 09:55:28 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-051 (PFFS)	04	09	1	1			H8145	051	0	2018	Select Counties in West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	052	0	1	09	04	H8145_052_0	2			1		08/04/2017	2018.03	08/04/2017 03:09:08 PM Eastern Daylight Time	08/04/2017 05:29:44 PM Eastern Daylight Time	08/04/2017 09:55:29 AM Eastern Daylight Time			08/06/2017 10:11:44 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-052 (PFFS)	04	09	1	1			H8145	052	0	2018	Select Counties in Pennsylvania		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	055	0	1	09	04	H8145_055_0	1			1		05/29/2017	2018.03	05/29/2017 01:05:01 PM Eastern Daylight Time	06/01/2017 09:21:42 PM Eastern Daylight Time				06/02/2017 08:39:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-055 (PFFS)	04	09	1	1			H8145	055	0	2018	Select Counties in Pennsylvania		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	061	0	1	09	04	H8145_061_0	4			1		05/27/2017	2018.03	05/27/2017 11:56:41 AM Eastern Daylight Time	08/04/2017 06:40:24 PM Eastern Daylight Time	08/04/2017 09:55:30 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-061 (PFFS)	04	09	1	1			H8145	061	0	2018	Select Counties in Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	063	0	1	09	04	H8145_063_0	6			1		07/13/2017	2018.03	07/13/2017 02:40:23 PM Eastern Daylight Time	08/04/2017 03:11:44 PM Eastern Daylight Time	08/04/2017 09:55:30 AM Eastern Daylight Time			08/06/2017 09:24:09 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-063 (PFFS)	04	09	1	1			H8145	063	0	2018	North Carolina Select		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	069	0	1	09	04	H8145_069_0	7			1		06/02/2017	2018.03	06/02/2017 06:29:30 PM Eastern Daylight Time	08/04/2017 03:00:51 PM Eastern Daylight Time	08/04/2017 09:55:31 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-069 (PFFS)	04	09	1	1			H8145	069	0	2018	Select Counties in Georgia and South Carolina		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	075	0	1	09	04	H8145_075_0	3			1		05/27/2017	2018.03	05/27/2017 12:16:53 PM Eastern Daylight Time	08/04/2017 01:55:11 PM Eastern Daylight Time	08/04/2017 09:55:31 AM Eastern Daylight Time			08/06/2017 01:19:39 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-075 (PFFS)	04	09	1	1			H8145	075	0	2018	Select Counties in Alabama		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	084	0	1	09	04	H8145_084_0	3			1		05/27/2017	2018.03	05/27/2017 11:39:22 AM Eastern Daylight Time	08/04/2017 04:13:13 PM Eastern Daylight Time	08/04/2017 09:55:32 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-084 (PFFS)	04	09	1	1			H8145	084	0	2018	Select Counties in Texas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	087	0	1	09	04	H8145_087_0	5			1		05/30/2017	2018.03	05/30/2017 03:45:02 PM Eastern Daylight Time	08/04/2017 02:03:28 PM Eastern Daylight Time	08/04/2017 09:55:33 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-087 (PFFS)	04	09	1	1			H8145	087	0	2018	Select Counties in Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	089	0	1	09	04	H8145_089_0	3			1		05/30/2017	2018.03	05/30/2017 05:24:58 PM Eastern Daylight Time	08/04/2017 04:29:40 PM Eastern Daylight Time	08/04/2017 09:55:33 AM Eastern Daylight Time			08/06/2017 09:30:02 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-089 (PFFS)	04	09	1	1			H8145	089	0	2018	Select Counties in IA, MN, MT, ND, SD		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	091	0	1	09	04	H8145_091_0	4			1		05/27/2017	2018.03	05/27/2017 12:17:35 PM Eastern Daylight Time	08/04/2017 01:57:22 PM Eastern Daylight Time	08/04/2017 09:55:34 AM Eastern Daylight Time			08/06/2017 01:19:39 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-091 (PFFS)	04	09	1	1			H8145	091	0	2018	Select Counties in Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	103	0	1	09	04	H8145_103_0	3			1		05/30/2017	2018.03	05/30/2017 04:31:10 PM Eastern Daylight Time	08/04/2017 01:21:05 PM Eastern Daylight Time	08/04/2017 09:55:34 AM Eastern Daylight Time			08/06/2017 09:06:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-103 (PFFS)	04	09	1	1			H8145	103	0	2018	Select Counties in Arizona		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	108	0	1	09	04	H8145_108_0	2			1		05/27/2017	2018.03	05/27/2017 02:04:06 PM Eastern Daylight Time	06/01/2017 06:19:45 PM Eastern Daylight Time				06/02/2017 08:53:22 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-108 (PFFS)	04	09	1	1			H8145	108	0	2018	Select Counties in Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	120	0	1	09	04	H8145_120_0	3			1		05/27/2017	2018.03	05/27/2017 03:21:12 PM Eastern Daylight Time	06/01/2017 05:23:56 PM Eastern Daylight Time				06/02/2017 08:27:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-120 (PFFS)	04	09	1	1			H8145	120	0	2018	Select counties in AR, CO, KS, MO and OK		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	121	0	1	09	04	H8145_121_0	6			1		06/28/2017	2018.03	06/28/2017 10:49:08 AM Eastern Daylight Time	06/01/2017 07:12:41 PM Eastern Daylight Time				06/29/2017 11:26:38 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-121 (PFFS)	04	09	1	1			H8145	121	0	2018	Select Counties in Illinois and Michigan		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	122	0	1	09	04	H8145_122_0	5			1		05/27/2017	2018.03	05/27/2017 04:16:54 PM Eastern Daylight Time	08/04/2017 02:53:24 PM Eastern Daylight Time	08/04/2017 09:55:35 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-122 (PFFS)	04	09	1	1			H8145	122	0	2018	Select counties in Arkansas, Kansas and Oklahoma		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	123	0	1	09	04	H8145_123_0	5			1		05/30/2017	2018.03	05/30/2017 07:52:23 PM Eastern Daylight Time	08/04/2017 04:10:04 PM Eastern Daylight Time	08/04/2017 09:55:35 AM Eastern Daylight Time			08/06/2017 09:14:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-123 (PFFS)	04	09	1	1			H8145	123	0	2018	Select Counties in Colorado and New Mexico		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	4b;8a1;8a2;8b3;	
H8145	125	0	1	09	04	H8145_125_0	4			1		05/27/2017	2018.03	05/27/2017 03:34:51 PM Eastern Daylight Time	08/04/2017 02:53:59 PM Eastern Daylight Time	08/04/2017 09:55:37 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-125 (PFFS)	04	09	1	1			H8145	125	0	2018	Select counties in Missouri		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8145	126	0	1	09	04	H8145_126_0	3			1		05/27/2017	2018.03	05/27/2017 11:40:38 AM Eastern Daylight Time	06/01/2017 04:19:44 PM Eastern Daylight Time				06/02/2017 08:21:00 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-126 (PFFS)	04	09	1	1			H8145	126	0	2018	Select Counties in Texas		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8145	155	0	1	09	04	H8145_155_0	3			1		05/30/2017	2018.03	05/30/2017 05:25:02 PM Eastern Daylight Time	06/01/2017 07:11:34 PM Eastern Daylight Time				06/02/2017 08:52:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Gold Choice H8145-155 (PFFS)	04	09	1	1			H8145	155	0	2018	Select Counties in Iowa		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8170	001	0	1	01	01	H8170_001_0	6			1		08/04/2017	2018.03	08/04/2017 03:16:59 PM Eastern Daylight Time	08/03/2017 06:07:16 PM Eastern Daylight Time	08/03/2017 10:41:46 AM Eastern Daylight Time			08/06/2017 09:29:58 AM Eastern Daylight Time	AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.	America's 1st Choice of South Carolina	www.americas1stchoice.com	AFC Care Rx (HMO)	01	01		1			H8170	001	0	2018	Select Counties in SC		2	0	2			2						www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8170	002	0	1	01	01	H8170_002_0	6		1	1		06/02/2017	2018.03	06/02/2017 01:33:26 PM Eastern Daylight Time	08/03/2017 12:14:49 PM Eastern Daylight Time	08/03/2017 10:41:07 AM Eastern Daylight Time			08/06/2017 09:29:58 AM Eastern Daylight Time	AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.	America's 1st Choice of South Carolina	www.americas1stchoice.com	AFC Special Care Rx (HMO SNP)	01	01		1			H8170	002	0	2018	Select Counties in SC		2	0	2			1	4			00000000000000000010		www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(888)563-3289		(803)391-3101		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8189	001	0	1	01	01	H8189_001_0	4		1	1	2	07/05/2017	2018.03	07/05/2017 07:41:42 AM Pacific Daylight Time	08/04/2017 04:35:04 PM Pacific Daylight Time	08/04/2017 04:35:27 PM Pacific Daylight Time			08/06/2017 09:35:23 AM Pacific Daylight Time	MANAGED HEALTH SERVICES, WISCONSIN	Allwell	https://advantage.mhswi.com	Allwell Dual Medicare (HMO SNP)	01	01		1			H8189	001	0	2018	Southeastern, Northeastern, Central Counties		2		2			1	3		1		1	https://advantage.mhswi.com/findadoctor	https://advantage.mhswi.com/partdformulary	https://advantage.mhswi.com/findadoctor	(877)935-8024		(877)935-8024		(877)826-5521		(877)826-5521		(877)935-8024		(877)935-8024		(877)826-5521		(877)826-5521		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8197	001	0	1	48	05	H8197_001_0	6			1		08/09/2017	2018.03	08/09/2017 12:40:55 PM Pacific Daylight Time					08/10/2017 08:25:24 AM Pacific Daylight Time	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H8197	001	0	2018	Texas		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(866)856-8699		(866)856-8699		(855)895-9992		(855)895-9992		(866)856-8699		(866)856-8699		(855)895-9992		(855)895-9992		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8211	001	0	1	04	01	H8211_001_0	4			1		06/01/2017	2018.03	06/01/2017 09:11:21 AM Central Daylight Time	08/03/2017 01:17:05 PM Central Daylight Time	08/01/2017 11:34:59 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	MAMSI LIFE AND HEALTH INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H8211	001	0	2018	Morgantown Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8211	002	0	1	04	01	H8211_002_0	4			1		06/01/2017	2018.03	06/01/2017 09:11:46 AM Central Daylight Time	08/03/2017 01:17:33 PM Central Daylight Time	08/01/2017 11:35:25 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	MAMSI LIFE AND HEALTH INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H8211	002	0	2018	Morgantown Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8211	003	0	1	04	01	H8211_003_0	4			1		06/01/2017	2018.03	06/01/2017 09:12:07 AM Central Daylight Time	08/03/2017 01:18:03 PM Central Daylight Time	08/01/2017 11:35:51 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	MAMSI LIFE AND HEALTH INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H8211	003	0	2018	Charleston and Huntington Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8211	004	0	1	04	01	H8211_004_0	4			1		06/01/2017	2018.03	06/01/2017 09:12:32 AM Central Daylight Time	08/03/2017 01:18:32 PM Central Daylight Time	08/01/2017 11:36:17 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	MAMSI LIFE AND HEALTH INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (PPO)	01	04		1			H8211	004	0	2018	Charleston and Huntington Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8213	001	0	1	48	05	H8213_001_0	4			1		08/10/2017	2018.03	08/10/2017 09:26:26 AM Central Daylight Time					08/10/2017 09:52:26 AM Central Daylight Time	SELECT HEALTH OF SOUTH CAROLINA, INC.	FIRST CHOICE VIP CARE PLUS	http://www.firstchoicevipcareplus.com	First Choice VIP Care Plus (Medicare-Medicaid Plan)	05	48		1			H8213	001	0	2018	South Carolina - 39 counties		2		2			2						http://www.firstchoicevipcareplus.com	http://www.firstchoicevipcareplus.com	http://www.firstchoicevipcareplus.com	(888)978-0862		(888)978-0862		(877)694-2314		(877)694-2314		(888)978-0862		(888)978-0862		(877)694-2314		(877)694-2314		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8237	001	0	1	01	01	H8237_001_0	8			1		08/03/2017	2018.03	08/03/2017 11:54:02 AM Central Daylight Time	08/03/2017 07:18:30 PM Central Daylight Time	08/01/2017 08:45:20 AM Central Daylight Time			08/04/2017 04:41:53 PM Central Daylight Time	INSURANCE COMPANY OF SCOTT AND WHITE	Baylor Scott & White Health Plan	advantage.swhp.org	Vital Traditions (HMO)	01	01		1			H8237	001	0	2018	Dallas-Ft. Worth Area		2	78322	2			2						www.swhp.org	www.swhp.org	advantage.swhp.org	(866)334-3141		(866)334-3141		(800)782-5068		(800)782-5068		(888)423-7633		(888)423-7633		(877)845-3903		(877)845-3903		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		(800)735-2989		2					2					2	2			
H8258	001	0	1	48	05	H8258_001_0	7			1		09/19/2017	2018.03	09/19/2017 04:09:21 PM Pacific Daylight Time					09/19/2017 04:09:57 PM Pacific Daylight Time	LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY	L.A. Care Cal MediConnect Plan	www.calmediconnectla.org	L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)	05	48		1			H8258	001	0	2018	Los Angeles County		2	153180	2			2						www.calmediconnectla.org	www.calmediconnectla.org	www.calmediconnectla.org	(888)522-1298		(888)522-1298		(855)522-8243		(855)522-8243		(888)522-1298		(888)522-1298		(855)522-8243		(855)522-8243		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8266	001	0	1	01	01	H8266_001_0	8			1		08/08/2017	2018.03	08/08/2017 05:02:33 PM SA Western Standard Time	08/04/2017 08:29:59 AM SA Western Standard Time	08/03/2017 05:40:14 PM SA Western Standard Time			08/08/2017 05:12:52 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Apollo - Constellation Health (HMO)	01	01		1			H8266	001	0	2018	Puerto Rico		2	91529	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H8266	002	0	1	01	01	H8266_002_0	7			1		08/03/2017	2018.03	08/03/2017 11:38:23 AM SA Western Standard Time	08/04/2017 08:31:41 AM SA Western Standard Time	08/03/2017 05:42:57 PM SA Western Standard Time			08/07/2017 07:02:05 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Orion - Constellation Health (HMO)	01	01		1			H8266	002	0	2018	Puerto Rico		2	1612	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H8266	004	0	1	01	01	H8266_004_0	7			1		08/07/2017	2018.03	08/07/2017 06:15:17 PM SA Western Standard Time	08/04/2017 08:33:38 AM SA Western Standard Time	08/03/2017 05:45:06 PM SA Western Standard Time			08/07/2017 07:02:05 PM SA Western Standard Time	CONSTELLATION HEALTH, LLC.	Constellation Health	www.constellationhealthpr.com	Apollo @ Home- Constellation Health (HMO)	01	01		1			H8266	004	0	2018	Puerto Rico		2	2687	2			2						www.constellationhealthpr.com	www.constellationhealthpr.com	www.constellationhealthpr.com	(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)714-0724		(787)304-4040		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		(866)805-7777		2					2					2	2			
H8280	001	0	1	01	01	H8280_001_0	7			1		08/04/2017	2018.03	08/04/2017 02:22:57 PM Central Daylight Time	08/03/2017 11:55:06 AM Central Daylight Time	08/03/2017 11:32:21 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC.	Bright Health	http://www.brighthealthplan.com/	Bright Advantage (HMO)	01	01		1			H8280	001	0	2018	Jefferson and Shelby Counties		2	21460	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		2					2					2	2			
H8280	002	0	1	01	01	H8280_002_0	7			1		07/20/2017	2018.03	07/20/2017 06:48:18 PM Central Daylight Time	08/03/2017 11:55:12 AM Central Daylight Time	08/03/2017 11:32:25 AM Central Daylight Time			08/04/2017 02:25:09 PM Central Daylight Time	BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC.	Bright Health	http://www.brighthealthplan.com/	Bright Advantage Plus (HMO)	01	01		1			H8280	002	0	2018	Jefferson and Shelby Counties		2	2384	2			2						http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	http://www.brighthealthplan.com/	(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		(844)202-4129		(844)202-4129		(844)679-2027		(844)679-2027		2					2					2	2			
H8298	001	0	1	01	01	H8298_001_0	5		1	1	2	05/30/2017	2018.03	05/30/2017 11:44:40 AM Eastern Daylight Time	08/03/2017 11:03:22 AM Eastern Daylight Time	08/03/2017 11:02:35 AM Eastern Daylight Time			08/03/2017 01:09:33 PM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey	www.Horizonblue.com/medicare	Horizon NJ TotalCare (HMO SNP)	01	01		1			H8298	001	0	2018	15 Counties Throughout New Jersey		2	112248	2			1	3		1		1	www.horizonblue.com/ma-pharmacy-search	www.horizonblue.com/ma-drug-search	http://doctorfinder.horizonblue.com/	(800)543-5656		(800)543-5656		(888)765-7134		(888)765-7134		(855)457-1346		(855)457-1346		(888)765-7134		(888)765-7134		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8423	001	0	1	48	05	H8423_001_0	4			1		08/10/2017	2018.03	08/10/2017 08:47:16 AM Central Daylight Time					08/10/2017 05:49:39 PM Central Daylight Time	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Cigna-HealthSpring CarePlan	www.CarePlanTX.com	Cigna-HealthSpring CarePlan (Medicare-Medicaid Plan)	05	48		1			H8423	001	0	2018	Select TX Counties		2		2			2						www.mycignahealthspring.com	www.CarePlanTX.com	www.CarePlanTX.com	(877)653-0327		(877)653-0327		(877)653-0327		(877)653-0327		(877)653-0327		(877)653-6725		(877)653-0327		(877)653-0327		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8424	001	0	1	20	08	H8424_001_0	1			1		06/02/2017	2018.03	06/02/2017 02:40:13 PM Central Daylight Time		06/02/2017 02:30:02 PM Central Daylight Time			06/02/2017 02:41:53 PM Central Daylight Time	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	https://www.unitypoint.org/siouxcity/services-pace	Siouxland PACE, INC (PACE)	08	20		1			H8424	001	0	2018	Siouxland PACE, INC		2		2			2						www.siouxlandpace.org	www.siouxlandpace.org										(888)722-3713		(712)224-7223	258	(888)722-3713		(712)224-7223	258									(800)383-4545		(712)224-7253		(800)383-4545		(712)224-7253																
H8424	002	0	1	20	08	H8424_002_0	1			1		06/02/2017	2018.03	06/02/2017 02:40:38 PM Central Daylight Time		06/02/2017 02:30:33 PM Central Daylight Time			06/02/2017 02:41:53 PM Central Daylight Time	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	www.siouxlandpace.org	Siouxland PACE, INC (PACE)	08	20		1			H8424	002	0	2018	Siouxland PACE, INC		2		2			2						www.siouxlandpace.org	www.siouxlandpace.org										(888)722-3713		(712)224-7223		(888)722-3713		(712)224-7223										(800)383-4545		(712)224-7253		(800)383-4545		(712)224-7253																
H8432	002	0	1	01	01	H8432_002_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 10:33:35 AM Eastern Daylight Time	08/07/2017 08:59:30 AM Eastern Daylight Time	08/06/2017 03:11:03 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H8432	002	0	2018	Select Counties in Maine		2	44835	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(844)887-6351		(844)887-6351		(844)296-3997		(844)296-3997		(844)887-6351		(844)887-6351		(844)296-7202		(844)296-7202		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	003	0	1	01	01	H8432_003_0	5			1		08/04/2017	2018.03	08/04/2017 10:34:52 AM Eastern Daylight Time	08/07/2017 08:59:31 AM Eastern Daylight Time	08/06/2017 03:11:03 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H8432	003	0	2018	Select Counties in Maine		2	7341	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2472		(855)310-2472		(844)373-7109		(844)373-7109		(855)310-2472		(855)310-2472		(844)373-7108		(844)373-7108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	004	0	1	01	01	H8432_004_0	5			1		06/02/2017	2018.03	06/02/2017 10:17:41 PM Eastern Daylight Time	08/07/2017 08:59:31 AM Eastern Daylight Time	08/06/2017 03:11:03 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H8432	004	0	2018	Penobscot County		2	2485	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2472		(855)310-2472		(844)373-7109		(844)373-7109		(855)310-2472		(855)310-2472		(844)373-7108		(844)373-7108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	005	0	1	02	01	H8432_005_0	4			1		07/13/2017	2018.03	07/13/2017 07:24:59 PM Eastern Daylight Time	08/07/2017 08:59:31 AM Eastern Daylight Time	08/06/2017 03:11:04 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Anthem MediBlue Choice (HMO-POS)	01	02		1			H8432	005	0	2018	Androscoggin, Cumberland, Kennebec, Knox, York		2	625	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2472		(855)310-2472		(844)373-7109		(844)373-7109		(855)310-2472		(855)310-2472		(844)373-7108		(844)373-7108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	006	0	1	02	01	H8432_006_0	4			1		07/13/2017	2018.03	07/13/2017 07:24:46 PM Eastern Daylight Time	08/07/2017 08:59:32 AM Eastern Daylight Time	08/06/2017 03:11:04 PM Eastern Daylight Time			08/07/2017 02:33:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Anthem MediBlue Choice (HMO-POS)	01	02		1			H8432	006	0	2018	Penobscot		2	1028	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)310-2472		(855)310-2472		(844)373-7109		(844)373-7109		(855)310-2472		(855)310-2472		(844)373-7108		(844)373-7108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	007	0	1	01	01	H8432_007_0	5		1	1	2	06/30/2017	2018.03	06/30/2017 08:44:23 AM Eastern Daylight Time	08/07/2017 08:59:32 AM Eastern Daylight Time	08/06/2017 03:11:04 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.anthem.com/shop	Empire MediBlue Dual Advantage (HMO SNP)	01	01		1			H8432	007	0	2018	New York City Area		2	126130	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(877)269-5706		(877)269-5706		(844)630-1023		(844)630-1023		(877)269-5706		(877)269-5706		(844)630-1024		(844)630-1024		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	008	5	1	01	01	H8432_008_5	3			1		08/04/2017	2018.03	08/04/2017 10:46:40 AM Eastern Daylight Time	08/07/2017 08:59:33 AM Eastern Daylight Time	08/06/2017 03:11:04 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	008	5	2018	New York City Area	Bronx	2	60158	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	008	6	1	01	01	H8432_008_6	3			1		08/04/2017	2018.03	08/04/2017 10:47:34 AM Eastern Daylight Time	08/07/2017 08:59:33 AM Eastern Daylight Time	08/06/2017 03:11:04 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	008	6	2018	New York City Area	Queens	2	196214	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	008	7	1	01	01	H8432_008_7	3			1		08/04/2017	2018.03	08/04/2017 10:59:23 AM Eastern Daylight Time	08/07/2017 08:59:33 AM Eastern Daylight Time	08/06/2017 03:11:05 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	008	7	2018	New York City Area	Kings	2	96518	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	009	0	1	01	01	H8432_009_0	4			1		07/13/2017	2018.03	07/13/2017 07:22:59 PM Eastern Daylight Time	08/07/2017 08:59:34 AM Eastern Daylight Time	08/06/2017 03:11:05 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	009	0	2018	Rockland and Westchester		2	84309	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	010	0	1	01	01	H8432_010_0	4			1		05/31/2017	2018.03	05/31/2017 12:41:40 PM Eastern Daylight Time	08/07/2017 08:59:34 AM Eastern Daylight Time	08/06/2017 03:11:05 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	010	0	2018	Nassau		2	93959	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	011	0	1	01	01	H8432_011_0	4			1		05/31/2017	2018.03	05/31/2017 12:41:50 PM Eastern Daylight Time	08/07/2017 08:59:34 AM Eastern Daylight Time	08/06/2017 03:11:05 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	011	0	2018	Suffolk		2	127483	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	012	0	1	01	01	H8432_012_0	3			1		05/31/2017	2018.03	05/31/2017 12:42:01 PM Eastern Daylight Time	07/17/2017 08:30:05 PM Eastern Daylight Time				07/18/2017 07:01:56 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Empire MediBlue Core (HMO)	01	01		1			H8432	012	0	2018	Select Counties in NY		2	6226	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8432	013	0	1	01	01	H8432_013_0	4			1		08/04/2017	2018.03	08/04/2017 11:00:27 AM Eastern Daylight Time	08/07/2017 09:02:15 AM Eastern Daylight Time	08/06/2017 03:11:06 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	013	0	2018	New York		2	50311	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	014	0	1	02	01	H8432_014_0	4			1		08/04/2017	2018.03	08/04/2017 11:00:12 AM Eastern Daylight Time	08/07/2017 09:02:15 AM Eastern Daylight Time	08/06/2017 03:11:06 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Choice (HMO-POS)	01	02		1			H8432	014	0	2018	Nassau		2	5996	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	015	0	1	02	01	H8432_015_0	4			1		05/31/2017	2018.03	05/31/2017 12:42:36 PM Eastern Daylight Time	08/07/2017 09:02:16 AM Eastern Daylight Time	08/06/2017 03:11:06 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Choice (HMO-POS)	01	02		1			H8432	015	0	2018	Kings		2	4103	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	016	0	1	01	01	H8432_016_0	5			1		07/13/2017	2018.03	07/13/2017 07:24:14 PM Eastern Daylight Time	08/07/2017 09:02:16 AM Eastern Daylight Time	08/06/2017 03:11:06 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Select (HMO)	01	01		1			H8432	016	0	2018	Dutchess, Orange, Putnam		2	4490	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	017	0	1	01	01	H8432_017_0	4			1		07/13/2017	2018.03	07/13/2017 07:24:30 PM Eastern Daylight Time	08/07/2017 09:02:17 AM Eastern Daylight Time	08/06/2017 03:11:06 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Plus (HMO)	01	01		1			H8432	017	0	2018	Albany, Rensselaer, Schenectady, Saratoga		2	2841	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(800)499-9554		(800)499-9554		(800)797-6159		(800)797-6159		(800)499-9554		(800)499-9554		(844)364-2115		(844)364-2115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	018	0	1	01	01	H8432_018_0	4		1	1	2	06/01/2017	2018.03	06/01/2017 05:11:18 PM Eastern Daylight Time	08/07/2017 09:02:17 AM Eastern Daylight Time	08/06/2017 03:11:07 PM Eastern Daylight Time			08/07/2017 02:47:43 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/shop	Empire MediBlue Dual Advantage (HMO SNP)	01	01		1			H8432	018	0	2018	Albany, Rensselaer, Schenectady, Dutchess, Putnam		2	1950	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(877)269-5706		(877)269-5706		(844)630-1023		(844)630-1023		(877)269-5706		(877)269-5706		(844)630-1024		(844)630-1024		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8432	801	0	1	01	01	H8432_801_0	7			1		06/03/2017	2018.03	06/03/2017 01:11:51 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/me/medicare	Anthem MediBlue (HMO)	01	01		1			H8432	801	0	2018	Select Counties in Maine		1	600	2			2						www.anthem.com/me/medicare	www.anthem.com/me/medicare	www.anthem.com/me/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H8432	802	0	1	01	01	H8432_802_0	7			1		06/03/2017	2018.03	06/03/2017 01:12:01 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/me/medicare	Anthem MediBlue (HMO)	01	01		1			H8432	802	0	2018	Select Counties in Maine		1	600	2			2						www.anthem.com/me/medicare	www.anthem.com/me/medicare	www.anthem.com/me/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H8432	803	0	1	02	01	H8432_803_0	7			1		06/03/2017	2018.03	06/03/2017 01:12:10 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/me/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H8432	803	0	2018	Maine - Select Counties		1	600	2			2						www.anthem.com/me/medicare	www.anthem.com/me/medicare	www.anthem.com/me/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H8432	804	0	1	01	01	H8432_804_0	7			1		06/03/2017	2018.03	06/03/2017 01:12:19 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.empireblue.com/ny/medicare	Empire MediBlue (HMO)	01	01		1			H8432	804	0	2018	New York - Select Counties		1	3732	2			2						www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H8432	805	0	1	01	01	H8432_805_0	7			1		06/03/2017	2018.03	06/03/2017 01:12:29 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.empireblue.com/ny/medicare	Empire MediBlue (HMO)	01	01		1			H8432	805	0	2018	New York - Select Counties		1	1122	2			2						www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H8432	806	0	1	02	01	H8432_806_0	7			1		06/03/2017	2018.03	06/03/2017 01:12:36 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM HEALTH PLANS OF MAINE, INC.	Anthem Blue Cross and Blue Shield	www.empireblue.com/ny/medicare	Empire MediBlue (HMO-POS)	01	02		1			H8432	806	0	2018	New York - Select Counties		1	600	2			2						www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	www.empireblue.com/ny/medicare	(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(855)249-9132		(855)249-9132		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H8452	001	0	1	48	05	H8452_001_0	8			1		08/28/2017	2018.03	08/28/2017 09:32:34 AM Eastern Daylight Time					08/28/2017 10:44:19 AM Eastern Daylight Time	CARESOURCE	CareSource MyCare Ohio	www.caresource.com/MyCare/	CareSource MyCare Ohio (Medicare-Medicaid Plan)	05	48		1			H8452	001	0	2018	Northeast, Northeast Central, East Central Ohio		2	318000	2			2						www.caresource.com	www.caresource.com/MyCare/	https://memberportal.caresource.com/App/OH/FindADoctor/MyCare	(855)475-3163		(855)475-3163		(855)475-3163		(855)475-3163		(855)475-3163		(855)475-3163		(855)475-3163		(855)475-3163		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750		(800)750-0750																
H8490	001	0	1	48	05	H8490_001_0	4			1		07/06/2017	2018.03	07/06/2017 09:23:28 AM Eastern Daylight Time					07/06/2017 09:24:45 AM Eastern Daylight Time	VNS CHOICE	VNSNY CHOICE FIDA Complete	www.vnsnychoice.org	VNSNY CHOICE FIDA Complete (Medicare-Medicaid Plan)	05	48		1			H8490	001	0	2018	Ki, Qu, Brx, NY, Ri, Wes, Suf and Na		2		2			2						www.vnsnychoice.org	www.vnsnychoice.org	www.vnsnychoice.org	(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(866)783-1444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8506	001	0	1	01	01	H8506_001_0	10			1		08/02/2017	2018.03	08/02/2017 09:51:17 AM Pacific Daylight Time	08/10/2017 10:39:01 AM Pacific Daylight Time	08/03/2017 02:51:38 PM Pacific Daylight Time			08/10/2017 01:37:54 PM Pacific Daylight Time	MODA HEALTH PLAN, INC.	Moda Health Plan, Inc.	www.modahealth.com/medicare	Moda Health HMO (HMO)	01	01		1			H8506	001	0	2018	Eastern Oregon		2	7788	2			2						www.modahealth.com/medicare	www.modahealth.com/medicare	www.modahealth.com/medicare	(877)299-9062		(503)265-4762		(888)217-2375		(503)265-2975		(888)786-7509		(503)265-4709		(888)217-2375		(503)265-2975		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8552	020	0	1	04	01	H8552_020_0	7			1		06/05/2017	2018.03	06/05/2017 11:17:03 PM Pacific Daylight Time	08/07/2017 06:02:18 AM Pacific Daylight Time	08/06/2017 12:11:07 PM Pacific Daylight Time			08/07/2017 12:12:07 PM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem MediBlue Access (PPO)	01	04		1			H8552	020	0	2018	Orange County		2	34787	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(877)811-3107		(877)811-3107		(844)364-2129		(844)364-2129		(877)811-3107		(877)811-3107		(844)364-2124		(844)364-2124		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8552	028	0	1	04	01	H8552_028_0	9		1	1		08/04/2017	2018.03	08/04/2017 04:09:04 PM Pacific Daylight Time		08/06/2017 12:11:07 PM Pacific Daylight Time		08/07/2017 06:02:18 AM Pacific Daylight Time	08/07/2017 12:12:07 PM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem MediBlue ESRD (PPO SNP)	01	04		1			H8552	028	0	2018	Select Counties in California		2	9328	2			1	4			00000000100000000000		www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(844)648-9540		(844)648-9540		(844)788-9044		(844)788-9044		(844)648-9540		(844)648-9540		(844)788-9045		(844)788-9045		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8552	801	0	1	04	01	H8552_801_0	1			1		06/03/2017	2018.03	06/03/2017 03:04:22 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem Medicare Preferred (PPO)	01	04		1			H8552	801	0	2018	California		1	47456	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H8552	802	0	1	04	01	H8552_802_0	1			1		06/03/2017	2018.03	06/03/2017 03:05:19 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem Medicare Preferred (PPO)	01	04		1			H8552	802	0	2018	California		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H8552	803	0	1	04	01	H8552_803_0	1			1		06/03/2017	2018.03	06/03/2017 03:04:31 PM Pacific Daylight Time					06/03/2017 03:57:33 PM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem Medicare Preferred (PPO)	01	04		1			H8552	803	0	2018	California		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H8552	805	0	2	04	01	H8552_805_0	2			1		06/04/2017	2018.03	06/04/2017 11:27:56 AM Pacific Daylight Time					06/04/2017 11:28:39 AM Pacific Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Anthem Blue Cross Life and Health Insurance Co.	www.anthem.com/ca/shop	Anthem Medicare Preferred (PPO)	01	04		2	1		H8552	805	0	2018	National		1	600	2			2						www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	www.anthem.com/ca/medicare	(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(877)411-1640		(877)411-1640		(877)411-1647		(877)411-1647		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	2		1									
H8554	001	0	1	01	01	H8554_001_0	8			1		08/07/2017	2018.03	08/07/2017 04:54:00 PM Central Daylight Time	08/04/2017 05:13:01 PM Central Daylight Time	08/01/2017 04:01:30 PM Central Daylight Time			08/07/2017 05:23:05 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Value (HMO)	01	01		1			H8554	001	0	2018	State of Texas		2		2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(855)805-4152		(855)805-4152		(877)583-8129		(877)583-8129		(855)805-4152		(855)805-4152		(877)213-1817		(877)213-1817		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8554	002	0	1	01	01	H8554_002_0	8			1		08/07/2017	2018.03	08/07/2017 04:54:15 PM Central Daylight Time	08/04/2017 05:14:24 PM Central Daylight Time	08/01/2017 04:02:01 PM Central Daylight Time			08/07/2017 05:23:05 PM Central Daylight Time	GHS INSURANCE COMPANY	Blue Cross and Blue Shield of Texas	www.getbluetx.com/mapd	Blue Cross Medicare Advantage Select (HMO)	01	01		1			H8554	002	0	2018	State of Texas		2		2			2						www.getbluetx.com/mapd/pharmacies	www.getbluetx.com/mapd/druglist	www.getbluetx.com/mapd/providers	(855)805-4152		(855)805-4152		(877)583-8129		(877)583-8129		(855)805-4152		(855)805-4152		(877)213-1817		(877)213-1817		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8578	001	0	1	01	01	H8578_001_0	5			1		06/29/2017	2018.03	06/29/2017 05:29:20 PM Eastern Daylight Time	08/07/2017 11:14:29 AM Eastern Daylight Time	08/07/2017 11:14:43 AM Eastern Daylight Time			08/07/2017 11:22:08 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Premium (HMO)	01	01		1			H8578	001	0	2018	Hampden, Hampshire, Franklin, Berkshire Counties		2	40173	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010		(800)546-5677		(800)546-5677		(800)546-5677		(800)546-5677		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(866)706-4757		(866)706-4757		2					2					2	2			
H8578	003	0	1	01	01	H8578_003_0	4			1		06/29/2017	2018.03	06/29/2017 05:21:50 PM Eastern Daylight Time	06/03/2017 09:53:34 AM Eastern Daylight Time				07/03/2017 12:04:45 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Premium No Rx (HMO)	01	01		1			H8578	003	0	2018	Hampden, Hampshire, Franklin, Berkshire Counties		2	2001	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8578	004	0	1	01	01	H8578_004_0	5			1		06/29/2017	2018.03	06/29/2017 05:22:24 PM Eastern Daylight Time	08/07/2017 11:14:44 AM Eastern Daylight Time	08/07/2017 11:14:43 AM Eastern Daylight Time			08/07/2017 11:22:08 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Plus (HMO)	01	01		1			H8578	004	0	2018	Hampden, Hampshire, Franklin, Berkshire Counties		2	46258	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010		(800)546-5677		(800)546-5677		(800)546-5677		(800)546-5677		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(866)706-4757		(866)706-4757		2					2					2	2			
H8578	009	0	1	01	01	H8578_009_0	4			1		06/29/2017	2018.03	06/29/2017 05:22:51 PM Eastern Daylight Time	06/03/2017 09:53:35 AM Eastern Daylight Time				07/03/2017 12:04:45 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Basic No Rx (HMO)	01	01		1			H8578	009	0	2018	Hampden, Hampshire, Franklin, Berkshire Counties		2	2155	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8578	012	0	1	01	01	H8578_012_0	5			1		06/29/2017	2018.03	06/29/2017 05:23:22 PM Eastern Daylight Time	08/07/2017 11:14:43 AM Eastern Daylight Time	08/07/2017 11:14:43 AM Eastern Daylight Time			08/07/2017 11:22:08 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Value (HMO)	01	01		1			H8578	012	0	2018	Hampden, Hampshire, Franklin, Berkshire Counties		2	13016	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010		(800)546-5677		(800)546-5677		(800)546-5677		(800)546-5677		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(866)706-4757		(866)706-4757		2					2					2	2			
H8578	801	0	1	02	01	H8578_801_0	3			1		06/02/2017	2018.03	06/02/2017 03:17:02 PM Eastern Daylight Time					06/03/2017 10:00:30 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	Health New England Medicare Employer Group RX (HMO-POS)	01	02		1			H8578	801	0	2018	United States		1	6600	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010		(800)546-5677		(800)546-5677		(800)546-5677		(800)546-5677		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(866)706-4757		(866)706-4757		1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1				
H8578	802	0	1	02	01	H8578_802_0	3			1		06/02/2017	2018.03	06/02/2017 03:17:31 PM Eastern Daylight Time					06/03/2017 10:00:30 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	HNE Medicare Employer Group Calendar (HMO-POS)	01	02		1			H8578	802	0	2018	United States		1	60	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010										(711)-		(711)-		(711)-		(711)-										1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1				
H8578	803	0	1	02	01	H8578_803_0	3			1		06/02/2017	2018.03	06/02/2017 03:18:41 PM Eastern Daylight Time					06/03/2017 10:00:30 AM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England Medicare Advantage Plans	www.healthnewengland.org/medicare	HNE Medicare Employer Group Non-Calendar (HMO-POS)	01	02		1			H8578	803	0	2018	United States		1	60	2			2						www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	www.healthnewengland.org/medicare	(877)443-3314		(413)787-0010		(877)443-3314		(413)787-0010		(800)546-5677		(800)546-5677		(800)546-5677		(800)546-5677		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(866)706-4757		(866)706-4757		1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1	1	2;5;6;7c;7i;8a;8b1;9a;9b;10a;11a;11b;11c;15;	2		1				
H8604	010	0	1	04	01	H8604_010_0	6			1		07/27/2017	2018.03	07/27/2017 09:21:18 PM Eastern Daylight Time	08/03/2017 02:24:07 PM Eastern Daylight Time	08/02/2017 04:23:30 PM Eastern Daylight Time			08/03/2017 02:43:57 PM Eastern Daylight Time	THP INSURANCE COMPANY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureChoice - Option II (PPO)	01	04		1			H8604	010	0	2018	Eastern OH		2	4000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8604	011	0	1	04	01	H8604_011_0	6			1		07/27/2017	2018.03	07/27/2017 09:21:42 PM Eastern Daylight Time	08/03/2017 02:27:31 PM Eastern Daylight Time	08/02/2017 04:23:30 PM Eastern Daylight Time			08/03/2017 02:43:57 PM Eastern Daylight Time	THP INSURANCE COMPANY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureChoice - Option II (PPO)	01	04		1			H8604	011	0	2018	Southeastern OH, West Virginia		2	12000	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8604	013	0	1	04	01	H8604_013_0	6			1		07/27/2017	2018.03	07/27/2017 09:22:14 PM Eastern Daylight Time	08/03/2017 02:38:20 PM Eastern Daylight Time	08/02/2017 04:23:31 PM Eastern Daylight Time			08/03/2017 02:43:57 PM Eastern Daylight Time	THP INSURANCE COMPANY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureChoice Capitol Plan (PPO)	01	04		1			H8604	013	0	2018	Kanawha and Surrounding Counties		2	3500	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8604	801	0	1	04	01	H8604_801_0	1			1		05/17/2017	2018.03	05/17/2017 02:29:35 PM Eastern Daylight Time					06/02/2017 11:40:34 PM Eastern Daylight Time	THP INSURANCE COMPANY	The Health Plan	www.healthplan.org/medicare	The Health Plan SecureChoice - Employer (PPO)	01	04		1			H8604	801	0	2018	Eastern Ohio and West Virginia, National		1	500	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(877)847-7907		(740)695-7907		(877)847-7915		(740)695-7915		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8634	002	0	1	04	01	H8634_002_0	7			1		08/04/2017	2018.03	08/04/2017 01:49:56 PM Central Daylight Time	08/04/2017 05:15:19 PM Central Daylight Time	08/01/2017 04:02:33 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getbluenm.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H8634	002	0	2018	Benalillo, Sandoval Torrance and Valencia counties		2	25464	2			2						www.getbluenm.com/mapd/pharmacies	www.getbluenm.com/mapd/druglist	www.getbluenm.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8634	003	0	1	04	01	H8634_003_0	7			1		06/26/2017	2018.03	06/26/2017 02:35:24 PM Mountain Daylight Time	08/04/2017 05:16:38 PM Central Daylight Time	08/01/2017 04:03:04 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getblueil.com/mapd	Blue Cross Medicare Advantage Choice Plus (PPO)	01	04		1			H8634	003	0	2018	Chicago Metro Area		2	79190	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8634	004	0	1	04	01	H8634_004_0	7			1		06/26/2017	2018.03	06/26/2017 02:35:40 PM Mountain Daylight Time	08/04/2017 05:55:54 PM Central Daylight Time	08/01/2017 04:03:36 PM Central Daylight Time			08/07/2017 04:40:59 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getblueil.com/mapd	Blue Cross Medicare Advantage Choice Premier (PPO)	01	04		1			H8634	004	0	2018	Chicago Metro Area		2	90098	2			2						www.getblueil.com/mapd/pharmacies	www.getblueil.com/mapd/druglist	www.getblueil.com/mapd/providers	(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(877)774-8592		(877)774-8592		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8634	801	0	1	04	01	H8634_801_0	2			1		05/23/2017	2018.03	05/23/2017 01:21:52 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicarenm.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	801	0	2018	State of New Mexico		1	1062	2			2						www.mybluemedicarenm.com	www.mybluemedicarenm.com	www.mybluemedicarenm.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	803	0	1	04	01	H8634_803_0	3			1		05/30/2017	2018.03	05/30/2017 12:41:52 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicarenm.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	803	0	2018	State of New Mexico		1	1	2			2						www.mybluemedicarenm.com	www.mybluemedicarenm.com	www.mybluemedicarenm.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	805	0	1	04	01	H8634_805_0	3			1		05/30/2017	2018.03	05/30/2017 12:41:59 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicarenm.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	805	0	2018	State of New Mexico		1	1	2			2						www.mybluemedicarenm.com	www.mybluemedicarenm.com	www.mybluemedicarenm.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	807	0	1	04	01	H8634_807_0	2			1		05/23/2017	2018.03	05/23/2017 01:02:41 PM Central Daylight Time					06/05/2017 12:35:50 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicareok.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	807	0	2018	State of Oklahoma		1	911	2			2						www.mybluemedicareok.com	www.mybluemedicareok.com	www.mybluemedicareok.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	809	0	1	04	01	H8634_809_0	2			1		05/23/2017	2018.03	05/23/2017 01:02:36 PM Central Daylight Time					06/05/2017 12:35:50 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicareok.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	809	0	2018	State of Oklahoma		1	1	2			2						www.mybluemedicareok.com	www.mybluemedicareok.com	www.mybluemedicareok.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	811	0	1	04	01	H8634_811_0	2			1		05/23/2017	2018.03	05/23/2017 01:02:26 PM Central Daylight Time					06/05/2017 12:35:50 PM Central Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.mybluemedicareok.com	BlueCross Medicare Advantage (PPO)	01	04		1			H8634	811	0	2018	State of Oklahoma		1	1	2			2						www.mybluemedicareok.com	www.mybluemedicareok.com	www.mybluemedicareok.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	813	0	1	04	01	H8634_813_0	3			1		05/30/2017	2018.03	05/30/2017 12:42:17 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getblueil.com	Blue Cross Medicare Advantage (PPO)	01	04		1			H8634	813	0	2018	State of Illinois		1	33922	2			2						www.getblueil.com	www.getblueil.com	www.getblueil.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	815	0	1	04	01	H8634_815_0	3			1		05/30/2017	2018.03	05/30/2017 12:44:53 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getblueil.com	Blue Cross Medicare Advantage (PPO)	01	04		1			H8634	815	0	2018	State of Illinois		1	84704	2			2						www.getblueil.com	www.getblueil.com	www.getblueil.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8634	817	0	1	04	01	H8634_817_0	3			1		05/30/2017	2018.03	05/30/2017 12:45:27 PM Mountain Daylight Time					06/05/2017 11:53:17 AM Mountain Daylight Time	HEALTH CARE SERVICE CORPORATION	Blue Cross and Blue Shield of IL, NM, OK	www.getblueil.com	Blue Cross Medicare Advantage (PPO)	01	04		1			H8634	817	0	2018	State of Illinois		1	111888	2			2						www.getblueil.com	www.getblueil.com	www.getblueil.com	(877)299-1008		(877)299-1008		(877)583-8129		(877)583-8129										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;11a;11b;11c;12;14d;14e1;14e2;15;	2		1									
H8649	003	0	1	01	01	H8649_003_0	4			1		08/01/2017	2018.03	08/01/2017 05:09:12 PM Mountain Daylight Time	08/02/2017 02:54:48 PM Eastern Daylight Time	07/31/2017 05:58:38 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	AETNA HEALTH OF UTAH, INC	Altius Health Plans	www.altiusadvantra.com	Altius Advantra (HMO)	01	01		1			H8649	003	0	2018	Northern Utah		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4918		(866)784-4918		(855)338-9559		(855)338-9559		(844)741-8423		(844)741-8423		(855)338-9559		(855)338-9559		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8649	008	0	1	01	01	H8649_008_0	3			1		06/28/2017	2018.03	06/28/2017 08:47:07 AM Central Daylight Time	08/02/2017 02:55:36 PM Eastern Daylight Time	07/31/2017 05:59:09 PM Eastern Daylight Time			08/04/2017 06:09:31 PM Eastern Daylight Time	AETNA HEALTH OF UTAH, INC	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Select (HMO)	01	01		1			H8649	008	0	2018	UT- Uintah, Duchesne / WY-Uinta		2		2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/formulary	www.coventry-medicare.com/findprovider	(866)784-4918		(866)784-4918		(855)338-9559		(855)338-9559		(844)741-8423		(844)741-8423		(855)338-9559		(855)338-9559		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8649	801	0	1	01	01	H8649_801_0	1			1		05/31/2017	2018.03	05/31/2017 08:06:35 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH OF UTAH, INC	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Emp Calendar Year (HMO)	01	01		1			H8649	801	0	2018	State of Utah		1	120	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(866)784-4918		(866)784-4918		(855)338-9559		(855)338-9559		(844)741-8423		(844)741-8423		(855)338-9559		(855)338-9559		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H8649	803	0	1	01	01	H8649_803_0	1			1		05/31/2017	2018.03	05/31/2017 08:06:44 AM Eastern Daylight Time					06/02/2017 01:31:03 PM Eastern Daylight Time	AETNA HEALTH OF UTAH, INC	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Emp MA Only (HMO)	01	01		1			H8649	803	0	2018	State of Utah		1	120	2			2						www.coventry-medicare.com/findpharmacy	www.coventry-medicare.com/group-formulary	www.coventry-medicare.com/findprovider	(866)784-4918		(866)784-4918		(855)338-9559		(855)338-9559										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7b;7c;7e;7h;7i;8a;8b1;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	3-1;7b;7c;7d;7f;7g;7i;8a;14d;14e2;18a;	1					1				
H8655	004	0	1	20	08	H8655_004_0	1			1		06/02/2017	2018.03	06/02/2017 12:59:11 PM Eastern Daylight Time		06/02/2017 12:56:51 PM Eastern Daylight Time			06/02/2017 01:33:31 PM Eastern Daylight Time	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	Riverside PACE Dual (PACE)	08	20		1			H8655	004	0	2018	Riverside PACE Dual		2		2			2						www.riversideonline.com	N/A - no formulary										(800)675-6368		(757)234-8104		(800)675-6368		(757)234-8104										(800)675-6368		(757)234-8104		(800)675-6368		(757)234-8104																
H8655	005	0	1	20	08	H8655_005_0	1			1		06/02/2017	2018.03	06/02/2017 12:59:18 PM Eastern Daylight Time		06/02/2017 12:56:52 PM Eastern Daylight Time			06/02/2017 01:33:31 PM Eastern Daylight Time	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	Riverside PACE Medicare ONLY (PACE)	08	20		1			H8655	005	0	2018	Riverside PACE Medicare ONLY		2		2			2						www.riversideonline.com	N/A - no formulary										(800)675-6368		(757)234-8104		(800)675-6368		(757)234-8104										(800)675-6368		(757)234-8104		(800)675-6368		(757)234-8104																
H8677	001	0	1	48	05	H8677_001_0	6			1		09/18/2017	2018.03	09/18/2017 04:06:07 PM Pacific Daylight Time					09/18/2017 04:11:59 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H8677	001	0	2018	Southern California		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(855)665-4627		(855)665-4627		(866)408-9501		(866)408-9501		(855)665-4627		(855)665-4627		(866)408-9501		(866)408-9501		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8677	002	0	1	48	05	H8677_002_0	7			1		09/19/2017	2018.03	09/19/2017 11:28:07 AM Pacific Daylight Time					09/19/2017 11:55:55 AM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinahealthcare.com/duals	Molina Dual Options (Medicare-Medicaid Plan)	05	48		1			H8677	002	0	2018	Los Angeles County		2		2			2						www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	www.molinahealthcare.com/duals	(855)665-4627		(855)665-4627		(866)408-9501		(866)408-9501		(855)665-4627		(855)665-4627		(866)408-9501		(866)408-9501		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8748	002	0	1	01	01	H8748_002_0	3			1		08/02/2017	2018.03	08/02/2017 01:46:56 PM Central Daylight Time	08/03/2017 12:44:25 PM Central Daylight Time	08/01/2017 11:36:44 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	002	0	2018	Greenville and Pickens counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	008	0	1	02	01	H8748_008_0	6			1		08/04/2017	2018.03	08/04/2017 08:16:26 AM Central Daylight Time	08/03/2017 12:44:53 PM Central Daylight Time	08/01/2017 11:37:10 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H8748	008	0	2018	Gainesville area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	009	0	1	02	01	H8748_009_0	6			1		06/29/2017	2018.03	06/29/2017 11:28:59 AM Central Daylight Time	08/03/2017 12:45:21 PM Central Daylight Time	08/01/2017 11:37:36 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 2 (HMO-POS)	01	02		1			H8748	009	0	2018	Gainesville area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	010	0	1	02	01	H8748_010_0	6			1		06/01/2017	2018.03	06/01/2017 09:42:37 AM Central Daylight Time	08/03/2017 12:45:49 PM Central Daylight Time	08/01/2017 11:38:02 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H8748	010	0	2018	Central Georgia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	011	0	1	02	01	H8748_011_0	6			1		06/28/2017	2018.03	06/28/2017 09:48:49 AM Central Daylight Time	08/03/2017 12:46:18 PM Central Daylight Time	08/01/2017 11:38:28 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 2 (HMO-POS)	01	02		1			H8748	011	0	2018	Central Georgia		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	012	0	1	01	01	H8748_012_0	4			1		08/02/2017	2018.03	08/02/2017 01:47:05 PM Central Daylight Time	08/03/2017 12:46:46 PM Central Daylight Time	08/01/2017 11:38:54 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	012	0	2018	Spartanburg County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	013	0	1	01	01	H8748_013_0	4			1		06/01/2017	2018.03	06/01/2017 09:14:36 AM Central Daylight Time	08/03/2017 12:47:14 PM Central Daylight Time	08/01/2017 11:39:20 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	013	0	2018	Lancaster and York Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	014	0	1	01	01	H8748_014_0	4			1		06/01/2017	2018.03	06/01/2017 09:15:01 AM Central Daylight Time	08/03/2017 12:47:42 PM Central Daylight Time	08/01/2017 11:39:46 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	014	0	2018	Beaufort and Colleton Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	015	0	1	01	01	H8748_015_0	4			1		06/01/2017	2018.03	06/01/2017 09:15:30 AM Central Daylight Time	08/03/2017 12:48:12 PM Central Daylight Time	08/01/2017 11:40:12 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	015	0	2018	Charleston, Berkeley, and Dorchester Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	01	7a;	
H8748	017	0	1	01	01	H8748_017_0	4			1		06/01/2017	2018.03	06/01/2017 09:15:53 AM Central Daylight Time	08/03/2017 12:48:41 PM Central Daylight Time	08/01/2017 11:40:38 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	017	0	2018	Orangeburg County		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	018	0	1	01	01	H8748_018_0	4			1		06/01/2017	2018.03	06/01/2017 09:16:25 AM Central Daylight Time	08/03/2017 12:49:10 PM Central Daylight Time	08/01/2017 11:41:04 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	018	0	2018	Central South Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	019	0	1	01	01	H8748_019_0	2			1		05/05/2017	2018.03	05/05/2017 12:05:57 PM Central Daylight Time	06/01/2017 12:49:59 PM Central Daylight Time				07/06/2017 03:18:57 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H8748	019	0	2018	Select Counties in South Carolina		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H8748	020	0	1	01	01	H8748_020_0	4			1		06/01/2017	2018.03	06/01/2017 09:16:45 AM Central Daylight Time	08/03/2017 12:49:38 PM Central Daylight Time	08/01/2017 11:41:30 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H8748	020	0	2018	Georgetown, Horry, and Williamsburg Counties		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	022	0	1	02	01	H8748_022_0	6			1		06/01/2017	2018.03	06/01/2017 09:43:25 AM Central Daylight Time	08/03/2017 12:50:07 PM Central Daylight Time	08/01/2017 11:41:57 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H8748	022	0	2018	Savannah Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8748	023	0	1	02	01	H8748_023_0	6			1		06/28/2017	2018.03	06/28/2017 09:49:11 AM Central Daylight Time	08/03/2017 12:50:35 PM Central Daylight Time	08/01/2017 11:42:23 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Plus Plan 2 (HMO-POS)	01	02		1			H8748	023	0	2018	Savannah Metro area		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8764	001	0	1	01	01	H8764_001_0	7			1		08/03/2017	2018.03	08/03/2017 09:14:31 AM Pacific Daylight Time	08/02/2017 03:50:58 PM Pacific Daylight Time	08/02/2017 01:28:12 PM Pacific Daylight Time			08/04/2017 02:40:53 PM Pacific Daylight Time	ASPIRE HEALTH PLAN	Aspire Health Plan	www.aspirehealthplan.org	Aspire Health Advantage (HMO)	01	01		1			H8764	001	0	2018	Monterey County		2		2			2						www.aspirehealthplan.org	www.aspirehealthplan.org	www.aspirehealthplan.org	(855)570-1600		(831)574-4938		(888)839-3991		(831)375-1462		(866)632-7958		(866)632-7958		(888)839-3991		(831)375-1462		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(711)-		(711)-		2					2					2	2			
H8764	002	0	1	02	01	H8764_002_0	5			1		07/12/2017	2018.03	07/12/2017 09:25:42 AM Pacific Daylight Time	08/02/2017 03:51:32 PM Pacific Daylight Time	08/02/2017 01:29:34 PM Pacific Daylight Time			08/04/2017 02:40:53 PM Pacific Daylight Time	ASPIRE HEALTH PLAN	Aspire Health Plan	www.aspirehealthplan.org	Aspire Health Plus (HMO-POS)	01	02		1			H8764	002	0	2018	Monterey County		2		2			2						www.aspirehealthplan.org	www.aspirehealthplan.org	www.aspirehealthplan.org	(855)570-1600		(831)574-4938		(888)839-3991		(831)375-1462		(866)632-7958		(866)632-7958		(888)839-3991		(831)375-1462		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(711)-		(711)-		2					2					2	2			
H8764	003	0	1	01	01	H8764_003_0	8			1		08/03/2017	2018.03	08/03/2017 09:11:11 AM Pacific Daylight Time	08/02/2017 03:52:28 PM Pacific Daylight Time	08/02/2017 01:30:54 PM Pacific Daylight Time			08/04/2017 02:40:53 PM Pacific Daylight Time	ASPIRE HEALTH PLAN	Aspire Health Plan	www.aspirehealthplan.org	Aspire Health Value (HMO)	01	01		1			H8764	003	0	2018	Monterey County		2		2			2						www.aspirehealthplan.org	www.aspirehealthplan.org	www.aspirehealthplan.org	(855)570-1600		(831)574-4938		(888)839-3991		(831)375-1462		(866)632-7958		(866)632-7958		(888)839-3991		(831)375-1462		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(711)-		(711)-		2					2					2	2			
H8764	801	0	1	02	01	H8764_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:42:35 AM Pacific Daylight Time					06/13/2017 10:43:46 AM Pacific Daylight Time	ASPIRE HEALTH PLAN	Aspire Health Plan	www.aspirehealthplan.org	Aspire Health Group Plus (HMO-POS)	01	02		1			H8764	801	0	2018	Monterey County		1	3000	2			2						www.aspirehealthplan.org	www.aspirehealthplan.org	www.aspirehealthplan.org	(855)570-1600		(831)574-4938		(888)839-3991		(831)375-1462		(866)632-7958		(866)632-7958		(888)839-3991		(831)375-1462		(711)-		(711)-		(711)-		(711)-		(866)706-4757		(866)706-4757		(711)-		(711)-		2					2					2	2			
H8768	001	0	1	04	01	H8768_001_0	5			1		08/02/2017	2018.03	08/02/2017 02:34:22 PM Central Daylight Time	08/03/2017 01:59:08 PM Central Daylight Time	08/01/2017 11:42:50 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H8768	001	0	2018	Select counties in Iowa and Illinois		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8768	002	0	1	04	01	H8768_002_0	5			1		08/02/2017	2018.03	08/02/2017 02:35:17 PM Central Daylight Time	08/03/2017 01:59:54 PM Central Daylight Time	08/01/2017 11:43:16 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H8768	002	0	2018	Select counties in Iowa		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8768	003	0	1	04	01	H8768_003_0	5			1		06/01/2017	2018.03	06/01/2017 09:43:14 AM Central Daylight Time	08/03/2017 02:00:38 PM Central Daylight Time	08/01/2017 11:43:42 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H8768	003	0	2018	Peoria area		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8768	004	0	1	04	01	H8768_004_0	5			1		06/01/2017	2018.03	06/01/2017 09:43:36 AM Central Daylight Time	08/03/2017 02:01:27 PM Central Daylight Time	08/01/2017 11:44:09 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	UnitedHealthcare	www.UHCMedicareSolutions.com	AARP MedicareComplete Choice (PPO)	01	04		1			H8768	004	0	2018	Winnebago county		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H8769	001	0	1	20	08	H8769_001_0	1			1		06/01/2017	2018.03	06/01/2017 11:55:18 AM Central Daylight Time		06/01/2017 10:31:04 AM Central Daylight Time			06/01/2017 11:56:55 AM Central Daylight Time	GENESYS REGIONAL MEDICAL CENTER, INC.	Genesys PACE of Genesee County	GenesysPACE.org	Genesys PACE of Genesee County (PACE)	08	20		1			H8769	001	0	2018	Genesee County		2		2			2						genesyspace.org	genesyspace.org										(810)236-7500		(810)236-7500		(800)000-0000		(810)236-7500										(810)236-7500		(810)236-7500		(888)-		(888)-																
H8769	002	0	1	20	08	H8769_002_0	1			1		06/01/2017	2018.03	06/01/2017 11:55:27 AM Central Daylight Time		06/01/2017 10:30:57 AM Central Daylight Time			06/01/2017 11:56:55 AM Central Daylight Time	GENESYS REGIONAL MEDICAL CENTER, INC.	Genesys PACE of Genesee County	GenesysPACE.org	Genesys PACE of Genesee County(PACE) (PACE)	08	20		1			H8769	002	0	2018	Genesee County		2		2			2						genesyspace.org	genesyspace.org										(800)000-0000		(810)236-7500		(800)000-0000		(810)236-7500										(888)-		(888)-		(888)-		(888)-																
H8777	001	0	1	20	08	H8777_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:20:23 PM Eastern Daylight Time		05/24/2017 10:56:28 AM Eastern Daylight Time			05/24/2017 01:24:37 PM Eastern Daylight Time	COMPLETE SENIOR CARE, INC.	Complete Senior Care	completeseniorcare.org	Complete Senior Care Dual (PACE)	08	20		1			H8777	001	0	2018	Niagara, NY		2		2			2						Pharmastar	Pharmastar										(716)285-8224	220	(716)285-8224	220	(716)285-8224	220	(716)285-8224	220									(716)285-8224	220	(716)285-8224	220	(716)285-8224	220	(716)285-8224	220															
H8777	002	0	1	20	08	H8777_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:21:23 PM Eastern Daylight Time		05/24/2017 10:57:33 AM Eastern Daylight Time			05/24/2017 01:24:37 PM Eastern Daylight Time	COMPLETE SENIOR CARE, INC.	Complete Senior Care	completeseniorcare.org	Complete Senior Care Medicare Only (PACE)	08	20		1			H8777	002	0	2018	Niagara, NY		2		2			2						Pharmastar	Pharmastar										(716)285-8224	220	(716)285-8224	220	(716)285-8224	220	(716)285-8224	220									(716)285-8224	220	(716)285-8224	220	(716)285-8224	220	(716)285-8224	220															
H8786	001	0	1	48	05	H8786_001_0	5			1		08/15/2017	2018.03	08/15/2017 04:19:23 PM Central Daylight Time					08/15/2017 04:23:02 PM Central Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup STAR+PLUS MMP	www.myamerigroup.com/txmmp	Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan)	05	48		1			H8786	001	0	2018	Select TX Service Areas		2	169773	2			2						www.myamerigroup/medicare.com	www.myamerigroup.com/txmmp	www.myamerigroup.com/txmmp	(855)878-1784		(855)878-1784		(855)878-1784		(855)878-1784		(855)878-1784		(855)878-1784		(855)878-1784		(855)878-1784		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8800	001	0	1	20	08	H8800_001_0	1			1		05/22/2017	2018.03	05/22/2017 12:25:21 PM Eastern Daylight Time		05/22/2017 12:24:00 PM Eastern Daylight Time			05/22/2017 12:36:26 PM Eastern Daylight Time	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	www.totalseniorcare.org	Total Senior Care - Dual (PACE)	08	20		1			H8800	001	0	2018	Cattaraugus, Allegany and Chautauqua counties		2		2			2						totalseniorcare.org	www.totalseniorcare.org	www.totalseniorcare.org									(866)939-8613		(716)379-8474		(866)939-8613		(716)379-8474										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																
H8800	002	0	1	20	08	H8800_002_0	1			1		05/22/2017	2018.03	05/22/2017 12:25:31 PM Eastern Daylight Time		05/22/2017 12:24:00 PM Eastern Daylight Time			05/22/2017 12:36:26 PM Eastern Daylight Time	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	www.totalseniorcare.org	Total Senior Care - Medicare Small Only (PACE)	08	20		1			H8800	002	0	2018	Cattaraugus, Allegany and Chautauqua counties		2		2			2						totalseniorcare.org	www.totalseniorcare.org	www.totalseniorcare.org									(866)939-8613		(716)379-8474		(866)939-8613		(716)379-8474										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220																
H8851	001	0	1	48	05	H8851_001_0	2			1		07/05/2017	2018.03	07/05/2017 09:00:51 PM Eastern Daylight Time					07/05/2017 09:04:52 PM Eastern Daylight Time	SENIOR WHOLE HEALTH OF NEW YORK, INC.	SWH Whole Health FIDA Plan	www.seniorwholehealth.com	SWH Whole Health FIDA (Medicare-Medicaid Plan)	05	48		1			H8851	001	0	2018	Kings, Queens, Bronx, and New York Counties		2	2038	2			2						www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(844)861-3432		(844)861-3432		(844)861-3432		(844)861-3432		(844)861-3432		(844)861-3432		(844)861-3432		(844)861-3432		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H8854	001	0	1	01	01	H8854_001_0	8			1		08/11/2017	2018.03	08/11/2017 02:36:33 PM Eastern Daylight Time	08/06/2017 09:15:37 PM Eastern Daylight Time	08/06/2017 09:15:37 PM Eastern Daylight Time			08/11/2017 02:53:09 PM Eastern Daylight Time	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	University of Maryland Health Advantage	www.UMMedicareAdvantage.org	University of Maryland Health Advantage Complete (HMO)	01	01		1			H8854	001	0	2018	Central Maryland and Select Eastern Shore counties		2	62136	2			2						www.UMMedicareAdvantage.org	www.UMMedicareAdvantage.org	www.UMMedicareAdvantage.org	(844)386-6762		(410)779-9932		(844)262-1122		(844)262-1122		(844)786-6762		(844)786-6762		(844)262-1122		(844)262-1122		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8854	002	0	1	01	01	H8854_002_0	8		1	1	2	08/06/2017	2018.03	08/06/2017 06:13:01 PM Eastern Daylight Time	08/06/2017 09:15:37 PM Eastern Daylight Time	08/06/2017 09:15:37 PM Eastern Daylight Time			08/06/2017 09:16:58 PM Eastern Daylight Time	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	University of Maryland Health Advantage	www.UMMedicareAdvantage.org	University of Maryland Health Advantage Dual (HMO SNP)	01	01		1			H8854	002	0	2018	Central Maryland and Select Eastern Shore counties		2	61289	2			1	3		2		1	www.UMMedicareAdvantage.org	www.UMMedicareAdvantage.org	www.UMMedicareAdvantage.org	(844)386-6762		(410)779-9932		(844)262-1122		(844)262-1122		(844)786-6762		(844)786-6762		(844)262-1122		(844)262-1122		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8908	001	0	1	01	01	H8908_001_0	4			1		05/27/2017	2018.03	05/27/2017 01:19:01 PM Eastern Daylight Time	08/04/2017 02:44:49 PM Eastern Daylight Time	08/04/2017 09:55:38 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Humana Medical Plan of Michigan, Inc.	www.humana.com/medicare	Humana Gold Plus H8908-001 (HMO)	01	01		1			H8908	001	0	2018	Detroit area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8908	002	0	1	01	01	H8908_002_0	4			1		06/28/2017	2018.03	06/28/2017 11:02:26 AM Eastern Daylight Time	08/04/2017 02:47:11 PM Eastern Daylight Time	08/04/2017 09:55:38 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Humana Medical Plan of Michigan, Inc.	www.humana.com/medicare	Humana Gold Plus H8908-002 (HMO)	01	01		1			H8908	002	0	2018	Grand Rapids area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8908	004	0	1	01	01	H8908_004_0	2			1		08/02/2017	2018.03	08/02/2017 03:07:25 PM Eastern Daylight Time	08/04/2017 02:49:04 PM Eastern Daylight Time	08/04/2017 09:55:39 AM Eastern Daylight Time			08/06/2017 10:25:33 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Humana Medical Plan of Michigan, Inc.	www.humana.com/medicare	Humana Gold Plus H8908-004 (HMO)	01	01		1			H8908	004	0	2018	Detroit area		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H8908	801	0	1	01	01	H8908_801_0	3			1		06/13/2017	2018.03	06/13/2017 10:30:43 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Humana Medical Plan of Michigan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H8908	801	0	2018	Select Counties in Michigan		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H8908	802	0	1	01	01	H8908_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:31:03 AM Eastern Daylight Time					06/13/2017 12:47:23 PM Eastern Daylight Time	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Humana Medical Plan of Michigan, Inc.	www.humana.com/medicare	Humana Medicare Employer (HMO)	01	01		1			H8908	802	0	2018	Select Counties in Michigan		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1					1				
H8967	001	0	1	01	01	H8967_001_0	3		1	1		08/07/2017	2018.03	08/07/2017 11:21:12 AM Central Daylight Time	08/07/2017 10:57:57 AM Central Daylight Time	08/07/2017 10:58:05 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	Good Samaritan Insurance Plan of North Dakota	www.goodsamaritaninsuranceplan.com	Good Samaritan Insurance Plan ND (HMO SNP)	01	01		1			H8967	001	0	2018	North Dakota (partial)		2	3888	2			1	1	1				www.gsipnd.com	www.gsipnd.com	www.goodsamaritaninsuranceplan.com	(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(844)637-4760		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	013	0	1	02	01	H9001_013_0	6	1		1		08/04/2017	2018.03	08/04/2017 11:29:54 AM Eastern Daylight Time	08/03/2017 04:49:08 PM Eastern Daylight Time	08/03/2017 03:07:18 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced Rx (HMO-POS)	01	02		1			H9001	013	0	2018	Worcester and Franklin counties		2	46902	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	015	0	1	01	01	H9001_015_0	7	1		1		08/04/2017	2018.03	08/04/2017 11:29:59 AM Eastern Daylight Time	08/03/2017 04:50:02 PM Eastern Daylight Time	08/03/2017 03:07:52 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Standard Enhanced Rx (HMO)	01	01		1			H9001	015	0	2018	Worcester and Franklin counties		2	11545	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	019	0	1	01	01	H9001_019_0	6	2	1	1	2	08/04/2017	2018.03	08/04/2017 11:30:05 AM Eastern Daylight Time	08/03/2017 04:50:58 PM Eastern Daylight Time	08/03/2017 03:08:28 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/navicare	NaviCare (HMO SNP)	01	01		1			H9001	019	0	2018	Massachusetts except Dukes and Nantucket counties		2	80743	2			1	3		1		1	www.fallonhealth.org/navicare-pharmacy	www.fallonhealth.org/navicare-formulary	www.fallonhealth.org/FindPhysician	(877)700-6996		(877)700-6996		(877)255-7108		(877)255-7108		(877)700-6996		(877)700-6996		(877)255-7108		(877)255-7108		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					1	2			
H9001	029	1	1	01	01	H9001_029_1	4	2		1		07/30/2017	2018.03	07/30/2017 06:15:33 PM Eastern Daylight Time	07/29/2017 01:48:52 PM Eastern Daylight Time				07/30/2017 06:19:03 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	1	2018	Massachusetts except Dukes and Nantucket counties	Essex and Suffolk counties	2	108	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	029	2	1	01	01	H9001_029_2	3	2		1		07/12/2017	2018.03	07/12/2017 12:55:21 PM Eastern Daylight Time	06/05/2017 12:11:30 PM Eastern Daylight Time				07/13/2017 12:27:16 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	2	2018	Massachusetts except Dukes and Nantucket counties	Middlesex, Norfolk, Bristol and Plymouth counties	2	852	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	029	4	1	01	01	H9001_029_4	4	2		1		07/21/2017	2018.03	07/21/2017 08:47:39 AM Eastern Daylight Time	07/18/2017 01:23:28 PM Eastern Daylight Time				07/21/2017 09:07:03 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	4	2018	Massachusetts except Dukes and Nantucket counties	Barnstable county	2	12	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	029	5	1	01	01	H9001_029_5	4	2		1		07/21/2017	2018.03	07/21/2017 08:47:45 AM Eastern Daylight Time	07/18/2017 01:24:24 PM Eastern Daylight Time				07/21/2017 09:07:03 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	5	2018	Massachusetts except Dukes and Nantucket counties	Hampden and Hampshire counties	2	660	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	029	6	1	01	01	H9001_029_6	3	2		1		07/12/2017	2018.03	07/12/2017 12:58:02 PM Eastern Daylight Time	06/05/2017 12:14:02 PM Eastern Daylight Time				07/13/2017 12:27:16 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	6	2018	Massachusetts except Dukes and Nantucket counties	Worcester and parts of Franklin	2	3474	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	029	7	1	01	01	H9001_029_7	3	2		1		07/12/2017	2018.03	07/12/2017 12:59:15 PM Eastern Daylight Time	06/05/2017 12:14:50 PM Eastern Daylight Time				07/13/2017 12:27:16 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	029	7	2018	Massachusetts except Dukes and Nantucket counties	Berkshire county	2	36	2			2						www.fallonhealth.org/medicare-pharmacy	www.fchp.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9001	030	1	1	01	01	H9001_030_1	6	2		1		08/04/2017	2018.03	08/04/2017 11:30:31 AM Eastern Daylight Time	08/03/2017 04:51:52 PM Eastern Daylight Time	08/03/2017 03:09:02 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced RX (HMO)	01	01		1			H9001	030	1	2018	Massachusetts except DUK, FRA, NAN, WOR counties	Essex and Suffolk counties	2	1773	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	030	2	1	01	01	H9001_030_2	6	2		1		08/04/2017	2018.03	08/04/2017 11:30:39 AM Eastern Daylight Time	08/03/2017 04:52:46 PM Eastern Daylight Time	08/03/2017 03:09:36 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced RX (HMO)	01	01		1			H9001	030	2	2018	Massachusetts except DUK, FRA, NAN, WOR counties	Middlesex, Norfolk, Bristol and Plymouth counties	2	9148	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	030	4	1	01	01	H9001_030_4	5	2		1		08/04/2017	2018.03	08/04/2017 11:30:46 AM Eastern Daylight Time	08/03/2017 04:53:40 PM Eastern Daylight Time	08/03/2017 03:10:10 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced RX (HMO)	01	01		1			H9001	030	4	2018	Massachusetts except DUK, FRA, NAN, WOR counties	Barnstable county	2	769	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	030	5	1	01	01	H9001_030_5	5	2		1		08/04/2017	2018.03	08/04/2017 11:30:53 AM Eastern Daylight Time	08/03/2017 04:54:36 PM Eastern Daylight Time	08/03/2017 03:10:44 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced RX (HMO)	01	01		1			H9001	030	5	2018	Massachusetts except DUK, FRA, NAN, WOR counties	Hampden and Hampshire counties	2	7926	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	030	7	1	01	01	H9001_030_7	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:01 AM Eastern Daylight Time	08/03/2017 04:55:30 PM Eastern Daylight Time	08/03/2017 03:11:18 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Saver Enhanced RX (HMO)	01	01		1			H9001	030	7	2018	Massachusetts except DUK, FRA, NAN, WOR counties	Berkshire county	2	156	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	031	1	1	01	01	H9001_031_1	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:11 AM Eastern Daylight Time	08/03/2017 04:56:28 PM Eastern Daylight Time	08/03/2017 03:11:52 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced RX (HMO)	01	01		1			H9001	031	1	2018	Massachusetts except DUK, HMD, HMP, NAN counties	Essex and Suffolk counties	2	831	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	031	2	1	01	01	H9001_031_2	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:20 AM Eastern Daylight Time	08/03/2017 04:57:26 PM Eastern Daylight Time	08/03/2017 03:12:26 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced RX (HMO)	01	01		1			H9001	031	2	2018	Massachusetts except DUK, HMD, HMP, NAN counties	Middlesex, Norfolk, Bristol and Plymouth counties	2	10831	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	031	4	1	01	01	H9001_031_4	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:27 AM Eastern Daylight Time	08/03/2017 04:58:22 PM Eastern Daylight Time	08/03/2017 03:13:00 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced RX (HMO)	01	01		1			H9001	031	4	2018	Massachusetts except DUK, HMD, HMP, NAN counties	Barnstable county	2	439	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	031	6	1	01	01	H9001_031_6	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:35 AM Eastern Daylight Time	08/03/2017 04:59:16 PM Eastern Daylight Time	08/03/2017 03:13:34 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced RX (HMO)	01	01		1			H9001	031	6	2018	Massachusetts except DUK, HMD, HMP, NAN counties	Worcester and parts of Franklin	2	7980	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	031	7	1	01	01	H9001_031_7	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:42 AM Eastern Daylight Time	08/03/2017 05:00:10 PM Eastern Daylight Time	08/03/2017 03:14:06 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced RX (HMO)	01	01		1			H9001	031	7	2018	Massachusetts except DUK, HMD, HMP, NAN counties	Berkshire county	2	168	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	1	1	01	01	H9001_032_1	6	2		1		08/04/2017	2018.03	08/04/2017 11:31:51 AM Eastern Daylight Time	08/03/2017 05:01:06 PM Eastern Daylight Time	08/03/2017 03:14:40 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	1	2018	Massachusetts except Dukes and Nantucket counties	Essex and Suffolk counties	2	2005	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	2	1	01	01	H9001_032_2	5	2		1		08/04/2017	2018.03	08/04/2017 11:31:58 AM Eastern Daylight Time	08/03/2017 05:02:02 PM Eastern Daylight Time	08/03/2017 03:15:14 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	2	2018	Massachusetts except Dukes and Nantucket counties	Middlesex, Norfolk, Bristol and Plymouth counties	2	10457	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	4	1	01	01	H9001_032_4	6	2		1		08/04/2017	2018.03	08/04/2017 11:32:06 AM Eastern Daylight Time	08/03/2017 05:02:56 PM Eastern Daylight Time	08/03/2017 03:15:48 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	4	2018	Massachusetts except Dukes and Nantucket counties	Barnstable county	2	2939	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	5	1	01	01	H9001_032_5	5	2		1		08/04/2017	2018.03	08/04/2017 11:32:13 AM Eastern Daylight Time	08/03/2017 05:03:52 PM Eastern Daylight Time	08/03/2017 03:16:22 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	5	2018	Massachusetts except Dukes and Nantucket counties	Hampden and Hampshire counties	2	6281	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	6	1	01	01	H9001_032_6	5	2		1		08/04/2017	2018.03	08/04/2017 11:32:20 AM Eastern Daylight Time	08/03/2017 05:04:46 PM Eastern Daylight Time	08/03/2017 03:16:56 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	6	2018	Massachusetts except Dukes and Nantucket counties	Worcester and parts of Franklin	2	12215	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	032	7	1	01	01	H9001_032_7	5	2		1		08/04/2017	2018.03	08/04/2017 11:32:27 AM Eastern Daylight Time	08/03/2017 05:05:40 PM Eastern Daylight Time	08/03/2017 03:17:30 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	032	7	2018	Massachusetts except Dukes and Nantucket counties	Berkshire county	2	228	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	033	0	1	02	01	H9001_033_0	6	2		1		08/04/2017	2018.03	08/04/2017 11:32:35 AM Eastern Daylight Time	08/03/2017 05:06:36 PM Eastern Daylight Time	08/03/2017 03:18:04 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Plus Enhanced Rx (HMO-POS)	01	02		1			H9001	033	0	2018	Hampden and Hampshire counties		2	8310	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	034	1	1	01	01	H9001_034_1	5	2		1		08/04/2017	2018.03	08/04/2017 06:44:44 AM Eastern Daylight Time	08/03/2017 05:07:30 PM Eastern Daylight Time	08/03/2017 03:18:38 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Flex Enhanced Rx (HMO)	01	01		1			H9001	034	1	2018	Massachusetts except BAR, BER, DUK, NAN counties	Essex and Suffolk counties	2	188	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	034	2	1	01	01	H9001_034_2	5	2		1		08/03/2017	2018.03	08/03/2017 03:52:31 PM Eastern Daylight Time	08/03/2017 05:08:24 PM Eastern Daylight Time	08/03/2017 03:19:12 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Flex Enhanced Rx (HMO)	01	01		1			H9001	034	2	2018	Massachusetts except BAR, BER, DUK, NAN counties	Middlesex, Norfolk, Bristol and Plymouth counties	2	2123	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	034	5	1	01	01	H9001_034_5	5	2		1		08/03/2017	2018.03	08/03/2017 03:51:54 PM Eastern Daylight Time	08/03/2017 05:09:20 PM Eastern Daylight Time	08/03/2017 03:19:44 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Flex Enhanced Rx (HMO)	01	01		1			H9001	034	5	2018	Massachusetts except BAR, BER, DUK, NAN counties	Hampden and Hampshire counties	2	569	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	034	6	1	01	01	H9001_034_6	5	2		1		08/03/2017	2018.03	08/03/2017 03:51:30 PM Eastern Daylight Time	08/03/2017 05:10:14 PM Eastern Daylight Time	08/03/2017 03:20:18 PM Eastern Daylight Time			08/04/2017 11:38:51 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	Fallon Senior Plan Flex Enhanced Rx (HMO)	01	01		1			H9001	034	6	2018	Massachusetts except BAR, BER, DUK, NAN counties	Worcester and parts of Franklin	2	2591	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	803	0	1	01	01	H9001_803_0	1			1		05/26/2017	2018.03	05/26/2017 07:56:25 AM Eastern Daylight Time					06/02/2017 09:30:09 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	MA-PD HMO (HMO)	01	01		1			H9001	803	0	2018	Full Service Area - Employer Groups		1	29561	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9001	804	0	1	02	01	H9001_804_0	1			1		05/26/2017	2018.03	05/26/2017 07:56:34 AM Eastern Daylight Time					06/02/2017 09:30:09 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Health	www.fallonhealth.org/seniorplan	MA-PD HMO POS (HMO-POS)	01	02		1			H9001	804	0	2018	Full Service Area - Employer Groups		1	24	2			2						www.fallonhealth.org/medicare-pharmacy	www.fallonhealth.org/medicare-formulary	www.fallonhealth.org/FindPhysician	(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(800)325-5669		(800)325-5669		(888)377-1980		(888)377-1980		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9003	001	0	1	01	01	H9003_001_0	11			1		08/04/2017	2018.03	08/04/2017 10:54:37 AM Pacific Daylight Time	08/03/2017 11:28:03 AM Pacific Daylight Time	08/03/2017 11:33:13 AM Pacific Daylight Time			08/04/2017 12:41:59 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H9003	001	0	2018	Portland-Vancouver Metro, Salem OR, Longview WA		2		2			2						Kp.org/directory	kp.org/seniorrx	kp.org/directory	(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9003	006	0	1	01	01	H9003_006_0	12			1		08/04/2017	2018.03	08/04/2017 10:54:42 AM Pacific Daylight Time	08/03/2017 11:30:08 AM Pacific Daylight Time	08/03/2017 11:34:39 AM Pacific Daylight Time			08/04/2017 12:41:59 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H9003	006	0	2018	Portland-Vancouver Metro, Salem OR, Longview WA		2		2			2						Kp.org/directory	kp.org/seniorrx	Kp.org/directory	(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9003	801	0	1	01	01	H9003_801_0	5			1		05/31/2017	2018.03	05/31/2017 10:17:08 AM Pacific Daylight Time					06/02/2017 05:18:03 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Employer Group Only with Part D (HMO)	01	01		1			H9003	801	0	2018	Portland-Vancouver Metro, Salem OR, Longview WA		1	241064	2			2						Kp.org/directory	kp.org/seniorrx	Kp.org/directory	(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;16b;	1					2				
H9003	802	0	1	01	01	H9003_802_0	5			1		05/31/2017	2018.03	05/31/2017 10:17:20 AM Pacific Daylight Time					06/02/2017 05:18:03 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Employer Group Only without Part D (HMO)	01	01		1			H9003	802	0	2018	Portland-Vancouver Metro, Salem OR, Longview WA		1	41195	2			2						Kp.org/directory	kp.org/seniorrx	Kp.org/directory	(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;16b;	1					2				
H9003	805	0	1	01	01	H9003_805_0	5			1		05/31/2017	2018.03	05/31/2017 10:17:28 AM Pacific Daylight Time					06/02/2017 05:18:03 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H9003	805	0	2018	Portland-Vancouver Metro, Salem OR, Longview WA		1	52067	2			2						Kp.org/directory	kp.org/seniorrx	Kp.org/directory	(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(877)221-8221		(877)221-8221		(877)408-3496		(877)408-3496		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;12;15;16b;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7f;7g;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14d;16b;	1					2				
H9047	001	0	1	01	01	H9047_001_0	10			1		08/07/2017	2018.03	08/07/2017 02:19:02 PM Pacific Daylight Time	08/07/2017 01:31:43 PM Pacific Daylight Time	08/07/2017 01:58:46 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Extra + RX (HMO)	01	01		1			H9047	001	0	2018	Portland Metro, Willamette Valley, Clark County		2	107957	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	013	0	2	01	01	H9047_013_0	11			1		08/04/2017	2018.03	08/04/2017 02:53:21 PM Pacific Daylight Time	08/07/2017 01:34:10 PM Pacific Daylight Time	08/07/2017 02:00:40 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Extra Part B Only + RX (HMO)	01	01		2	1		H9047	013	0	2018	Portland Metro and Willamette Valley		2	24	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	024	0	1	02	01	H9047_024_0	9			1		08/04/2017	2018.03	08/04/2017 02:55:31 PM Pacific Daylight Time	08/07/2017 01:35:30 PM Pacific Daylight Time	08/07/2017 02:04:17 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Choice + RX (HMO-POS)	01	02		1			H9047	024	0	2018	Portland Metro, Willamette Valley, Clark County		2	275561	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	033	0	1	01	01	H9047_033_0	9			1		07/12/2017	2018.03	07/12/2017 12:10:22 PM Pacific Daylight Time	07/07/2017 02:55:51 PM Pacific Daylight Time				07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Extra (HMO)	01	01		1			H9047	033	0	2018	Portland Metro, Willamette Valley, Clark County		2	10056	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9047	035	0	1	02	01	H9047_035_0	8			1		07/07/2017	2018.03	07/07/2017 07:01:17 AM Pacific Daylight Time	07/07/2017 02:52:50 PM Pacific Daylight Time				07/10/2017 07:53:17 AM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Choice (HMO-POS)	01	02		1			H9047	035	0	2018	Portland Metro, Willamette Valley, Clark County		2	16332	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9047	037	0	1	02	01	H9047_037_0	12			1		08/07/2017	2018.03	08/07/2017 04:44:50 PM Pacific Daylight Time	08/07/2017 07:28:52 PM Pacific Daylight Time	08/07/2017 02:05:13 PM Pacific Daylight Time			08/07/2017 07:53:28 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Prime + RX (HMO-POS)	01	02		1			H9047	037	0	2018	Portland Metro		2	46713	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	038	0	1	02	01	H9047_038_0	10			1		08/04/2017	2018.03	08/04/2017 02:57:05 PM Pacific Daylight Time	08/07/2017 01:47:37 PM Pacific Daylight Time	08/07/2017 02:06:17 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Latitude + RX (HMO-POS)	01	02		1			H9047	038	0	2018	Central OR, Hood River		2	4168	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	039	0	1	02	01	H9047_039_0	10			1		08/04/2017	2018.03	08/04/2017 02:58:44 PM Pacific Daylight Time	08/07/2017 01:49:20 PM Pacific Daylight Time	08/07/2017 02:07:21 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Compass + RX (HMO-POS)	01	02		1			H9047	039	0	2018	Central OR, Hood River		2	6647	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	043	0	1	01	01	H9047_043_0	10		1	1	2	08/04/2017	2018.03	08/04/2017 03:00:11 PM Pacific Daylight Time	08/07/2017 01:55:21 PM Pacific Daylight Time	08/07/2017 02:08:24 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Dual Plus (HMO SNP)	01	01		1			H9047	043	0	2018	Portland Metro		2	23342	2			1	3		2		2	providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	045	0	1	01	01	H9047_045_0	12			1		08/09/2017	2018.03	08/09/2017 03:11:27 PM Pacific Daylight Time	08/10/2017 08:20:22 AM Pacific Daylight Time	08/07/2017 02:09:19 PM Pacific Daylight Time			08/10/2017 08:50:24 AM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Enrich + RX (HMO)	01	01		1			H9047	045	0	2018	Linn and Benton Counties		2	1224	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	047	0	1	02	01	H9047_047_0	10			1		08/04/2017	2018.03	08/04/2017 03:03:55 PM Pacific Daylight Time	08/07/2017 01:52:31 PM Pacific Daylight Time	08/07/2017 02:10:19 PM Pacific Daylight Time			08/07/2017 02:24:29 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Summit + RX (HMO-POS)	01	02		1			H9047	047	0	2018	King and Snohomish Counties		2	7200	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	049	0	1	01	01	H9047_049_0	15			1		08/07/2017	2018.03	08/07/2017 04:45:11 PM Pacific Daylight Time	08/07/2017 07:30:55 PM Pacific Daylight Time	08/07/2017 02:11:09 PM Pacific Daylight Time			08/07/2017 07:53:28 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Harbor + RX (HMO)	01	01		1			H9047	049	0	2018	King and Snohomish Counties		2	22800	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	801	0	1	01	01	H9047_801_0	5			1		07/07/2017	2018.03	07/07/2017 07:07:04 AM Pacific Daylight Time					07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Align Group Plan (HMO)	01	01		1			H9047	801	0	2018	Portland Metro, Willamette Valley,Central OR,Clark		1	432	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9047	804	0	1	01	01	H9047_804_0	5			1		07/07/2017	2018.03	07/07/2017 07:07:41 AM Pacific Daylight Time					07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Align Group Plan + RX (HMO)	01	01		1			H9047	804	0	2018	Portland Metro, Willamette Valley,Central OR,Clark		1	17291	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	805	0	1	02	01	H9047_805_0	5			1		07/07/2017	2018.03	07/07/2017 07:08:13 AM Pacific Daylight Time					07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Flex Group Plan + RX (HMO-POS)	01	02		1			H9047	805	0	2018	Portland Metro, Willamette Valley,Central OR,Clark		1	43	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	808	0	1	01	01	H9047_808_0	5			1		07/07/2017	2018.03	07/07/2017 07:08:53 AM Pacific Daylight Time					07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Align Group Plan + RX (HMO)	01	01		1			H9047	808	0	2018	Portland Metro, Willamette Valley,Central OR,Clark		1	115167	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9047	809	0	1	02	01	H9047_809_0	5			1		07/07/2017	2018.03	07/07/2017 07:09:29 AM Pacific Daylight Time					07/12/2017 02:28:40 PM Pacific Daylight Time	PROVIDENCE HEALTH ASSURANCE	Providence Health Assurance	www.providencehealthassurance.com	Providence Medicare Flex Group Plan + RX (HMO-POS)	01	02		1			H9047	809	0	2018	Portland Metro, Willamette Valley,Central OR,Clark		1	32093	2			2						providencehealthplan.com	providencehealthplan.com	www.providencehealthassurance.com/providerdirectory	(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(800)603-2340		(503)574-8000		(800)457-6064		(503)574-5551		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9068	001	0	1	20	08	H9068_001_0	2			1		07/18/2017	2018.03	07/18/2017 11:00:57 AM Eastern Daylight Time		07/18/2017 10:47:51 AM Eastern Daylight Time			07/18/2017 11:03:29 AM Eastern Daylight Time	ALBRIGHT CARE SERVICES	ALBRIGHT CARE SERVICES	www.albrightlife.org	Albright LIFE (PACE)	08	20		1			H9068	001	0	2018	Lancaster,Lebanon,Lycoming Co.,19320 of Chester Co		2		2			2						www.albrightcare.org	www.albrightcare.org										(888)791-0094		(570)522-3880		(888)791-0094		(570)522-3880										(711)-		(711)-		(711)-		(711)-																
H9068	002	0	1	20	08	H9068_002_0	2			1		07/18/2017	2018.03	07/18/2017 11:01:35 AM Eastern Daylight Time		07/18/2017 10:48:13 AM Eastern Daylight Time			07/18/2017 11:03:29 AM Eastern Daylight Time	ALBRIGHT CARE SERVICES	ALBRIGHT CARE SERVICES	www.albrightlife.org	Albright LIFE Medicare Only (PACE)	08	20		1			H9068	002	0	2018	Lancaster,Lebanon,Lycoming, 19320 of Chester Co		2		2			2						www.albrightcare.org	www.albrightcare.org										(888)791-0094		(570)522-3880		(888)791-0094		(570)522-3880										(711)-		(711)-		(711)-		(711)-																
H9082	007	0	1	01	01	H9082_007_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 08:44:14 AM Pacific Daylight Time	08/04/2017 08:33:58 AM Pacific Daylight Time	08/01/2017 09:20:34 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Molina Healthcare of New Mexico, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Options Plus (HMO SNP)	01	01		1			H9082	007	0	2018	Albuquerque, Santa Fe		2		2			1	3		2		2	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(866)440-0127		(866)440-0127		(866)403-8293		(866)403-8293		(866)440-0127		(866)440-0127		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9082	008	0	1	01	01	H9082_008_0	6			1		08/04/2017	2018.03	08/04/2017 08:53:55 AM Pacific Daylight Time	08/04/2017 08:35:26 AM Pacific Daylight Time	08/01/2017 09:22:04 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Molina Healthcare of New Mexico, Inc.	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H9082	008	0	2018	Albuquerque, Santa Fe		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(866)440-0127		(866)440-0127		(866)403-8293		(866)403-8293		(866)440-0127		(866)440-0127		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	001	0	1	01	01	H9096_001_0	5			1		07/07/2017	2018.03	07/07/2017 09:42:10 AM Central Daylight Time	08/02/2017 08:50:59 AM Central Daylight Time	08/02/2017 08:51:03 AM Central Daylight Time			08/02/2017 04:19:53 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage Assurance (HMO)	01	01		1			H9096	001	0	2018	South Central Wisconsin		2	14387	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	002	0	1	01	01	H9096_002_0	5			1		07/07/2017	2018.03	07/07/2017 09:42:33 AM Central Daylight Time	08/02/2017 08:51:06 AM Central Daylight Time	08/02/2017 08:51:09 AM Central Daylight Time			08/02/2017 04:19:53 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage Balance (HMO)	01	01		1			H9096	002	0	2018	South Central Wisconsin		2	17332	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	003	0	1	02	01	H9096_003_0	5			1		07/07/2017	2018.03	07/07/2017 09:42:46 AM Central Daylight Time	08/02/2017 08:51:14 AM Central Daylight Time	08/02/2017 08:51:17 AM Central Daylight Time			08/02/2017 04:19:53 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage Confidence (HMO-POS)	01	02		1			H9096	003	0	2018	South Central Wisconsin		2	13081	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	004	0	1	01	01	H9096_004_0	5			1		07/07/2017	2018.03	07/07/2017 09:43:14 AM Central Daylight Time	08/02/2017 08:51:21 AM Central Daylight Time	08/02/2017 08:51:24 AM Central Daylight Time			08/02/2017 04:19:53 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage Essential (HMO)	01	01		1			H9096	004	0	2018	South Central Wisconsin		2	6167	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	005	0	1	01	01	H9096_005_0	5			1		07/07/2017	2018.03	07/07/2017 09:44:27 AM Central Daylight Time	08/02/2017 08:51:27 AM Central Daylight Time	08/02/2017 08:51:31 AM Central Daylight Time			08/02/2017 04:19:53 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage Gold Complete (HMO)	01	01		1			H9096	005	0	2018	South Central Wisconsin		2	3084	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9096	801	0	1	01	01	H9096_801_0	3			1		05/23/2017	2018.03	05/23/2017 10:34:56 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage - EGWP MAPD CY (HMO)	01	01		1			H9096	801	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1					1				
H9096	802	0	1	01	01	H9096_802_0	3			1		05/23/2017	2018.03	05/23/2017 10:34:39 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage - EGWP MAPD Non CY (HMO)	01	01		1			H9096	802	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1					1				
H9096	803	0	1	01	01	H9096_803_0	3			1		05/23/2017	2018.03	05/23/2017 11:33:15 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage - EGWP MA only (HMO)	01	01		1			H9096	803	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1					1				
H9096	804	0	1	02	01	H9096_804_0	3			1		05/23/2017	2018.03	05/23/2017 10:52:05 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage EGWP CY HMOPOS (HMO-POS)	01	02		1			H9096	804	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1				
H9096	805	0	1	02	01	H9096_805_0	3			1		05/23/2017	2018.03	05/23/2017 10:53:26 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage EGWP Non CY HMOPOS (HMO-POS)	01	02		1			H9096	805	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1				
H9096	806	0	1	02	01	H9096_806_0	3			1		05/23/2017	2018.03	05/23/2017 11:32:26 AM Central Daylight Time					06/03/2017 10:18:20 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Advantage	www.deancare.com/medicare	Dean Advantage EGWP MA Only HMOPOS (HMO-POS)	01	02		1			H9096	806	0	2018	Wisconsin		1	1	2			2						www.deancare.com	www.deancare.com	www.deancare.com/find-a-doc/	(877)232-7566		(608)828-1978		(877)234-0126		(608)828-1941										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1	1	1a;1b;2;5;6;7c;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;16b;	2		1				
H9104	006	0	1	01	01	H9104_006_0	4		1	1		08/07/2017	2018.03	08/07/2017 11:46:10 AM Pacific Daylight Time	08/03/2017 04:19:58 PM Pacific Daylight Time	07/31/2017 04:03:52 PM Pacific Daylight Time			08/07/2017 04:00:57 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Healthy at Home (HMO SNP)	01	01		1			H9104	006	0	2018	Los Angeles, Orange, and Inland Empire Areas		2		2			1	1	2				www.scanhealthplan.com	www.scanhealthplan.com	www.scanhealthplan.com	(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(800)559-3500		(800)559-3500		(800)915-7226		(800)915-7226		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9115	001	0	1	48	05	H9115_001_0	3			1		07/06/2017	2018.03	07/06/2017 09:50:32 AM Eastern Daylight Time					07/06/2017 09:51:08 AM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus FIDA	www.metroplus.org/fida	MetroPlus FIDA (Medicare-Medicaid Plan)	05	48		1			H9115	001	0	2018	Manhattan, Brooklyn, Queens and Bronx		2	2400	2			2						www.caremark.com	www.metroplus.org	www.metroplus.org/fida	(844)288-3432		(844)288-3432		(844)288-3432		(844)288-3432		(844)288-3432		(844)288-3432		(844)288-3432		(844)288-3432		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H9153	001	0	1	01	01	H9153_001_0	3		1	1		08/04/2017	2018.03	08/04/2017 05:41:52 PM Central Daylight Time	08/07/2017 10:57:58 AM Central Daylight Time	08/07/2017 10:58:06 AM Central Daylight Time			08/07/2017 11:10:56 AM Central Daylight Time	WEST VIRGINIA SENIOR ADVANTAGE, INC.	West Virginia Senior Advantage (HMO SNP)	www.wvsenioradvantage.com	WV Senior Advantage (HMO SNP)	01	01		1			H9153	001	0	2018	BER,GRB,HSN,KA,MNL,MGL,MRO,MOR,PL,PR,RAL&WOD		2	5280	2			1	1	1				www.wvsenioradvantage.com	www.wvsenioradvantage.com	www.wvsenioradvantage.com	(844)854-6888		(844)854-6888		(844)854-6888		(844)854-6888		(844)854-6888		(844)854-6888		(844)854-6888		(844)854-6888		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9185	001	0	1	20	08	H9185_001_0	2			1		05/25/2017	2018.03	05/25/2017 09:59:16 AM Eastern Daylight Time		05/25/2017 11:32:27 AM Eastern Daylight Time			05/25/2017 11:36:02 AM Eastern Daylight Time	A&D CHARITABLE FOUNDATION, INC.	Great Lakes PACE	http://www.greatlakespace.org	Great Lakes PACE - Dual Eligible (PACE)	08	20		1			H9185	001	0	2018	Great Lakes Bay Region: Saginaw, Midland, Bay, Tus		2		2			2						www.a-dhomecare.com	www.a-dhomecare.com										(844)445-7223		(989)272-7610		(844)445-7223		(989)272-7610										(844)445-7223		(989)272-7610		(844)445-7223		(989)272-7619																
H9185	002	0	1	20	08	H9185_002_0	2			1		05/25/2017	2018.03	05/25/2017 09:59:37 AM Eastern Daylight Time		05/25/2017 11:32:06 AM Eastern Daylight Time			05/25/2017 11:36:02 AM Eastern Daylight Time	A&D CHARITABLE FOUNDATION, INC.	Great Lakes PACE	http://www.greatlakespace.org	Great Lakes PACE (PACE)	08	20		1			H9185	002	0	2018	Great Lakes Bay Region: Saginaw, Midland, Bay, Tus		2		2			2						www.a-dhomecare.com	www.a-dhomecare.com										(844)445-7223		(989)272-7610		(844)445-7223		(989)272-7610										(844)445-7223		(989)272-7610		(844)445-7223		(989)272-7610																
H9190	001	0	1	01	01	H9190_001_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 01:47:49 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:41:50 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Diamond (HMO SNP)	01	01		1			H9190	001	0	2018	Ohio Counties		2	22280	2			1	3		1		1	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	002	0	1	01	01	H9190_002_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 01:33:52 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:44:32 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Ruby (HMO SNP)	01	01		1			H9190	002	0	2018	Ohio Counties		2	4199	2			1	3		2		2	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	006	0	1	01	01	H9190_006_0	5			1		08/04/2017	2018.03	08/04/2017 01:34:42 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:46:48 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Prime (HMO)	01	01		1			H9190	006	0	2018	Ohio Counties		2	2008	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	007	0	1	01	01	H9190_007_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 01:47:29 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:49:33 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Diamond (HMO SNP)	01	01		1			H9190	007	0	2018	North Carolina Counties		2	22003	2			1	3		1		1	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	008	0	1	01	01	H9190_008_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 01:36:51 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:36 PM Eastern Daylight Time			08/05/2017 01:51:37 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Ruby (HMO SNP)	01	01		1			H9190	008	0	2018	North Carolina Counties		2	2935	2			1	3		2		2	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	012	0	1	01	01	H9190_012_0	5			1		08/04/2017	2018.03	08/04/2017 01:37:41 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 01:56:08 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Prime (HMO)	01	01		1			H9190	012	0	2018	North Carolina Counties		2	764	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	013	0	1	01	01	H9190_013_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 01:47:12 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 01:59:07 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Diamond (HMO SNP)	01	01		1			H9190	013	0	2018	Kentucky Counties		2	9772	2			1	3		1		1	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	014	0	1	01	01	H9190_014_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 01:39:11 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 02:01:20 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Ruby (HMO SNP)	01	01		1			H9190	014	0	2018	Kentucky Counties		2	1683	2			1	3		2		2	www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	018	0	1	01	01	H9190_018_0	5			1		08/04/2017	2018.03	08/04/2017 01:40:01 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 02:04:24 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Prime (HMO)	01	01		1			H9190	018	0	2018	Kentucky Counties		2	1398	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	019	0	1	01	01	H9190_019_0	5			1		08/04/2017	2018.03	08/04/2017 01:40:43 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 02:06:47 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Select (HMO)	01	01		1			H9190	019	0	2018	Ohio Counties		2	28621	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	020	0	1	01	01	H9190_020_0	5			1		08/04/2017	2018.03	08/04/2017 01:41:43 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 02:09:13 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Select (HMO)	01	01		1			H9190	020	0	2018	North Carolina Counties		2	26633	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6430		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	021	0	1	01	01	H9190_021_0	5			1		08/04/2017	2018.03	08/04/2017 01:42:35 PM Eastern Daylight Time	08/05/2017 01:28:38 PM Eastern Daylight Time	08/05/2017 01:28:37 PM Eastern Daylight Time			08/05/2017 02:11:36 PM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.medicareassured.com	Gateway Health Medicare Assured Select (HMO)	01	01		1			H9190	021	0	2018	Kentucky Counties		2	24117	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(855)847-6380		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	801	0	1	01	01	H9190_801_0	2			1		05/02/2017	2018.03	05/02/2017 01:12:17 PM Eastern Daylight Time					06/02/2017 06:08:14 AM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.MedicareAssured.com	Gateway Health Medicare Assured Flex (HMO)	01	01		1			H9190	801	0	2018	Kentucky, North Carolina and Ohio counties		1	14	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9190	802	0	1	01	01	H9190_802_0	2			1		05/02/2017	2018.03	05/02/2017 01:14:39 PM Eastern Daylight Time					06/02/2017 06:09:32 AM Eastern Daylight Time	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Medicare Assured	www.MedicareAssured.com	Gateway Health Medicare Assured Flex (HMO)	01	01		1			H9190	802	0	2018	Kentucky, North Carolina and Ohio counties		1	14	2			2						www.MedicareAssured.com	www.MedicareAssured.com	www.MedicareAssured.com	(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(888)447-4505		(412)255-1323		(877)935-2168		(412)255-1193		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	001	0	1	01	01	H9207_001_0	4			1		07/12/2017	2018.03	07/12/2017 05:13:00 PM Eastern Daylight Time	07/17/2017 11:57:48 AM Eastern Daylight Time				07/17/2017 12:00:24 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Basic (HMO)	01	01		1			H9207	001	0	2018	Bucks, Chester, Delaware, Montgomery, Philadelphia		2	3200	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9207	002	0	1	01	01	H9207_002_0	7			1		08/02/2017	2018.03	08/02/2017 04:02:16 PM Eastern Daylight Time	08/02/2017 03:42:34 PM Eastern Daylight Time	08/01/2017 03:05:30 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Prime (HMO)	01	01		1			H9207	002	0	2018	Philadelphia County		2	108433	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	004	0	1	01	01	H9207_004_0	6		1	1	2	08/02/2017	2018.03	08/02/2017 04:08:39 PM Eastern Daylight Time	08/02/2017 05:44:34 PM Eastern Daylight Time	08/01/2017 03:05:56 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Special (HMO SNP)	01	01		1			H9207	004	0	2018	Bucks, Chester, Del, Lan, Leh, Montg, Nrtha, Phil		2	167718	2			1	3		2		2	HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	005	0	1	01	01	H9207_005_0	9			1		08/02/2017	2018.03	08/02/2017 04:04:11 PM Eastern Daylight Time	08/02/2017 06:08:04 PM Eastern Daylight Time	08/01/2017 03:16:18 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Prime (HMO)	01	01		1			H9207	005	0	2018	Bucks, Chester, Delaware and Montgomery Counties		2	9146	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	007	0	1	01	01	H9207_007_0	6			1		08/02/2017	2018.03	08/02/2017 04:14:25 PM Eastern Daylight Time	08/02/2017 08:29:24 PM Eastern Daylight Time	08/01/2017 03:16:42 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Value (HMO)	01	01		1			H9207	007	0	2018	Philadelphia County		2	9434	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	008	0	1	01	01	H9207_008_0	6			1		08/02/2017	2018.03	08/02/2017 04:17:03 PM Eastern Daylight Time	08/02/2017 08:30:48 PM Eastern Daylight Time	08/01/2017 03:17:06 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Value (HMO)	01	01		1			H9207	008	0	2018	Bucks, Chester, Delaware and Montgomery Counties		2	3271	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	009	0	1	01	01	H9207_009_0	6			1		08/02/2017	2018.03	08/02/2017 04:19:27 PM Eastern Daylight Time	08/02/2017 09:05:20 PM Eastern Daylight Time	08/01/2017 03:17:30 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Value (HMO)	01	01		1			H9207	009	0	2018	Lancaster, Lehigh, Northampton Counties		2	1086	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9207	010	0	1	01	01	H9207_010_0	7			1		08/02/2017	2018.03	08/02/2017 04:05:28 PM Eastern Daylight Time	08/02/2017 04:13:06 PM Eastern Daylight Time	08/01/2017 03:17:52 PM Eastern Daylight Time			08/03/2017 05:00:00 PM Eastern Daylight Time	HEALTH PARTNERS PLANS, INC.	Health Partners Medicare	HPPMedicare.com	Health Partners Medicare Prime (HMO)	01	01		1			H9207	010	0	2018	Lancaster, Lehigh, Northampton Counties		2	1158	2			2						HPPMedicare.com	HPPMedicare.com	HPPMedicare.com	(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(866)901-8000		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9208	001	0	1	01	01	H9208_001_0	4			1		08/03/2017	2018.03	08/03/2017 02:13:46 PM Central Daylight Time	08/02/2017 01:32:40 PM Central Daylight Time	08/01/2017 02:08:06 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	RIVERLINK HEALTH	RiverLink Health	www.RiverLinkHealth.com	Classic Plus Rx (HMO)	01	01		1			H9208	001	0	2018	Butler, Clermont, Hamilton and Warren Counties		2		2			2						www.RiverLinkHealth.com	www.RiverLinkHealth.com	www.RiverLinkHealth.com	(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H9208	002	0	1	01	01	H9208_002_0	4			1		08/03/2017	2018.03	08/03/2017 02:14:25 PM Central Daylight Time	08/02/2017 01:31:36 PM Central Daylight Time	08/03/2017 02:06:02 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	RIVERLINK HEALTH	RiverLink Health	www.RiverLinkHealth.com	Classic Plus Rx - N Kentucky (HMO)	01	01		1			H9208	002	0	2018	Boone, Campbell and Kenton Counties		2		2			2						www.RiverLinkHealth.com	www.RiverLinkHealth.com	www.RiverLinkHealth.com	(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(866)329-3970		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H9266	001	0	1	20	08	H9266_001_0	1			1		05/25/2017	2018.03	05/25/2017 08:33:25 AM Eastern Daylight Time		05/25/2017 06:56:04 AM Eastern Daylight Time			05/26/2017 09:34:35 AM Eastern Daylight Time	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	http://www.piedmonthealthseniorcare.org/	Piedmont Health SeniorCare - Dual (PACE)	08	20		1			H9266	001	0	2018	Alamance, Caswell, and Orange counties		2		2			2						no answer	no answer										(877)714-2100		(336)532-0000		(877)714-2100		(336)532-0000										(800)735-2962		(800)735-2962		(877)714-2100		(336)532-0000																
H9266	003	0	1	20	08	H9266_003_0	1			1		05/25/2017	2018.03	05/25/2017 08:33:18 AM Eastern Daylight Time		05/25/2017 06:56:25 AM Eastern Daylight Time			05/26/2017 09:34:35 AM Eastern Daylight Time	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	http://www.piedmonthealthseniorcare.org/	Piedmont Health SeniorCare - Dual (PACE)	08	20		1			H9266	003	0	2018	Chatham, Lee and Orange counties		2		2			2						no answer	no answer										(877)714-2100		(919)545-7337		(877)714-2100		(336)532-0000										(800)735-2962		(800)735-2962		(877)714-2100		(336)532-0000																
H9276	001	0	1	01	01	H9276_001_0	3			1		08/07/2017	2018.03	08/07/2017 06:05:34 PM Pacific Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	001	0	2018	Duval, Lake, Pinellas, Polk,  and Volusia Counties		2		2			2						https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	002	0	1	01	01	H9276_002_0	4			1		08/03/2017	2018.03	08/03/2017 01:23:25 PM Eastern Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	002	0	2018	Pinellas, Polk, Hernando, Pasco, Volusia, Duval		2		2			2						https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	003	0	1	01	01	H9276_003_0	4			1		08/03/2017	2018.03	08/03/2017 01:23:33 PM Eastern Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	003	0	2018	Manatee, Marion, Palm Beach, and Seminole Counties		2		2			2						https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	004	0	1	01	01	H9276_004_0	3			1		08/03/2017	2018.03	08/03/2017 01:23:47 PM Eastern Daylight Time	08/04/2017 04:35:05 PM Pacific Daylight Time	08/04/2017 04:35:28 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	004	0	2018	Miami-Dade County		2		2			2						https://advantage.sunshinehealth.com/findadoctor	https://advantage.sunshinehealth.com/partdformulary	https://advantage.sunshinehealth.com/findadoctor	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	005	0	1	01	01	H9276_005_0	4			1		08/03/2017	2018.03	08/03/2017 01:14:33 PM Eastern Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	005	0	2018	Miami-Dade County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	006	0	1	01	01	H9276_006_0	4			1		08/03/2017	2018.03	08/03/2017 01:24:00 PM Eastern Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	006	0	2018	Hillsborough County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	007	0	1	01	01	H9276_007_0	5			1		08/03/2017	2018.03	08/03/2017 01:24:19 PM Eastern Daylight Time	08/07/2017 07:34:31 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	007	0	2018	Hillsborough County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	008	0	1	01	01	H9276_008_0	4			1		08/03/2017	2018.03	08/03/2017 01:24:28 PM Eastern Daylight Time	08/07/2017 07:34:32 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	008	0	2018	Osceola County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	009	0	1	01	01	H9276_009_0	4			1		08/03/2017	2018.03	08/03/2017 01:24:39 PM Eastern Daylight Time	08/07/2017 07:34:32 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	009	0	2018	Osceola County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	010	0	1	01	01	H9276_010_0	4			1		08/03/2017	2018.03	08/03/2017 01:24:50 PM Eastern Daylight Time	08/07/2017 07:34:32 PM Pacific Daylight Time	08/04/2017 04:49:28 PM Pacific Daylight Time			08/07/2017 07:44:43 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	010	0	2018	Orange County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	011	0	1	01	01	H9276_011_0	3			1		08/03/2017	2018.03	08/03/2017 01:24:59 PM Eastern Daylight Time	08/04/2017 04:35:05 PM Pacific Daylight Time	08/04/2017 04:35:28 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	011	0	2018	Orange County		2	500	2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	012	0	1	01	01	H9276_012_0	3			1		08/03/2017	2018.03	08/03/2017 01:25:08 PM Eastern Daylight Time	08/04/2017 04:35:05 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare (HMO)	01	01		1			H9276	012	0	2018	Broward County		2	500	2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9276	013	0	1	01	01	H9276_013_0	3			1		08/03/2017	2018.03	08/03/2017 01:25:17 PM Eastern Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/05/2017 06:55:48 PM Pacific Daylight Time	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	Allwell	allwell.sunshinehealth.com	Allwell Medicare Premier (HMO)	01	01		1			H9276	013	0	2018	Broward County		2		2			2						http://advantage.sunshinehealth.com/home/find-a-provider-or-pharmacy/	http://advantage.sunshinehealth.com/home/prescription-drug-part-d-benefitinformation/	https://allwell.sunshinehealth.com/find-doctor.html	(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(844)293-2636		(844)293-2636		(877)826-3692		(877)826-3692		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9287	001	0	1	01	01	H9287_001_0	3			1		08/02/2017	2018.03	08/02/2017 12:29:35 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:21:10 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC.	Allwell	www.healthnet.com/medicare	Allwell Medicare Premier (HMO)	01	01		1			H9287	001	0	2018	Pima County, AZ		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9287	004	0	1	01	01	H9287_004_0	3			1		08/02/2017	2018.03	08/02/2017 12:30:21 PM Mountain Standard Time	08/04/2017 04:44:26 PM Pacific Daylight Time	08/04/2017 04:44:27 PM Pacific Daylight Time			08/04/2017 07:21:10 PM Pacific Daylight Time	HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC.	Allwell	www.allwell.healthnetadvantage.com	Allwell Medicare Essentials I (HMO)	01	01		1			H9287	004	0	2018	Maricopa		2		2			2						https://www.healthnet.com/medicare/pharmacy	https://www.healthnet.com/medicare/pharmacy	https://www.allwell.healthnetadvantage.com/find-doctor.html	(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(800)977-7522		(800)977-7522		(800)333-3930		(800)333-3930		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9302	003	0	1	01	01	H9302_003_0	4			1		06/27/2017	2018.03	06/27/2017 11:16:00 AM Central Daylight Time	08/03/2017 08:57:24 AM Central Daylight Time	08/01/2017 02:11:12 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	SOUNDPATH HEALTH	Soundpath Health	www.SoundpathHealth.com	Soundpath Health Charter + Rx (HMO)	01	01		1			H9302	003	0	2018	Western and Central Washington Areas		2		2			2						www.SoundpathHealth.com	www.SoundpathHealth.com	www.SoundpathHealth.com	(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H9302	004	0	1	01	01	H9302_004_0	3			1		06/27/2017	2018.03	06/27/2017 11:22:37 AM Central Daylight Time	06/04/2017 06:06:30 PM Central Daylight Time				06/28/2017 07:12:40 PM Central Daylight Time	SOUNDPATH HEALTH	Soundpath Health	www.SoundpathHealth.com	Soundpath Health Alpine (HMO)	01	01		1			H9302	004	0	2018	Western and Central Washington Areas		2		2			2						www.SoundpathHealth.com	www.SoundpathHealth.com	www.SoundpathHealth.com	(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830										(711)-		(711)-		(711)-		(711)-										2					2					2	1	11	18a;	18a1;
H9302	007	0	1	01	01	H9302_007_0	4			1		06/27/2017	2018.03	06/27/2017 11:30:10 AM Central Daylight Time	08/03/2017 08:58:44 AM Central Daylight Time	08/01/2017 02:12:00 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	SOUNDPATH HEALTH	Soundpath Health	www.SoundpathHealth.com	Soundpath Health Sound + Rx (HMO)	01	01		1			H9302	007	0	2018	Western Washington Areas		2		2			2						www.SoundpathHealth.com	www.SoundpathHealth.com	www.SoundpathHealth.com	(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H9302	011	0	1	01	01	H9302_011_0	5			1		08/03/2017	2018.03	08/03/2017 02:19:07 PM Central Daylight Time	08/02/2017 01:36:34 PM Central Daylight Time	08/01/2017 02:12:46 PM Central Daylight Time			08/05/2017 12:34:17 PM Central Daylight Time	SOUNDPATH HEALTH	Soundpath Health	www.SoundpathHealth.com	Soundpath Health Peak + Rx (HMO)	01	01		1			H9302	011	0	2018	Western and Central Washington Areas		2		2			2						www.SoundpathHealth.com	www.SoundpathHealth.com	www.SoundpathHealth.com	(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	1	11	18a;	18a1;
H9302	801	0	1	01	01	H9302_801_0	1			1		05/18/2017	2018.03	05/18/2017 01:08:27 PM Central Daylight Time					06/03/2017 05:36:50 PM Central Daylight Time	SOUNDPATH HEALTH	Soundpath Health	www.SoundpathHealth.com	Soundpath Health + Rx (HMO)	01	01		1			H9302	801	0	2018	Western and Central Washington Areas		1	12	2			2						www.SoundpathHealth.com	www.SoundpathHealth.com	www.SoundpathHealth.com	(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(866)789-7747		(253)779-8830		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9312	001	0	1	04	01	H9312_001_0	6		1	1		06/28/2017	2018.03	06/28/2017 10:48:37 AM Central Daylight Time		08/03/2017 04:28:30 PM Central Daylight Time		08/03/2017 04:28:28 PM Central Daylight Time	08/03/2017 04:34:28 PM Central Daylight Time	FRESENIUS HEALTH PLANS INSURANCE COMPANY	Fresenius Health Plans	www.esrdplans.com	Fresenius Total Health (PPO SNP)	01	04		1			H9312	001	0	2018	Maricopa County		2	1920	2			1	4			00000000100000000000		www.esrdplans.com	www.esrdplans.com	www.esrdplans.com	(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		2					2						2			
H9312	002	0	1	04	01	H9312_002_0	6		1	1		06/28/2017	2018.03	06/28/2017 10:48:52 AM Central Daylight Time		08/03/2017 04:28:36 PM Central Daylight Time		08/03/2017 04:28:33 PM Central Daylight Time	08/03/2017 04:34:28 PM Central Daylight Time	FRESENIUS HEALTH PLANS INSURANCE COMPANY	Fresenius Health Plans	www.esrdplans.com	Fresenius Total Health (PPO SNP)	01	04		1			H9312	002	0	2018	San Diego County		2	1920	2			1	4			00000000100000000000		www.esrdplans.com	www.esrdplans.com	www.esrdplans.com	(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(855)598-6774		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		(844)209-9094		2					2						2			
H9323	001	0	1	20	08	H9323_001_0	1			1		05/31/2017	2018.03	05/31/2017 02:59:53 PM Eastern Daylight Time		05/31/2017 02:35:42 PM Eastern Daylight Time			05/31/2017 03:00:36 PM Eastern Daylight Time	BEACON HEALTH & SOCIAL SERVICE, INC	Beacon of LIFE	beaconhss.com	Beacon Health and Social Services, Inc (PACE)	08	20		1			H9323	001	0	2018	Monmouth County		2		2			2						NA	NA										(732)592-3400		(732)592-3400		(732)592-3400		(732)592-3400										(732)532-3400		(732)592-3400		(732)592-3400		(732)592-3400																
H9323	002	0	1	20	08	H9323_002_0	1			1		05/26/2017	2018.03	05/26/2017 01:39:34 PM Eastern Daylight Time		05/31/2017 02:35:39 PM Eastern Daylight Time			05/31/2017 03:00:36 PM Eastern Daylight Time	BEACON HEALTH & SOCIAL SERVICE, INC	Beacon of LIFE	beaconhss.com	Beacon Health and Social Services, Inc (PACE)	08	20		1			H9323	002	0	2018	Monmouth County		2		2			2						NA	NA										(732)592-3400		(732)592-3400		(732)592-3400		(732)592-3400										(732)532-3400		(732)592-3400		(732)592-3400		(732)592-3400																
H9345	001	0	1	48	05	H9345_001_0	3			1		07/07/2017	2018.03	07/07/2017 02:12:35 PM Eastern Daylight Time					07/07/2017 02:12:44 PM Eastern Daylight Time	VILLAGE SENIOR SERVICES CORPORATION	VillageCareMAX Full Advantage FIDA	www.villagecaremax.org	VillageCareMAX Full Advantage FIDA (Medicare-Medicaid Plan)	05	48		1			H9345	001	0	2018	Kings, Queens, Bronx, New York		2	50	2			2						www.villagecaremax.org	www.villagecaremax.org	www.villagecaremax.org	(800)469-6292		(800)469-6292		(800)469-6292		(800)469-6292		(888)807-6806		(888)807-6806		(800)469-6292		(800)469-6292		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H9403	001	0	1	01	01	H9403_001_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 11:57:19 AM Eastern Daylight Time	08/04/2017 10:38:37 AM Eastern Daylight Time	08/04/2017 09:00:25 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (SC)	Eon Health	www.eonhealthplan.com	EON DELUXE (HMO SNP)	01	01		1			H9403	001	0	2018	Select South Carolina Counties		2	8895	2			1	3		1		1	www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9403	003	0	1	01	01	H9403_003_0	9		1	1		08/04/2017	2018.03	08/04/2017 11:58:32 AM Eastern Daylight Time	08/04/2017 10:40:12 AM Eastern Daylight Time	08/04/2017 09:01:17 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (SC)	Eon Health	www.eonhealthplan.com	EON SILVER (HMO SNP)	01	01		1			H9403	003	0	2018	Select South Carolina Counties		2	3271	2			1	4			00000000000000000010		www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9403	004	0	1	01	01	H9403_004_0	9			1		08/04/2017	2018.03	08/04/2017 11:58:52 AM Eastern Daylight Time	08/04/2017 10:42:10 AM Eastern Daylight Time	08/04/2017 09:02:37 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (SC)	Eon Health	www.eonhealthplan.com	EON SELECT (HMO)	01	01		1			H9403	004	0	2018	Select South Carolina Counties		2	2837	2			2						www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9408	001	0	1	04	01	H9408_001_0	7			1		08/03/2017	2018.03	08/03/2017 05:46:09 PM Eastern Daylight Time	08/04/2017 02:31:56 PM Eastern Daylight Time	08/02/2017 10:53:48 AM Eastern Daylight Time			08/04/2017 04:06:17 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Essential Coverage (PPO)	01	04		1			H9408	001	0	2018	Southcentral and Northeast Pennsylvania		2	26400	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9408	002	0	1	04	01	H9408_002_0	6			1		06/04/2017	2018.03	06/04/2017 04:37:25 PM Eastern Daylight Time	08/04/2017 02:33:24 PM Eastern Daylight Time	08/02/2017 10:54:32 AM Eastern Daylight Time			08/04/2017 04:06:17 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Enhanced Coverage (PPO)	01	04		1			H9408	002	0	2018	Southcentral and Northeast Pennsylvania		2	12000	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9408	801	0	1	04	01	H9408_801_0	2			1		06/02/2017	2018.03	06/02/2017 07:55:32 PM Eastern Daylight Time					06/04/2017 06:16:14 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Employer Group Coverage CY MAPD (PPO)	01	04		1			H9408	801	0	2018	Southcentral and Northeast Pennsylvania		1	7200	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;11a;11b;11c;12;16b;	2		1									
H9408	802	0	1	04	01	H9408_802_0	2			1		06/02/2017	2018.03	06/02/2017 07:56:35 PM Eastern Daylight Time					06/04/2017 06:16:14 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Employer Group Coverage FY MAPD (PPO)	01	04		1			H9408	802	0	2018	Southcentral and Northeast Pennsylvania		1	24	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;11a;11b;11c;12;16b;	2		1									
H9408	803	0	1	04	01	H9408_803_0	2			1		06/02/2017	2018.03	06/02/2017 07:56:29 PM Eastern Daylight Time					06/04/2017 06:16:14 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Employer Group Coverage CY MA (PPO)	01	04		1			H9408	803	0	2018	Southcentral and Northeast Pennsylvania		1	2400	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;11a;11b;11c;12;16b;	2		1									
H9408	804	0	1	04	01	H9408_804_0	2			1		06/02/2017	2018.03	06/02/2017 07:56:23 PM Eastern Daylight Time					06/04/2017 06:16:14 PM Eastern Daylight Time	VIBRA HEALTH PLAN, INC.	Vibra Health Plan	www.vibrahealthplan.com	Vibra Health Plan Employer Group Coverage FY MA (PPO)	01	04		1			H9408	804	0	2018	Southcentral and Northeast Pennsylvania		1	24	2			2						www.vibrahealthplan.com	www.vibrahealthplan.com	www.vibrahealthplan.com/directory-test	(844)388-8268		(717)510-6300		(844)388-8268		(717)510-6300										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7i;8b1;8b2;8b3;11a;11b;11c;12;16b;	2		1									
H9412	803	0	1	04	01	H9412_803_0	3			1		05/25/2017	2018.03	05/25/2017 11:20:56 AM Eastern Daylight Time					06/04/2017 09:47:33 PM Eastern Daylight Time	GEISINGER QUALITY OPTIONS, INC.	Geisinger Gold	www.GeisingerGold.com	Geisinger Gold Preferred Rx (PPO) EGWP NJ (PPO)	01	04		1			H9412	803	0	2018	Ocean & Monmouth Counties, NJ		1	600	2			2						www.GeisingerGold.com	www.GeisingerGold.com	www.GeisingerGold.com	(800)498-9731		(570)271-8771		(800)514-0138		(800)514-0138		(800)988-4861		(570)271-5673		(800)514-0138		(800)514-0138		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9438	001	0	1	20	08	H9438_001_0	2			1		05/23/2017	2018.03	05/23/2017 04:07:45 PM Central Daylight Time		07/25/2017 02:04:48 PM Central Daylight Time			07/25/2017 02:09:59 PM Central Daylight Time	BLUESTEM PACE, INC.	Bluestem PACE	www.bluestempace.org	Bluestem PACE (PACE)	08	20		1			H9438	001	0	2018	Counties:  RC, HV, RN, MN, MP, SA, EW, DK, OT, LC		2		2			2						NA	NA										(844)588-7223		(620)504-5900		(844)588-7223		(620)504-5674												(620)504-5900		(844)588-7223		(620)504-5674																
H9438	002	0	1	20	08	H9438_002_0	2			1		05/23/2017	2018.03	05/23/2017 04:06:53 PM Central Daylight Time		07/25/2017 02:04:25 PM Central Daylight Time			07/25/2017 02:09:59 PM Central Daylight Time	BLUESTEM PACE, INC.	Bluestem PACE	www.bluestempace.org	Bluestem PACE (PACE)	08	20		1			H9438	002	0	2018	Counties:  RC, HV, RN, MN, MP, SA, EW, DK, OT, LC		2		2			2						NA	NA										(844)588-7223		(620)504-5900		(844)588-7223		(620)504-5900												(620)504-5900				(620)504-5900																
H9460	001	0	1	01	01	H9460_001_0	3			1		08/02/2017	2018.03	08/02/2017 05:25:27 PM Central Daylight Time	08/03/2017 11:54:08 AM Central Daylight Time	08/01/2017 02:16:44 PM Central Daylight Time			08/04/2017 09:54:23 PM Central Daylight Time	CIGNA HEALTHCARE OF ST LOUIS, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H9460	001	0	2018	Select counties in Kansas and Missouri		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9460	002	0	1	01	01	H9460_002_0	2			1		05/23/2017	2018.03	05/23/2017 07:49:09 PM Central Daylight Time	05/30/2017 10:15:27 AM Central Daylight Time				06/02/2017 07:37:45 AM Central Daylight Time	CIGNA HEALTHCARE OF ST LOUIS, INC.	Cigna-HealthSpring	www.cignahealthspring.com	Cigna-HealthSpring Advantage (HMO)	01	01		1			H9460	002	0	2018	Select counties in Kansas and Missouri		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879										(711)-		(711)-		(711)-		(711)-										2					2					2	2			
H9487	001	0	1	48	05	H9487_001_0	4			1		08/24/2017	2018.03	08/24/2017 09:33:01 AM Eastern Daylight Time					08/24/2017 09:52:42 AM Pacific Daylight Time	MICHIGAN COMPLETE HEALTH, INC.	Michigan Complete Health	http://mmp.michigancompletehealth.com	Michigan Complete Health (Medicare-Medicaid Plan)	05	48		1			H9487	001	0	2018	Wayne and Macomb Counties		2	27359	2			2						https://providersearch.michigancompletehealth.com/	https://mmp.michigancompletehealth.com/2017/prescription-drug-part-d.html	https://providersearch.michigancompletehealth.com/	(844)239-7387		(844)239-7387		(844)239-7387		(844)239-7387		(844)239-7387		(844)239-7387		(844)239-7387		(844)239-7387		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H9525	003	0	1	01	01	H9525_003_0	6		1	1	2	08/04/2017	2018.03	08/04/2017 10:06:28 AM Eastern Daylight Time	08/07/2017 09:02:19 AM Eastern Daylight Time	08/06/2017 03:11:08 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H9525	003	0	2018	Select Counties in Wisconsin		2	10188	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(866)242-0251		(866)242-0251		(844)788-9046		(844)788-9046		(866)242-0251		(866)242-0251		(844)788-9047		(844)788-9047		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9525	004	0	1	01	01	H9525_004_0	6			1		08/04/2017	2018.03	08/04/2017 09:36:34 PM Eastern Daylight Time	08/07/2017 09:02:19 AM Eastern Daylight Time	08/06/2017 03:11:08 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9525	004	0	2018	Select Counties in Wisconsin		2	46152	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)304-1774		(855)304-1774		(844)364-2130		(844)364-2130		(855)304-1774		(855)304-1774		(844)373-7115		(844)373-7115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9525	006	0	1	01	01	H9525_006_0	6			1		08/04/2017	2018.03	08/04/2017 09:36:39 PM Eastern Daylight Time	08/07/2017 09:02:19 AM Eastern Daylight Time	08/06/2017 03:11:08 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9525	006	0	2018	Green Bay Area		2	23292	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)304-1774		(855)304-1774		(844)364-2130		(844)364-2130		(855)304-1774		(855)304-1774		(844)373-7115		(844)373-7115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9525	007	0	1	01	01	H9525_007_0	8		1	1	2	08/04/2017	2018.03	08/04/2017 10:21:17 AM Eastern Daylight Time	08/07/2017 09:02:20 AM Eastern Daylight Time	08/06/2017 03:11:08 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H9525	007	0	2018	Select counties in KY		2	21108	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare		(844)879-3601		(844)879-3601		(844)788-9046		(844)788-9046		(844)879-3601		(844)879-3601		(844)788-9047		(844)788-9047		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9525	008	0	1	01	01	H9525_008_0	6			1		08/04/2017	2018.03	08/04/2017 10:23:36 AM Eastern Daylight Time	08/07/2017 09:02:20 AM Eastern Daylight Time	08/06/2017 03:11:09 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com	Anthem MediBlue Plus (HMO)	01	01		1			H9525	008	0	2018	Select counties in KY		2	149388	2			2						www.anthem.com/medicare	www.anthem.com/medicare		(855)558-1439		(855)558-1439		(844)364-2130		(844)364-2130		(855)558-1439		(855)558-1439		(844)373-7115		(844)373-7115		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9525	801	0	1	01	01	H9525_801_0	8			1		06/04/2017	2018.03	06/04/2017 09:47:26 AM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/wi/medicare	Anthem MediBlue (HMO)	01	01		1			H9525	801	0	2018	Wisconsin select counties		1	600	2			2						www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9525	802	0	1	01	01	H9525_802_0	8			1		06/03/2017	2018.03	06/03/2017 04:00:45 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/wi/medicare	Anthem MediBlue (HMO)	01	01		1			H9525	802	0	2018	Select counties in Wisconsin		1	600	2			2						www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9525	803	0	1	02	01	H9525_803_0	8			1		06/03/2017	2018.03	06/03/2017 04:00:52 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/wi/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H9525	803	0	2018	Wisconsin - Select Counties		1	600	2			2						www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	www.anthem.com/wi/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H9525	804	0	1	01	01	H9525_804_0	8			1		06/04/2017	2018.03	06/04/2017 09:50:47 AM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/ky/medicare	Anthem Senior Advantage (HMO)	01	01		1			H9525	804	0	2018	Kentucky - Select Counties		1	347	2			2						www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9525	805	0	1	01	01	H9525_805_0	8			1		06/03/2017	2018.03	06/03/2017 04:01:54 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/ky/medicare	Anthem Senior Advantage (HMO)	01	01		1			H9525	805	0	2018	Kentucky - Select Counties		1	600	2			2						www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9525	806	0	1	02	01	H9525_806_0	8			1		06/03/2017	2018.03	06/03/2017 04:02:04 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com/ky/medicare	Anthem Senior Advantage (HMO-POS)	01	02		1			H9525	806	0	2018	Kentucky - Select Counties		1	600	2			2						www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	www.anthem.com/ky/medicare	(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(855)320-6557		(855)320-6557		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H9572	001	1	1	04	01	H9572_001_1	6			1		07/10/2017	2018.03	07/10/2017 09:23:39 AM Eastern Daylight Time	08/04/2017 03:45:25 PM Eastern Daylight Time	08/04/2017 03:45:11 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	1	2018	State of Michigan	Region 1	2	17904	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	001	2	1	04	01	H9572_001_2	6			1		07/10/2017	2018.03	07/10/2017 09:24:04 AM Eastern Daylight Time	08/04/2017 03:45:25 PM Eastern Daylight Time	08/04/2017 03:45:11 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	2	2018	State of Michigan	Region 2	2	46168	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	001	3	1	04	01	H9572_001_3	6			1		07/10/2017	2018.03	07/10/2017 09:24:32 AM Eastern Daylight Time	08/04/2017 03:45:25 PM Eastern Daylight Time	08/04/2017 03:45:12 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	3	2018	State of Michigan	Region 3	2	54763	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	001	4	1	04	01	H9572_001_4	6			1		07/10/2017	2018.03	07/10/2017 09:24:55 AM Eastern Daylight Time	08/04/2017 03:45:26 PM Eastern Daylight Time	08/04/2017 03:45:12 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	4	2018	State of Michigan	Region 4	2	94854	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	001	6	1	04	01	H9572_001_6	6			1		07/10/2017	2018.03	07/10/2017 09:25:17 AM Eastern Daylight Time	08/04/2017 03:45:27 PM Eastern Daylight Time	08/04/2017 03:45:13 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	6	2018	State of Michigan	Region 6	2	317813	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	002	1	1	04	01	H9572_002_1	7			1		07/14/2017	2018.03	07/14/2017 10:24:12 AM Eastern Daylight Time	08/04/2017 03:45:27 PM Eastern Daylight Time	08/04/2017 03:45:13 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	1	2018	State of Michigan	Region 1	2	10153	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	002	2	1	04	01	H9572_002_2	7			1		07/14/2017	2018.03	07/14/2017 10:24:29 AM Eastern Daylight Time	08/04/2017 03:45:27 PM Eastern Daylight Time	08/04/2017 03:45:13 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	2	2018	State of Michigan	Region 2	2	23240	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	002	3	1	04	01	H9572_002_3	7			1		07/14/2017	2018.03	07/14/2017 10:24:51 AM Eastern Daylight Time	08/04/2017 03:45:27 PM Eastern Daylight Time	08/04/2017 03:45:13 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	3	2018	State of Michigan	Region 3	2	22396	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	002	4	1	04	01	H9572_002_4	7			1		07/14/2017	2018.03	07/14/2017 10:25:12 AM Eastern Daylight Time	08/04/2017 03:45:29 PM Eastern Daylight Time	08/04/2017 03:45:14 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	4	2018	State of Michigan	Region 4	2	51517	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	002	6	1	04	01	H9572_002_6	7			1		07/14/2017	2018.03	07/14/2017 10:25:31 AM Eastern Daylight Time	08/04/2017 03:45:30 PM Eastern Daylight Time	08/04/2017 03:45:14 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	6	2018	State of Michigan	Region 6	2	68187	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	003	1	1	04	01	H9572_003_1	6			1		07/10/2017	2018.03	07/10/2017 09:29:28 AM Eastern Daylight Time	08/04/2017 03:45:31 PM Eastern Daylight Time	08/04/2017 03:45:14 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	1	2018	State of Michigan	Region 1	2	8060	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	003	2	1	04	01	H9572_003_2	6			1		07/10/2017	2018.03	07/10/2017 09:29:48 AM Eastern Daylight Time	08/04/2017 03:45:31 PM Eastern Daylight Time	08/04/2017 03:45:14 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	2	2018	State of Michigan	Region 2	2	16625	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	003	3	1	04	01	H9572_003_3	6			1		07/10/2017	2018.03	07/10/2017 09:30:08 AM Eastern Daylight Time	08/04/2017 03:45:31 PM Eastern Daylight Time	08/04/2017 03:45:15 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	3	2018	State of Michigan	Region 3	2	10491	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	003	4	1	04	01	H9572_003_4	6			1		07/10/2017	2018.03	07/10/2017 09:30:26 AM Eastern Daylight Time	08/04/2017 03:45:32 PM Eastern Daylight Time	08/04/2017 03:45:15 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	4	2018	State of Michigan	Region 4	2	29315	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	003	6	1	04	01	H9572_003_6	6			1		07/10/2017	2018.03	07/10/2017 09:30:46 AM Eastern Daylight Time	08/04/2017 03:45:33 PM Eastern Daylight Time	08/04/2017 03:45:15 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	6	2018	State of Michigan	Region 6	2	53727	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	004	1	1	04	01	H9572_004_1	6			1		07/10/2017	2018.03	07/10/2017 09:31:24 AM Eastern Daylight Time	08/04/2017 03:45:33 PM Eastern Daylight Time	08/04/2017 03:45:16 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Essential (PPO)	01	04		1			H9572	004	1	2018	State of Michigan	Region 1	2	4609	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	004	2	1	04	01	H9572_004_2	6			1		07/10/2017	2018.03	07/10/2017 09:31:45 AM Eastern Daylight Time	08/04/2017 03:45:34 PM Eastern Daylight Time	08/04/2017 03:45:16 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Essential (PPO)	01	04		1			H9572	004	2	2018	State of Michigan	Region 2	2	20306	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	004	3	1	04	01	H9572_004_3	6			1		07/10/2017	2018.03	07/10/2017 09:32:04 AM Eastern Daylight Time	08/04/2017 03:45:35 PM Eastern Daylight Time	08/04/2017 03:45:17 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Essential (PPO)	01	04		1			H9572	004	3	2018	State of Michigan	Region 3	2	27914	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	004	4	1	04	01	H9572_004_4	6			1		07/10/2017	2018.03	07/10/2017 09:32:23 AM Eastern Daylight Time	08/04/2017 03:45:36 PM Eastern Daylight Time	08/04/2017 03:45:17 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Essential (PPO)	01	04		1			H9572	004	4	2018	State of Michigan	Region 4	2	56217	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	004	6	1	04	01	H9572_004_6	6			1		07/10/2017	2018.03	07/10/2017 09:33:01 AM Eastern Daylight Time	08/04/2017 03:45:36 PM Eastern Daylight Time	08/04/2017 03:45:17 PM Eastern Daylight Time			08/04/2017 04:33:03 PM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Essential (PPO)	01	04		1			H9572	004	6	2018	State of Michigan	Region 6	2	89661	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(877)241-2583		(877)241-2583		(888)563-3307		(888)563-3307		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9572	801	0	1	04	01	H9572_801_0	4			1		05/31/2017	2018.03	05/31/2017 08:53:07 AM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer Rx CY (PPO)	01	04		1			H9572	801	0	2018	State of Michigan		1	376140	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicar	www.bcbsm.com/providersmedicare	(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H9572	802	0	1	04	01	H9572_802_0	4			1		05/31/2017	2018.03	05/31/2017 08:53:38 AM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer CY (PPO)	01	04		1			H9572	802	0	2018	State of Michigan		1	4133129	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H9572	803	0	1	04	01	H9572_803_0	4			1		05/31/2017	2018.03	05/31/2017 08:53:48 AM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer Rx non-CY (PPO)	01	04		1			H9572	803	0	2018	State of Michigan		1	1200	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H9572	804	0	1	04	01	H9572_804_0	4			1		05/31/2017	2018.03	05/31/2017 08:55:13 AM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer non-CY (PPO)	01	04		1			H9572	804	0	2018	State of Michigan		1	1200	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H9572	805	0	1	04	01	H9572_805_0	4			1		05/31/2017	2018.03	05/31/2017 08:55:21 AM Eastern Daylight Time					06/06/2017 02:11:17 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer CY ASC (PPO)	01	04		1			H9572	805	0	2018	State of Michigan		1	1200	2			2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare	www.bcbsm.com/providersmedicare	(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7e;7f;7h;7i;8a;8b1;8b2;9a;9b;9c;10a;11a;11b;11c;12;15;	2		1									
H9576	001	0	1	48	05	H9576_001_0	6			1		08/01/2017	2018.03	08/01/2017 02:02:55 PM Eastern Daylight Time					08/01/2017 02:07:12 PM Eastern Daylight Time	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	www.nhpri.org/INTEGRITY	Neighborhood INTEGRITY (Medicare-Medicaid Plan)	05	48		1			H9576	001	0	2018	State of Rhode Island		2	170574	2			2						www.nhpri.org/INTEGRITY	www.nhpri.org/INTEGRITY	www.nhpri.org/INTEGRITY	(844)812-6896		(401)427-8181		(844)812-6896		(401)427-8181		(844)812-6896		(401)427-8181		(844)812-6896		(401)427-8181		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H9585	001	0	1	01	01	H9585_001_0	2		1	1	2	08/04/2017	2018.03	08/04/2017 02:19:17 PM Eastern Daylight Time	08/04/2017 10:53:08 AM Eastern Daylight Time	08/03/2017 03:32:52 PM Eastern Daylight Time			08/07/2017 01:59:49 PM Eastern Daylight Time	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	BMC HealthNet Plan Senior Care Options	www.SeniorsGetMore.org	BMC HealthNet Plan Senior Care Options (HMO SNP)	01	01		1			H9585	001	0	2018	Suffolk County		2		2			1	3		1		1	www.SeniorsGetMore.org\pharmacy	www.SeniorsGetMore.org\pharmacy	www.SeniorsGetMore.org	(855)833-8125		(855)833-8125		(855)833-8125		(855)833-8125		(855)833-8125		(855)833-8125		(855)833-8125		(855)833-8125		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9589	001	0	1	04	01	H9589_001_0	9		1	1		08/04/2017	2018.03	08/04/2017 11:59:13 AM Eastern Daylight Time	08/04/2017 10:47:52 AM Eastern Daylight Time	08/04/2017 09:03:36 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (GA)	Eon Health	www.eonhealthplan.com	EON GOLD (PPO SNP)	01	04		1			H9589	001	0	2018	Select Georgia Counties		2	3755	2			1	4			00000000000000000010		www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9589	003	0	1	04	01	H9589_003_0	9			1		08/04/2017	2018.03	08/04/2017 11:59:30 AM Eastern Daylight Time	08/04/2017 10:53:38 AM Eastern Daylight Time	08/04/2017 09:05:05 AM Eastern Daylight Time			08/04/2017 02:23:32 PM Eastern Daylight Time	EON HEALTH, INC. (GA)	Eon Health	www.eonhealthplan.com	EON CHOICE (PPO)	01	04		1			H9589	003	0	2018	Select Georgia Counties		2	1313	2			2						www.eonhealthplan.com	www.eonhealthplan.com	www.eonhealthplan.com	(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(888)906-3889		(888)906-3889		(888)912-8055		(888)912-8055		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9592	001	0	1	20	08	H9592_001_0	3			1		05/25/2017	2018.03	05/25/2017 08:45:52 AM Pacific Daylight Time		07/18/2017 04:43:37 PM Pacific Daylight Time			07/18/2017 04:45:42 PM Pacific Daylight Time	CENTRAL VALLEY MEDICAL SERVICES CORPORATION	Fresno PACE	www.fresnopace.org	Fresno PACE (PACE)	08	20		1			H9592	001	0	2018	Fresno County Area		2		2			2						www.fresnopace.org	www.pharmastarpbm.com/										(855)630-7223		(855)630-7223		(855)630-7223		(855)630-7223										(855)630-7223		(855)630-7223		(855)630-7223		(855)630-7223																
H9592	002	0	1	20	08	H9592_002_0	3			1		05/25/2017	2018.03	05/25/2017 08:46:17 AM Pacific Daylight Time		07/18/2017 04:43:59 PM Pacific Daylight Time			07/18/2017 04:45:42 PM Pacific Daylight Time	CENTRAL VALLEY MEDICAL SERVICES CORPORATION	Fresno PACE	www.fresnopace.org	Fresno PACE (PACE)	08	20		1			H9592	002	0	2018	Fresno County Area		2		2			2						www.fresnopace.org	www.pharmastarpbm.com/										(855)630-7223		(855)630-7223		(855)630-7223		(855)630-7223										(855)630-7223		(855)630-7223		(855)630-7223		(855)630-7223																
H9595	002	0	1	01	01	H9595_002_0	5			1		08/04/2017	2018.03	08/04/2017 08:54:21 AM Pacific Daylight Time	08/04/2017 08:36:36 AM Pacific Daylight Time	08/01/2017 09:23:50 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF VIRGINIA, INC.	Molina Healthcare of Virginia	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H9595	002	0	2018	Richmond		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9595	003	0	1	01	01	H9595_003_0	5			1		06/05/2017	2018.03	06/05/2017 09:47:18 AM Pacific Daylight Time	08/04/2017 08:37:48 AM Pacific Daylight Time	08/01/2017 09:25:30 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF VIRGINIA, INC.	Molina Healthcare of Virginia	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H9595	003	0	2018	Roanoke		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9595	004	0	1	01	01	H9595_004_0	5			1		08/04/2017	2018.03	08/04/2017 08:55:07 AM Pacific Daylight Time	08/04/2017 08:39:04 AM Pacific Daylight Time	08/01/2017 09:27:30 AM Pacific Daylight Time			08/07/2017 02:26:48 PM Pacific Daylight Time	MOLINA HEALTHCARE OF VIRGINIA, INC.	Molina Healthcare of Virginia	www.molinahealthcare.com/medicare	Molina Medicare Options (HMO)	01	01		1			H9595	004	0	2018	Norfolk		2		2			2						www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	www.molinahealthcare.com/medicare	(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(844)509-7583		(844)509-7583		(866)403-8293		(866)403-8293		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9615	007	0	1	04	01	H9615_007_0	9			1		07/18/2017	2018.03	07/18/2017 11:46:42 AM Eastern Daylight Time	08/07/2017 05:15:51 PM Eastern Daylight Time	08/07/2017 05:09:54 PM Eastern Daylight Time			08/07/2017 05:31:13 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Gold PPO with Part D (PPO)	01	04		1			H9615	007	0	2018	Central NY, Eastern NY, Western VT		2	12840	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2						2			
H9615	008	0	1	04	01	H9615_008_0	6			1		08/05/2017	2018.03	08/05/2017 09:07:44 AM Eastern Daylight Time	08/07/2017 05:15:41 PM Eastern Daylight Time	08/07/2017 05:09:38 PM Eastern Daylight Time			08/07/2017 05:31:13 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	BasiCare with Part D (PPO)	01	04		1			H9615	008	0	2018	Central NY, Eastern NY, Western VT		2	23844	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2						2			
H9615	009	0	1	04	01	H9615_009_0	7			1		07/18/2017	2018.03	07/18/2017 11:46:56 AM Eastern Daylight Time	08/07/2017 05:15:26 PM Eastern Daylight Time	08/07/2017 05:09:27 PM Eastern Daylight Time			08/07/2017 05:31:13 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Gold PPO with Part D (PPO)	01	04		1			H9615	009	0	2018	Hudson Valley NY		2	6372	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2						2			
H9615	010	0	1	04	01	H9615_010_0	7			1		08/05/2017	2018.03	08/05/2017 09:17:36 AM Eastern Daylight Time	08/07/2017 05:15:15 PM Eastern Daylight Time	08/07/2017 05:09:16 PM Eastern Daylight Time			08/07/2017 05:31:13 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	BasiCare with Part D (PPO)	01	04		1			H9615	010	0	2018	Hudson Valley NY		2	16560	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2						2			
H9615	012	0	1	04	01	H9615_012_0	6			1		07/06/2017	2018.03	07/06/2017 01:14:15 PM Eastern Daylight Time	08/07/2017 05:15:00 PM Eastern Daylight Time	08/07/2017 05:09:02 PM Eastern Daylight Time			08/07/2017 05:31:13 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinmvpmedicare.com	WellSelect with Part D (PPO)	01	04		1			H9615	012	0	2018	Western NY (Rochester/Buffalo)		2	57300	2			2						www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com/medicare/partd/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		2					2						2			
H9615	802	0	1	04	01	H9615_802_0	1			1		06/04/2017	2018.03	06/04/2017 08:25:13 PM Eastern Daylight Time					06/04/2017 08:29:19 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	GoldAnywhere Rx - Employer Group (PPO)	01	04		1			H9615	802	0	2018	Employer Group East/West		1	130044	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H9615	807	0	1	04	01	H9615_807_0	1			1		06/04/2017	2018.03	06/04/2017 08:26:33 PM Eastern Daylight Time					06/04/2017 08:29:19 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	USA Care Rx - Employer Group (PPO)	01	04		1			H9615	807	0	2018	United States and Puerto Rico		1	24600	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899		(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899		(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220		(711)-		(711)-		(800)662-1220		(800)662-1220		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H9615	810	0	1	04	01	H9615_810_0	1			1		06/04/2017	2018.03	06/04/2017 08:27:45 PM Eastern Daylight Time					06/04/2017 08:29:19 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	GoldAnywhere - Employer Group (PPO)	01	04		1			H9615	810	0	2018	Western NY, Central NY, Eastern NY, Western VT		1	1500	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H9615	811	0	1	04	01	H9615_811_0	1			1		06/04/2017	2018.03	06/04/2017 08:28:43 PM Eastern Daylight Time					06/04/2017 08:29:19 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	USA Care without Part D - Employer Group (PPO)	01	04		1			H9615	811	0	2018	United States and Puerto Rico		1	300	2			2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com	(800)665-7924		(800)665-7924		(800)324-3899		(800)324-3899										(800)662-1220		(800)662-1220		(800)662-1220		(800)662-1220										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	2		1									
H9616	001	0	1	20	08	H9616_001_0	3			1		05/23/2017	2018.03	05/23/2017 01:52:21 PM Pacific Daylight Time		07/21/2017 11:10:41 AM Pacific Daylight Time			07/21/2017 03:45:18 PM Pacific Daylight Time	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	San Diego PACE	http://www.syhc.org/sdpace/	San Diego PACE (Duals) (PACE)	08	20		1			H9616	001	0	2018	San Diego County		2		2			2						http://www.syhc.org/services/senior-services/san-diego-pace/	http://www.syhc.org/services/senior-services/san-diego-pace/										(844)473-7223		(619)205-4585		(844)473-7223		(619)205-4585										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H9616	002	0	1	20	08	H9616_002_0	3			1		05/23/2017	2018.03	05/23/2017 01:37:34 PM Pacific Daylight Time		07/21/2017 11:11:09 AM Pacific Daylight Time			07/21/2017 03:45:18 PM Pacific Daylight Time	CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO	San Diego PACE	http://www.syhc.org/sdpace/	San Diego PACE (Medicare Only) (PACE)	08	20		1			H9616	002	0	2018	San Diego County		2		2			2						http://www.syhc.org/services/senior-services/san-diego-pace/	http://www.syhc.org/services/senior-services/san-diego-pace/										(844)473-7223		(619)205-4585		(844)473-7223		(619)205-4585										(800)735-2922		(800)735-2922		(800)735-2922		(800)735-2922																
H9630	001	0	1	01	01	H9630_001_0	2			1		08/03/2017	2018.03	08/03/2017 10:36:49 AM Pacific Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/04/2017 07:37:47 PM Pacific Daylight Time	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Allwell	www.allwell.arhealthwellness.com	Allwell Medicare (HMO)	01	01		1			H9630	001	0	2018	Benton, Crawford, Sebastian, Washington		2		2			2						www.centene.com	www.centene.com	https://www.allwell.arhealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H9630	002	0	1	01	01	H9630_002_0	2			1		08/03/2017	2018.03	08/03/2017 10:40:37 AM Pacific Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/04/2017 07:37:47 PM Pacific Daylight Time	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Allwell	www.allwell.arhealthwellness.com	Allwell Medicare (HMO)	01	01		1			H9630	002	0	2018	Garland, Pulaski, Saline		2		2			2						www.centene.com	www.centene.com	https://www.allwell.arhealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H9630	003	0	1	01	01	H9630_003_0	3			1		08/03/2017	2018.03	08/03/2017 10:42:16 AM Pacific Daylight Time	08/07/2017 03:15:50 PM Pacific Daylight Time	08/07/2017 03:11:58 PM Pacific Daylight Time			08/07/2017 04:00:47 PM Pacific Daylight Time	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	Allwell	www.allwell.arhealthwellness.com	Allwell Medicare Select (HMO)	01	01		1			H9630	003	0	2018	Benton, Washington		2		2			2						www.centene.com	www.centene.com	https://www.allwell.arhealthwellness.com/find-doctor.html	(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		(888)888-8888		2					2					2	2			
H9699	004	1	1	01	01	H9699_004_1	7			1		08/03/2017	2018.03	08/03/2017 08:06:28 AM Central Daylight Time	08/04/2017 11:36:11 AM Central Daylight Time	08/03/2017 03:34:00 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	HMO PARTNERS, INC.	Health Advantage	www.arkansasbluecross.com/medicare	Medi-Pak Advantage (HMO)	01	01		1			H9699	004	1	2018	State of Arkansas	Northwest and West Central AR counties	2	51588	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)349-9335		(877)349-9335		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9699	004	2	1	01	01	H9699_004_2	7			1		08/03/2017	2018.03	08/03/2017 09:23:45 AM Central Daylight Time	08/04/2017 11:37:10 AM Central Daylight Time	08/03/2017 03:34:30 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	HMO PARTNERS, INC.	Health Advantage	www.arkansasbluecross.com/medicare	Medi-Pak Advantage (HMO)	01	01		1			H9699	004	2	2018	State of Arkansas	East Central AR counties	2	27900	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)349-9335		(877)349-9335		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9699	004	3	1	01	01	H9699_004_3	7			1		08/03/2017	2018.03	08/03/2017 09:27:47 AM Central Daylight Time	08/04/2017 11:38:15 AM Central Daylight Time	08/03/2017 03:34:59 PM Central Daylight Time			08/04/2017 01:00:37 PM Central Daylight Time	HMO PARTNERS, INC.	Health Advantage	www.arkansasbluecross.com/medicare	Medi-Pak Advantage (HMO)	01	01		1			H9699	004	3	2018	State of Arkansas	Central AR counties	2	7032	2			2						http://www.arkansasbluecross.com	www.arkansasbluecross.com/medicare	www.arkansasbluecross.com	(877)349-9335		(877)349-9335		(844)298-2444		(844)298-2444		(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9712	001	0	1	48	05	H9712_001_0	7			1		08/24/2017	2018.03	08/24/2017 05:09:47 PM Eastern Daylight Time					08/24/2017 05:32:23 PM Eastern Daylight Time	HAP MIDWEST HEALTH PLAN, INC.	HAP Midwest MI Health Link	http://www.midwesthealthplan.com/mihealthlink	HAP Midwest MI Health Link (Medicare-Medicaid Plan)	05	48		1			H9712	001	0	2018	HAP Midwest MI Health Link		2		1	1		2						http://www.midwesthealthplan.com/mihealthlink	http://www.midwesthealthplan.com/mihealthlink	http://www.midwesthealthplan.com/mihealthlink	(888)654-0706		(248)663-3800		(888)654-0706		(248)663-3800		(888)445-5580		(248)663-3800		(888)654-0706		(248)663-3800		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-																
H9725	001	0	1	01	01	H9725_001_0	4			1		08/02/2017	2018.03	08/02/2017 02:01:12 PM Central Daylight Time	08/03/2017 10:47:52 AM Central Daylight Time	08/01/2017 02:17:06 PM Central Daylight Time			08/04/2017 09:36:31 PM Central Daylight Time	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Cigna-Healthspring	www.cignahealthspring.com	Cigna-HealthSpring Preferred (HMO)	01	01		1			H9725	001	0	2018	North Carolina		2		2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9725	003	0	1	01	01	H9725_003_0	5		1	1	2	08/02/2017	2018.03	08/02/2017 01:09:22 PM Central Daylight Time	08/03/2017 10:48:14 AM Central Daylight Time	08/01/2017 02:17:28 PM Central Daylight Time			08/04/2017 09:36:31 PM Central Daylight Time	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Cigna-Healthspring	www.cignahealthspring.com	Cigna-HealthSpring TotalCare (HMO SNP)	01	01		1			H9725	003	0	2018	North Carolina		2		2			1	3		2		2	www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(800)668-3813		(800)668-3813		(888)767-1879		(888)767-1879		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9725	801	0	1	01	01	H9725_801_0	3			1		05/22/2017	2018.03	05/22/2017 09:02:33 PM Central Daylight Time					06/01/2017 05:15:41 PM Central Daylight Time	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	Cigna-Healthspring	www.cignahealthspring.com	Cigna-HealthSpring Preferred Rx CY (HMO)	01	01		1			H9725	801	0	2018	North Carolina		1	6000	2			2						www.cignahealthspring.com	www.cignahealthspring.com	www.cignahealthspring.com	(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(888)281-7867		(888)281-7867		(866)593-4468		(866)593-4468		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;5;6;7c;7d;7e;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;12;15;16b;	1	1a;3-1;3-2;3-3;7b;7c;7d;7f;7i;8a;8b1;8b2;8b3;9a;9b;12;14d;14e2;18a;	1					1				
H9730	002	0	1	01	01	H9730_002_0	3			1		08/03/2017	2018.03	08/03/2017 01:29:59 PM Eastern Daylight Time	08/04/2017 03:19:03 PM Eastern Daylight Time	07/31/2017 07:20:01 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	WellCare	www.wellcare.com/medicare	WellCare Value (HMO)	01	01		1			H9730	002	0	2018	Select Counties in KY		2	25977	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H9730	003	0	1	01	01	H9730_003_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 02:27:36 PM Eastern Daylight Time	08/04/2017 03:20:18 PM Eastern Daylight Time	07/31/2017 07:20:27 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	WellCare	www.wellcare.com/medicare	Wellcare Access (HMO SNP)	01	01		1			H9730	003	0	2018	Select Counties in KY		2	37938	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H9730	004	0	1	01	01	H9730_004_0	2		1	1	2	06/01/2017	2018.03	06/01/2017 05:24:08 PM Eastern Daylight Time	08/04/2017 03:21:35 PM Eastern Daylight Time	07/31/2017 07:20:54 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	WellCare	www.wellcare.com/medicare	WellCare Liberty (HMO SNP)	01	01		1			H9730	004	0	2018	Select KY Counties		2	26180	2			1	3		1		1	www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)560-3206		(877)560-3206		(866)527-0056		(866)527-0056		(877)560-3206		(877)560-3206		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H9730	005	0	1	02	01	H9730_005_0	3			1		08/03/2017	2018.03	08/03/2017 01:30:59 PM Eastern Daylight Time	08/04/2017 03:22:51 PM Eastern Daylight Time	07/31/2017 07:21:20 PM Eastern Daylight Time			08/04/2017 06:51:47 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	WellCare	www.wellcare.com/medicare	WellCare Essential (HMO-POS)	01	02		1			H9730	005	0	2018	Selected KY Counties		2	28701	2			2						www.wellcare.com/medicare	www.wellcare.com/medicare	www.wellcare.com/medicare	(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)560-2766		(877)560-2766		(866)527-0056		(866)527-0056		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		(877)247-6272		2					2					2	2			
H9808	004	0	1	04	01	H9808_004_0	6			1		08/04/2017	2018.03	08/04/2017 04:18:27 PM Eastern Daylight Time	08/04/2017 04:22:56 PM Eastern Daylight Time	08/04/2017 04:27:58 PM Eastern Daylight Time			08/07/2017 11:05:07 AM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	HealthTeam Advantage	www.healthteamadvantage.com	HealthTeam Advantage Plan I (PPO)	01	04		1			H9808	004	0	2018	Piedmont/Triad		2	168000	2			2						www.healthteamadvantage.com	www.healthteamadvantage.com	www.healthteamadvantage.com	(888)965-1965		(888)965-1965		(877)905-9216		(877)905-9216		(844)846-8003		(844)846-8003		(877)905-9216		(877)905-9216		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9808	005	0	1	04	01	H9808_005_0	5			1		08/04/2017	2018.03	08/04/2017 04:18:50 PM Eastern Daylight Time	08/04/2017 04:24:17 PM Eastern Daylight Time	08/04/2017 04:28:57 PM Eastern Daylight Time			08/07/2017 11:05:07 AM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	HealthTeam Advantage	www.healthteamadvantage.com	HealthTeam Advantage Plan II (PPO)	01	04		1			H9808	005	0	2018	Piedmont/Triad		2	17000	2			2						www.healthteamadvantage.com	www.healthteamadvantage.com	www.healthteamadvantage.com	(888)965-1965		(888)965-1965		(877)905-9216		(877)905-9216		(844)846-8003		(844)846-8003		(877)905-9216		(877)905-9216		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9808	804	0	1	04	01	H9808_804_0	1			1		05/25/2017	2018.03	05/25/2017 11:02:24 AM Eastern Daylight Time					06/04/2017 10:32:40 PM Eastern Daylight Time	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	HealthTeam Advantage	www.healthteamadvantage.com	HealthTeam Advantage Employer Group NCY (PPO)	01	04		1			H9808	804	0	2018	Piedmont/Triad		1	1	2			2						www.healthteamadvantage.com	www.healthteamadvantage.com	www.healthteamadvantage.com	(888)965-1965		(888)965-1965		(877)905-9216		(877)905-9216		(844)846-8003		(844)846-8003		(877)905-9216		(877)905-9216		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
H9811	001	0	1	01	01	H9811_001_0	2			1		08/02/2017	2018.03	08/02/2017 12:58:23 PM Pacific Daylight Time	08/04/2017 04:35:06 PM Pacific Daylight Time	08/04/2017 04:35:29 PM Pacific Daylight Time			08/05/2017 07:11:59 PM Pacific Daylight Time	MAGNOLIA HEALTH PLAN, INC.	Allwell	https://advantage.magnoliahealthplan.com/	Allwell Medicare (HMO)	01	01		1			H9811	001	0	2018	George, Harr, Hinds, Jackson, Mad, Rankin, Stone		2		2			2						https://advantage.magnoliahealthplan.com/findadoctor	https://advantage.magnoliahealthplan.com/partdformulary	https://advantage.magnoliahealthplan.com/findadoctor	(844)786-7711		(844)786-7711		(877)826-5517		(877)826-5517		(844)786-7711		(844)786-7711		(877)826-5517		(877)826-5517		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9830	001	0	1	20	08	H9830_001_0	1			1		05/24/2017	2018.03	05/24/2017 01:10:08 PM Eastern Daylight Time		05/24/2017 01:01:32 PM Eastern Daylight Time			05/24/2017 01:12:59 PM Eastern Daylight Time	NEWCOURTLAND LIFE PROGRAM	NewCourtland LIFE Program	www.newcourtlandlife.org	NewCourtland LIFE  - Dual (PACE)	08	20		1			H9830	001	0	2018	NewCourtland LIFE - North, NW, NE Phila Svc Area		2		2			2						http://www.medicineshoppe.com/FranchiseeLocations/1024/SpecialServices.aspx	N/A										(888)530-4913		(215)951-4400		(888)530-4913		(215)951-4400										(888)530-4913		(267)335-1500		(888)530-4913		(267)335-1500																
H9830	002	0	1	20	08	H9830_002_0	1			1		05/24/2017	2018.03	05/24/2017 01:09:56 PM Eastern Daylight Time		05/24/2017 01:01:36 PM Eastern Daylight Time			05/24/2017 01:12:59 PM Eastern Daylight Time	NEWCOURTLAND LIFE PROGRAM	NewCourtland LIFE Program	www.newcourtlandlife.org	NewCourland LIFE - Medicare Only (PACE)	08	20		1			H9830	002	0	2018	NewCourtland LIFE - North, NW, NE Phila Svc Area		2		2			2						http://www.medicineshoppe.com/FranchiseeLocations/1024/SpecialServices.aspx	N/A										(888)530-4913		(267)335-1500		(888)530-4913		(267)335-1500										(888)530-4913		(267)335-1500		(888)530-4913		(267)335-1500																
H9834	001	0	1	01	01	H9834_001_0	3			1		06/02/2017	2018.03	06/02/2017 04:30:54 PM Central Daylight Time	06/05/2017 01:49:04 PM Central Daylight Time	06/05/2017 01:49:07 PM Central Daylight Time			06/20/2017 04:10:07 PM Central Daylight Time	GUNDERSEN HEALTH PLAN OF MINNESOTA	Senior Preferred	www.seniorpreferred.org	Gundersen MN Senior Preferred Elite (w/Rx) (HMO)	01	01		1			H9834	001	0	2018	Counties: Fillmore, Houston, Winona		2	1152	2			2						https://www.seniorpreferred.org/seniorpreferredgundersenmn/DrugCoverage/FindaPharmacy	https://www.seniorpreferred.org/seniorpreferredgundersenmn/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredgundersenmn/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H9834	003	0	1	01	01	H9834_003_0	5			1		07/12/2017	2018.03	07/12/2017 11:45:33 AM Central Daylight Time	06/05/2017 01:49:04 PM Central Daylight Time	06/05/2017 01:49:07 PM Central Daylight Time			07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN OF MINNESOTA	Senior Preferred	www.seniorpreferred.org	Gundersen MN Senior Preferred Value (w/Rx) (HMO)	01	01		1			H9834	003	0	2018	Counties: Fillmore, Houston, Winona		2	7584	2			2						https://www.seniorpreferred.org/seniorpreferredgundersenmn/DrugCoverage/FindaPharmacy	https://www.seniorpreferred.org/seniorpreferredgundersenmn/DrugCoverage/PartDDrugFormulary	https://www.seniorpreferred.org/seniorpreferredgundersenmn/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		(800)877-8973		(711)-		2					2					2	2			
H9834	004	0	1	01	01	H9834_004_0	6			1		07/12/2017	2018.03	07/12/2017 11:45:23 AM Central Daylight Time	06/21/2017 08:40:20 AM Central Daylight Time				07/12/2017 12:54:58 PM Central Daylight Time	GUNDERSEN HEALTH PLAN OF MINNESOTA	Senior Preferred	www.seniorpreferred.org	Gundersen MN Senior Preferred Value (no Rx) (HMO)	01	01		1			H9834	004	0	2018	Counties: Fillmore, Houston, Winona		2	859	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferredgundersenmn/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H9834	005	0	1	01	01	H9834_005_0	5			1		05/18/2017	2018.03	05/18/2017 09:37:22 AM Central Daylight Time	06/21/2017 08:36:43 AM Central Daylight Time				06/22/2017 08:37:40 AM Central Daylight Time	GUNDERSEN HEALTH PLAN OF MINNESOTA	Senior Preferred	www.seniorpreferred.org	Gundersen MN Senior Preferred Elite (no Rx) (HMO)	01	01		1			H9834	005	0	2018	Counties: Fillmore, Houston, Winona		2	131	2			2						N/A	N/A	https://www.seniorpreferred.org/seniorpreferredgundersenmn/FindaDoctor	(800)394-5566		(608)881-8275		(800)394-5566		(608)881-8275										(800)877-8973		(711)-		(800)877-8973		(711)-										2					2					2	2			
H9842	001	0	1	20	08	H9842_001_0	1			1		05/25/2017	2018.03	05/25/2017 01:35:15 PM Eastern Daylight Time		05/25/2017 11:27:38 AM Eastern Daylight Time			05/25/2017 01:43:21 PM Eastern Daylight Time	SAINT JOSEPH PACE	Saint Joseph PACE	sjmed.com\PACE	Saint Joseph PACE (PACE)	08	20		1			H9842	001	0	2018	Partial Saint Joseph, Marshall & Elkhart counties		2		2			2						TBD	TBD												(574)247-8700				(574)247-8700												(574)247-8701				(574)247-8701																
H9842	002	0	1	20	08	H9842_002_0	1			1		05/25/2017	2018.03	05/25/2017 01:35:55 PM Eastern Daylight Time		05/25/2017 11:27:05 AM Eastern Daylight Time			05/25/2017 01:43:21 PM Eastern Daylight Time	SAINT JOSEPH PACE	Saint Joseph PACE	sjmed.com\PACE	Saint Joseph PACE - Medicare Only (PACE)	08	20		1			H9842	002	0	2018	Partial St. Joseph, Marshall & Elkhart Counties		2		2			2						TBD	TBD												(574)247-8700				(574)247-8700												(574)247-8701				(574)247-8701																
H9869	001	0	1	48	05	H9869_001_0	10			1		08/17/2017	2018.03	08/17/2017 06:06:27 PM Central Daylight Time					08/17/2017 06:06:40 PM Central Daylight Time	PARTNERS HEALTH PLAN, INC.	Partners Health Plan	www.phpcares.org	PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan)	05	48		1			H9869	001	0	2018	Bx,NY,Kngs,Queens,Rich,Nass,Suff,Rock,West		2		2			2						www.phpcares.org	www.phpcares.org	www.phpcares.org	(855)747-5483		(855)747-5483		(855)747-5483		(855)747-5483		(855)508-1718		(855)508-1718		(855)508-1718		(855)508-1718		(800)662-1220		(711)-		(800)662-1220		(711)-		(800)662-1220		(711)-		(800)662-1220		(711)-																
H9870	001	0	1	01	01	H9870_001_0	5		1	1	2	08/02/2017	2018.03	08/02/2017 03:28:09 PM Eastern Daylight Time	08/04/2017 01:38:44 PM Eastern Daylight Time	08/04/2017 01:38:50 PM Eastern Daylight Time			08/04/2017 01:52:53 PM Eastern Daylight Time	UNIVERSITY HEALTH CARE, INC.	Passport Advantage	www.passportadvantage.com	Passport Advantage (HMO SNP)	01	01		1			H9870	001	0	2018	Jefferson, Hardin, Bullitt and Nelson Counties		2	31776	2			1	3		1		1	www.passportadvantage.com	www.passportadvantage.com	www.passportadvantage.com	(844)859-6152		(844)859-6152		(844)643-2780		(844)643-2780		(844)859-6152		(844)859-6152		(844)643-2780		(844)643-2780		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9877	001	0	1	01	01	H9877_001_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 04:23:53 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time			08/04/2017 04:25:07 PM Eastern Daylight Time	VIRGINIA PREMIER HEALTH PLAN, INC.	Virginia Premier Health Plan, Inc.	www.vapremier.com	Virginia Premier Advantage Elite (HMO SNP)	01	01		1			H9877	001	0	2018	Central, Tidewater, Western, Roanoke, NOVA		2	78576	2			1	3		1		1	www.vapremier.com	www.vapremier.com	www.vapremier.com	(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9877	002	0	1	01	01	H9877_002_0	8			1		08/04/2017	2018.03	08/04/2017 04:24:14 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time			08/04/2017 04:27:03 PM Eastern Daylight Time	VIRGINIA PREMIER HEALTH PLAN, INC.	Virginia Premier Health Plan, Inc.	www.vapremier.com	Virginia Premier Advantage Gold (HMO)	01	01		1			H9877	002	0	2018	Central Virginia		2	13260	2			2						www.vapremier.com	www.vapremier.com	www.vapremier.com	(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9877	003	0	1	01	01	H9877_003_0	6			1		08/04/2017	2018.03	08/04/2017 02:06:48 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time	08/04/2017 04:22:38 PM Eastern Daylight Time			08/04/2017 04:27:59 PM Eastern Daylight Time	VIRGINIA PREMIER HEALTH PLAN, INC.	Virginia Premier Health Plan, Inc.	www.vapremier.com	Virginia Premier Advantage Platinum (HMO)	01	01		1			H9877	003	0	2018	Central Virginia		2	6000	2			2						www.vapremier.com	www.vapremier.com	www.vapremier.com	(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(877)739-1370		(804)819-5151		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9886	003	0	1	01	01	H9886_003_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 10:25:25 AM Eastern Daylight Time	08/07/2017 09:02:21 AM Eastern Daylight Time	08/06/2017 03:11:09 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H9886	003	0	2018	Select Counties in Missouri		2	23988	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(844)879-3611		(844)879-3611		(844)335-6637		(844)335-6637		(844)879-3611		(844)879-3611		(844)335-9441		(844)335-9441		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9886	004	0	1	01	01	H9886_004_0	5			1		08/04/2017	2018.03	08/04/2017 10:29:14 AM Eastern Daylight Time	08/07/2017 09:02:21 AM Eastern Daylight Time	08/06/2017 03:11:09 PM Eastern Daylight Time			08/07/2017 02:48:06 PM Eastern Daylight Time	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9886	004	0	2018	Select Counties in Missouri		2	108744	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)251-8826		(855)251-8826		(844)373-7111		(844)373-7111		(855)251-8826		(855)251-8826		(844)373-7110		(844)373-7110		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9886	801	0	1	01	01	H9886_801_0	7			1		06/03/2017	2018.03	06/03/2017 04:02:39 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/mo/medicare	Anthem MediBlue (HMO)	01	01		1			H9886	801	0	2018	Select Counties in Missouri		1	600	2			2						www.anthem.com/mo/medicare	www.anthem.com/no/medicare	www.anthem.com/mo/medicare	(855)275-1404		(855)275-1404		(866)845-8608		(866)845-8608		(855)275-1404		(855)275-1404		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9886	802	0	1	01	01	H9886_802_0	7			1		06/03/2017	2018.03	06/03/2017 04:02:45 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/mo/medicare	Anthem MediBlue (HMO)	01	01		1			H9886	802	0	2018	Select Counties in Missouri		1	600	2			2						www.anthem.com/mo/medicare	www.anthem.com/mo/medicare	www.anthem.com/mo/medicare	(855)275-1404		(855)275-1404		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9886	803	0	1	02	01	H9886_803_0	7			1		06/03/2017	2018.03	06/03/2017 04:02:51 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/mo/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H9886	803	0	2018	Missouri - Select Counties		1	600	2			2						www.anthem.com/mo/medicare	www.anthem.com/mo/medicare	www.anthem.com/mo/medicare	(855)275-1404		(855)275-1404		(866)845-8608		(866)845-8608		(855)275-1404		(855)275-1404		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H9915	001	0	1	01	01	H9915_001_0	6			1		08/07/2017	2018.03	08/07/2017 02:32:50 PM Eastern Daylight Time	08/03/2017 04:22:14 PM Eastern Daylight Time	08/03/2017 03:02:54 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice (HMO)	01	01		1			H9915	001	0	2018	DC Metro		2		2			2						www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9915	006	0	1	01	01	H9915_006_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 05:38:59 PM Eastern Daylight Time	08/03/2017 04:23:22 PM Eastern Daylight Time	08/03/2017 03:03:44 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice Dual Advantage (HMO SNP)	01	01		1			H9915	006	0	2018	DC Metro		2		2			1	3		2		2	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9915	007	0	1	01	01	H9915_007_0	4		1	1		08/04/2017	2018.03	08/04/2017 05:38:30 PM Eastern Daylight Time	08/03/2017 04:24:34 PM Eastern Daylight Time	08/03/2017 03:04:36 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice Care Advantage (HMO SNP)	01	01		1			H9915	007	0	2018	DC Metro		2		2			1	4			00000000000000000100		www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9915	008	0	1	01	01	H9915_008_0	4			1		08/04/2017	2018.03	08/04/2017 05:39:07 PM Eastern Daylight Time	08/03/2017 04:25:26 PM Eastern Daylight Time	08/03/2017 03:05:54 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice (HMO)	01	01		1			H9915	008	0	2018	Baltimore Metro, Baltimore and DC Suburb		2		2			2						www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9915	009	0	1	01	01	H9915_009_0	4		1	1	2	08/04/2017	2018.03	08/04/2017 05:38:21 PM Eastern Daylight Time	08/03/2017 04:26:20 PM Eastern Daylight Time	08/03/2017 03:06:38 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice Dual Advantage (HMO SNP)	01	01		1			H9915	009	0	2018	Baltimore Metro, Baltimore and DC Suburb		2		2			1	3		2		2	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9915	010	0	1	01	01	H9915_010_0	4		1	1		08/06/2017	2018.03	08/06/2017 04:34:29 PM Eastern Daylight Time	08/03/2017 04:36:02 PM Eastern Daylight Time	08/03/2017 03:07:20 PM Eastern Daylight Time			08/07/2017 02:54:42 PM Eastern Daylight Time	MEDSTAR FAMILY CHOICE, INC.	MedStar Family Choice, Inc	www.medstarmedicarechoice.com	MedStar Medicare Choice Care Advantage (HMO SNP)	01	01		1			H9915	010	0	2018	Baltimore Metro, Baltimore and DC Suburb		2		2			1	4			00000000000000000100		www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	www.medstarmedicarechoice.com	(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)222-1041		(855)222-1041		(855)242-4870		(855)242-4870		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		(855)250-5604		2					2					2	2			
H9954	002	0	1	01	01	H9954_002_0	5			1		08/04/2017	2018.03	08/04/2017 10:49:51 AM Pacific Daylight Time	08/07/2017 06:02:22 AM Pacific Daylight Time	08/06/2017 12:11:09 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9954	002	0	2018	Select Counties in Indiana		2	32472	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)251-8827		(855)251-8827		(844)373-7113		(844)373-7113		(855)251-8827		(855)251-8827		(844)373-7112		(844)373-7112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9954	004	0	1	01	01	H9954_004_0	7		1	1	2	08/04/2017	2018.03	08/04/2017 10:50:35 AM Pacific Daylight Time	08/07/2017 06:02:12 AM Pacific Daylight Time	08/06/2017 12:11:02 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Dual Advantage (HMO SNP)	01	01		1			H9954	004	0	2018	Select Counties in Indiana		2	57876	2			1	3		1		1	www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(844)533-2021		(844)533-2021		(844)337-7143		(844)337-7143		(844)533-2021		(844)533-2021		(844)338-0056		(844)338-0056		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9954	005	0	1	01	01	H9954_005_0	5			1		08/04/2017	2018.03	08/04/2017 10:51:45 AM Pacific Daylight Time	08/07/2017 06:02:12 AM Pacific Daylight Time	08/06/2017 12:11:02 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9954	005	0	2018	Select Counties in Indiana		2	29592	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)251-8827		(855)251-8827		(844)373-7113		(844)373-7113		(855)251-8827		(855)251-8827		(844)373-7112		(844)373-7112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9954	006	0	1	01	01	H9954_006_0	5			1		08/04/2017	2018.03	08/04/2017 10:53:10 AM Pacific Daylight Time	08/07/2017 06:02:13 AM Pacific Daylight Time	08/06/2017 12:11:02 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Plus (HMO)	01	01		1			H9954	006	0	2018	Select Counties in Indiana		2	76956	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(855)251-8827		(855)251-8827		(844)373-7113		(844)373-7113		(855)251-8827		(855)251-8827		(844)373-7112		(844)373-7112		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2					2	2			
H9954	801	0	1	01	01	H9954_801_0	7			1		06/03/2017	2018.03	06/03/2017 04:09:06 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/in/medicare	Anthem MediBlue (HMO)	01	01		1			H9954	801	0	2018	Select Counties in Indiana		1	600	2			2						www.anthem.com/in/medicare	www.anthem.com/in/medicare	www.anthem.com/in/medicare	(855)275-1405		(855)275-1405		(866)845-8608		(866)845-8608		(855)275-1405		(855)275-1405		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9954	802	0	1	01	01	H9954_802_0	7			1		06/03/2017	2018.03	06/03/2017 04:09:12 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/in/medicare	Anthem MediBlue (HMO)	01	01		1			H9954	802	0	2018	Select Counties in Indiana		1	600	2			2						www.anthem.com/in/medicare	www.anthem.com/in/medicare	www.anthem.com/in/medicare	(855)275-1405		(855)275-1405		(866)845-8608		(866)845-8608										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1					1				
H9954	803	0	1	02	01	H9954_803_0	7			1		06/03/2017	2018.03	06/03/2017 04:09:19 PM Pacific Daylight Time					06/05/2017 10:10:23 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/in/medicare	Anthem MediBlue (HMO-POS)	01	02		1			H9954	803	0	2018	Indiana - Select Counties		1	600	2			2						www.anthem.com/in/medicare	www.anthem.com/in/medicare	www.anthem.com/in/medicare	(855)275-1405		(855)275-1405		(866)845-8608		(866)845-8608		(855)275-1405		(855)275-1405		(866)845-8608		(866)845-8608		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;10a;11a;11b;11c;14d;14e1;14e2;14e3;15;18a;	1	6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;14d;14e1;14e2;14e3;	1	2		2		1				
H9998	001	0	1	20	08	H9998_001_0	1			1		05/25/2017	2018.03	05/25/2017 11:57:48 AM Central Daylight Time		05/25/2017 10:05:04 AM Central Daylight Time			05/25/2017 12:09:39 PM Central Daylight Time	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	Silver Star	www.silverstarlubbock.org	Silver Star - Dual (PACE)	08	20		1			H9998	001	0	2018	Lubbock County		2		2			2						http://www.seniorscript.com/	www.silverstarlubbock.org										(806)767-1736		(806)740-1500		(806)767-1736		(806)740-1500										(806)767-1736		(806)740-1500		(806)767-1736		(806)740-1500																
H9998	002	0	1	20	08	H9998_002_0	1			1		05/25/2017	2018.03	05/25/2017 11:58:20 AM Central Daylight Time		05/25/2017 10:04:56 AM Central Daylight Time			05/25/2017 12:09:39 PM Central Daylight Time	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	Silver Star	www.silverstarlubbock.org	Silver Star - Medicare only (PACE)	08	20		1			H9998	002	0	2018	Lubbock County		2		2			2						http://www.seniorscript.com/	www.silverstarlubbock.org										(806)767-1736		(806)740-1500		(806)767-1736		(806)740-1500										(806)767-1736		(806)740-1500		(806)767-1736		(806)740-1500																
R0110	001	0	1	31	11	R0110_001_0	2			1		06/02/2017	2018.03	06/02/2017 03:21:12 PM Eastern Daylight Time	08/04/2017 02:01:02 PM Eastern Daylight Time				08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0110-001 (Regional PPO)	11	31		1			R0110	001	0	2018	States of Louisiana and Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R0110	002	0	1	31	11	R0110_002_0	2			1		06/02/2017	2018.03	06/02/2017 03:23:56 PM Eastern Daylight Time	08/04/2017 02:01:32 PM Eastern Daylight Time	08/04/2017 09:55:39 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0110-002 (Regional PPO)	11	31		1			R0110	002	0	2018	States of Louisiana and Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R0110	003	0	1	31	11	R0110_003_0	3			1		06/28/2017	2018.03	06/28/2017 11:26:43 AM Eastern Daylight Time	08/04/2017 02:16:26 PM Eastern Daylight Time	08/04/2017 09:55:40 AM Eastern Daylight Time			08/06/2017 08:45:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0110-003 (Regional PPO)	11	31		1			R0110	003	0	2018	States of Louisiana and Mississippi		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R0110	801	0	1	31	11	R0110_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:32:28 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0110	801	0	2018	States of Louisiana and Mississippi		1	6780	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0110	802	0	1	31	11	R0110_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:32:40 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0110	802	0	2018	States of Louisiana and Mississippi		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0110	803	0	1	31	11	R0110_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:32:58 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R0110	803	0	2018	States of Louisiana and Mississippi		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0865	001	0	1	31	11	R0865_001_0	2			1		08/02/2017	2018.03	08/02/2017 03:28:03 PM Eastern Daylight Time	08/04/2017 05:25:42 PM Eastern Daylight Time				08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0865-001 (Regional PPO)	11	31		1			R0865	001	0	2018	States of Indiana and Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R0865	003	0	1	31	11	R0865_003_0	2			1		06/02/2017	2018.03	06/02/2017 04:16:45 PM Eastern Daylight Time	08/04/2017 05:42:14 PM Eastern Daylight Time	08/04/2017 09:55:40 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0865-003 (Regional PPO)	11	31		1			R0865	003	0	2018	States of Indiana and Kentucky		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R0865	801	0	1	31	11	R0865_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:33:55 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0865	801	0	2018	States of Indiana and Kentucky		1	9336	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0865	802	0	1	31	11	R0865_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:34:07 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0865	802	0	2018	States of Indiana and Kentucky		1	2556	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0865	803	0	1	31	11	R0865_803_0	3			1		06/13/2017	2018.03	06/13/2017 10:34:26 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R0865	803	0	2018	States of Indiana and Kentucky		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0923	001	0	1	31	11	R0923_001_0	2			1		06/02/2017	2018.03	06/02/2017 04:19:23 PM Eastern Daylight Time	08/04/2017 05:25:12 PM Eastern Daylight Time				08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0923-001 (Regional PPO)	11	31		1			R0923	001	0	2018	States of Pennsylvania and West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R0923	002	0	1	31	11	R0923_002_0	2			1		06/02/2017	2018.03	06/02/2017 04:22:08 PM Eastern Daylight Time	08/04/2017 05:41:47 PM Eastern Daylight Time	08/04/2017 09:55:41 AM Eastern Daylight Time			08/06/2017 10:42:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R0923-002 (Regional PPO)	11	31		1			R0923	002	0	2018	States of Pennsylvania and West Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R0923	801	0	1	31	11	R0923_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:35:07 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0923	801	0	2018	States of Pennsylvania and West Verginia		1	1968	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0923	802	0	1	31	11	R0923_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:35:24 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R0923	802	0	2018	States of Pennsylvania and West Verginia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R0923	803	0	1	31	11	R0923_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:36:08 AM Eastern Daylight Time					06/13/2017 12:52:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R0923	803	0	2018	States of Pennsylvania and West Verginia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1390	001	0	1	31	11	R1390_001_0	2			1		08/03/2017	2018.03	08/03/2017 12:35:01 PM Eastern Daylight Time	08/04/2017 03:10:43 PM Eastern Daylight Time				08/06/2017 09:25:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R1390-001 (Regional PPO)	11	31		1			R1390	001	0	2018	States of North Carolina and Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R1390	002	0	1	31	11	R1390_002_0	3			1		07/12/2017	2018.03	07/12/2017 09:46:45 AM Eastern Daylight Time	08/04/2017 03:11:15 PM Eastern Daylight Time	08/04/2017 09:55:41 AM Eastern Daylight Time			08/06/2017 09:25:28 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R1390-002 (Regional PPO)	11	31		1			R1390	002	0	2018	States of North Carolina and Virginia		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R1390	801	0	1	31	11	R1390_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:36:28 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R1390	801	0	2018	States of North Carolina and Virginia		1	2388	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1390	802	0	1	31	11	R1390_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:36:53 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R1390	802	0	2018	States of North Carolina and Virginia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1390	803	0	1	31	11	R1390_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:37:05 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R1390	803	0	2018	States of North Carolina and Virginia		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1532	001	0	1	31	11	R1532_001_0	2			1		08/02/2017	2018.03	08/02/2017 02:39:22 PM Eastern Daylight Time	08/04/2017 02:52:02 PM Eastern Daylight Time				08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R1532-001 (Regional PPO)	11	31		1			R1532	001	0	2018	States of Arkansas and Missouri		2		2			2						www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription-drugs/medicare_drug_tools/medicare_drug_list	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R1532	002	0	1	31	11	R1532_002_0	2			1		06/02/2017	2018.03	06/02/2017 03:12:47 PM Eastern Daylight Time	08/04/2017 02:51:00 PM Eastern Daylight Time	08/04/2017 09:55:42 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R1532-002 (Regional PPO)	11	31		1			R1532	002	0	2018	States of Arkansas and Missouri		2		2			2						www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription-drugs/medicare_drug_tools/medicare_drug_list	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R1532	801	0	1	31	11	R1532_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:38:13 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R1532	801	0	2018	States of Arkansas and Missouri		1	1860	2			2						www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription-drugs/medicare_drug_tools/medicare_drug_list	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1532	802	0	1	31	11	R1532_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:38:25 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R1532	802	0	2018	States of Arkansas and Missouri		1	1200	2			2						www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription-drugs/medicare_drug_tools/medicare_drug_list	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1532	803	0	1	31	11	R1532_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:38:57 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R1532	803	0	2018	States of Arkansas and Missouri		1	1200	2			2						www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription-drugs/medicare_drug_tools/medicare_drug_list	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R1548	001	0	1	31	11	R1548_001_0	4		1	1	2	08/03/2017	2018.03	08/03/2017 10:30:15 AM Central Daylight Time	08/03/2017 02:11:28 PM Central Daylight Time	08/01/2017 11:44:36 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R1548	001	0	2018	North Carolina and Virginia		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3175	003	0	1	31	11	R3175_003_0	3		1	1	2	08/02/2017	2018.03	08/02/2017 01:39:14 PM Central Daylight Time	08/03/2017 02:11:55 PM Central Daylight Time	08/01/2017 11:45:02 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R3175	003	0	2018	State of Hawaii		2		2			1	3		1		1	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(866)622-8054		(866)622-8054		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3175	801	0	1	31	11	R3175_801_0	1			1		05/24/2017	2018.03	05/24/2017 01:53:16 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R3175	801	0	2018	State of Hawaii		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
R3175	802	0	1	31	11	R3175_802_0	1			1		05/24/2017	2018.03	05/24/2017 01:54:45 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R3175	802	0	2018	State of Hawaii		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
R3332	001	0	1	31	11	R3332_001_0	13			1		08/03/2017	2018.03	08/03/2017 01:16:52 PM Eastern Daylight Time	08/04/2017 11:17:20 AM Eastern Daylight Time	08/02/2017 01:12:44 PM Eastern Daylight Time			08/07/2017 06:28:03 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Choice (Regional PPO)	11	31		1			R3332	001	0	2018	State of Florida		2		2			2						www.myprime.com	MyPrime.com	www.BlueMedicareFL.com	(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770		2					2						2			
R3392	001	0	1	31	11	R3392_001_0	4			1		08/03/2017	2018.03	08/03/2017 12:32:11 PM Eastern Daylight Time	08/04/2017 02:59:53 PM Eastern Daylight Time				08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R3392-001 (Regional PPO)	11	31		1			R3392	001	0	2018	States of Georgia and South Carolina		2		2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R3392	002	0	1	31	11	R3392_002_0	3			1		06/03/2017	2018.03	06/03/2017 02:02:03 PM Eastern Daylight Time	08/04/2017 03:01:22 PM Eastern Daylight Time	08/04/2017 09:55:42 AM Eastern Daylight Time			08/06/2017 09:42:39 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R3392-002 (Regional PPO)	11	31		1			R3392	002	0	2018	States of Georgia and South Carolina		2		2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3392	801	0	1	31	11	R3392_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:39:32 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R3392	801	0	2018	States of Georgia and South Carolina		1	3996	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R3392	802	0	1	31	11	R3392_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:39:51 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R3392	802	0	2018	States of Georgia and South Carolina		1	1200	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R3392	803	0	1	31	11	R3392_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:40:26 AM Eastern Daylight Time					06/13/2017 12:56:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R3392	803	0	2018	States of Georgia and South Carolina		1	1200	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R3444	008	0	1	31	11	R3444_008_0	3		1	1		08/04/2017	2018.03	08/04/2017 08:49:37 AM Central Daylight Time	08/03/2017 02:12:23 PM Central Daylight Time	08/01/2017 11:45:29 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R3444	008	0	2018	Arkansas and Missouri		2		2			1	4			00000000000000000100		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3444	009	0	1	31	11	R3444_009_0	3		1	1		06/28/2017	2018.03	06/28/2017 09:52:00 AM Central Daylight Time	08/04/2017 11:04:14 AM Central Daylight Time	08/01/2017 11:45:55 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R3444	009	0	2018	Arkansas and Missouri		2		2			1	4			00000000000000000010		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3444	011	0	1	31	11	R3444_011_0	3		1	1	2	08/03/2017	2018.03	08/03/2017 01:09:28 PM Central Daylight Time	08/03/2017 02:13:19 PM Central Daylight Time	08/01/2017 11:46:21 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Dual Advantage (Regional PPO SNP)	11	31		1			R3444	011	0	2018	Arkansas and Missouri		2		2			1	3		1		1	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3444	012	0	1	31	11	R3444_012_0	3			1		06/28/2017	2018.03	06/28/2017 09:52:50 AM Central Daylight Time	08/03/2017 02:13:46 PM Central Daylight Time	08/01/2017 11:46:48 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R3444	012	0	2018	Arkansas and Missouri		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3887	001	0	1	31	11	R3887_001_0	3			1		06/28/2017	2018.03	06/28/2017 10:53:53 AM Eastern Daylight Time	08/04/2017 02:40:07 PM Eastern Daylight Time				08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R3887-001 (Regional PPO)	11	31		1			R3887	001	0	2018	State of Michigan		2		2			2						http://www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tool/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R3887	002	0	1	31	11	R3887_002_0	3			1		06/28/2017	2018.03	06/28/2017 10:54:27 AM Eastern Daylight Time	08/04/2017 02:50:58 PM Eastern Daylight Time	08/04/2017 09:55:43 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R3887-002 (Regional PPO)	11	31		1			R3887	002	0	2018	State of Michigan		2		2			2						http://www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tool/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R3887	801	0	1	31	11	R3887_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:41:01 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R3887	801	0	2018	State of Michigan		1	7680	2			2						http://www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tool/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R3887	802	0	1	31	11	R3887_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:41:49 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R3887	802	0	2018	State of Michigan		1	5856	2			2						http://www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tool/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R3887	803	0	1	31	11	R3887_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:01 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R3887	803	0	2018	State of Michigan		1	1200	2			2						http://www.humana.com/medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tool/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4182	001	0	1	31	11	R4182_001_0	2			1		08/02/2017	2018.03	08/02/2017 03:34:11 PM Eastern Daylight Time	08/04/2017 04:07:56 PM Eastern Daylight Time				08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R4182-001 (Regional PPO)	11	31		1			R4182	001	0	2018	State of Texas		2		2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R4182	003	0	1	31	11	R4182_003_0	2			1		06/02/2017	2018.03	06/02/2017 03:00:06 PM Eastern Daylight Time	08/04/2017 04:06:51 PM Eastern Daylight Time	08/04/2017 09:55:44 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R4182-003 (Regional PPO)	11	31		1			R4182	003	0	2018	State of Texas		2		2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R4182	004	0	1	31	11	R4182_004_0	2			1		06/02/2017	2018.03	06/02/2017 03:02:59 PM Eastern Daylight Time	08/04/2017 04:09:03 PM Eastern Daylight Time	08/04/2017 09:55:44 AM Eastern Daylight Time			08/06/2017 09:07:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R4182-004 (Regional PPO)	11	31		1			R4182	004	0	2018	State of Texas		2		2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R4182	801	0	1	31	11	R4182_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:31 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R4182	801	0	2018	State of Texas		1	4584	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)824-8242		(800)824-8242		(800)833-2364		(800)833-2364		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4182	802	0	1	31	11	R4182_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:43 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R4182	802	0	2018	State of Texas		1	1200	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4182	803	0	1	31	11	R4182_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:42:57 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R4182	803	0	2018	State of Texas		1	1200	2			2						http:www.humana.com/medicare/medicare_prescription_drugs/	http:www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4845	001	0	1	31	11	R4845_001_0	2			1		06/02/2017	2018.03	06/02/2017 03:15:30 PM Eastern Daylight Time	08/04/2017 02:52:44 PM Eastern Daylight Time				08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R4845-001 (Regional PPO)	11	31		1			R4845	001	0	2018	States of Kansas and Oklahoma		2		2			2						https://www.humana.com/pharmacy/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R4845	002	0	1	31	11	R4845_002_0	2			1		06/02/2017	2018.03	06/02/2017 03:18:41 PM Eastern Daylight Time	08/04/2017 02:50:16 PM Eastern Daylight Time	08/04/2017 09:55:45 AM Eastern Daylight Time			08/06/2017 10:31:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R4845-002 (Regional PPO)	11	31		1			R4845	002	0	2018	States of Kansas and Oklahoma		2		2			2						https://www.humana.com/pharmacy/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R4845	801	0	1	31	11	R4845_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:43:25 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R4845	801	0	2018	States of Kansas and Oklahoma		1	1200	2			2						https://www.humana.com/pharmacy/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4845	802	0	1	31	11	R4845_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:43:42 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R4845	802	0	2018	States of Kansas and Oklahoma		1	1200	2			2						https://www.humana.com/pharmacy/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R4845	803	0	1	31	11	R4845_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:44:24 AM Eastern Daylight Time					06/13/2017 12:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R4845	803	0	2018	States of Kansas and Oklahoma		1	1200	2			2						https://www.humana.com/pharmacy/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5329	001	0	1	31	11	R5329_001_0	4			1		06/01/2017	2018.03	06/01/2017 09:16:58 AM Central Daylight Time	08/03/2017 02:14:13 PM Central Daylight Time	08/01/2017 11:47:14 AM Central Daylight Time			08/04/2017 12:12:12 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (Regional PPO)	11	31		1			R5329	001	0	2018	Rural ME and NH		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5342	001	0	1	31	11	R5342_001_0	3			1		06/01/2017	2018.03	06/01/2017 09:44:58 AM Central Daylight Time	08/03/2017 02:14:39 PM Central Daylight Time	08/01/2017 11:47:40 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice Plan 1 (Regional PPO)	11	31		1			R5342	001	0	2018	State of New York		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5342	002	0	1	31	11	R5342_002_0	3			1		05/15/2017	2018.03	05/15/2017 01:08:32 PM Central Daylight Time	08/03/2017 02:15:07 PM Central Daylight Time				08/07/2017 08:50:38 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice Essential (Regional PPO)	11	31		1			R5342	002	0	2018	State of New York		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2						2			
R5342	005	0	1	31	11	R5342_005_0	3			1		06/01/2017	2018.03	06/01/2017 09:45:14 AM Central Daylight Time	08/03/2017 02:15:33 PM Central Daylight Time	08/01/2017 11:48:06 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice Plan 3 (Regional PPO)	11	31		1			R5342	005	0	2018	State of New York		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5342	006	0	1	31	11	R5342_006_0	4			1		08/07/2017	2018.03	08/07/2017 04:06:25 PM Central Daylight Time	08/03/2017 02:16:00 PM Central Daylight Time	08/01/2017 11:48:32 AM Central Daylight Time			08/07/2017 04:23:51 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)	11	31		1			R5342	006	0	2018	State of New York		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(800)711-6088		(800)711-6088		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5342	801	0	1	31	11	R5342_801_0	2			1		06/08/2017	2018.03	06/08/2017 11:44:20 AM Central Daylight Time					06/13/2017 05:08:42 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	801	0	2018	State of New York		1	2748	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
R5342	802	0	1	31	11	R5342_802_0	1			1		05/25/2017	2018.03	05/25/2017 12:49:53 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	802	0	2018	State of New York		1	0	2			2						9999	www.UHCMedicareSolutions.com	610097	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178										(711)-		(711)-		(711)-		(711)-										1	2		2		1									
R5342	803	0	1	31	11	R5342_803_0	1			1		05/25/2017	2018.03	05/25/2017 12:50:47 PM Pacific Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	803	0	2018	New York		1	0	2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(800)457-8506		(800)457-8506		(877)714-0178		(877)714-0178		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	2		2		1									
R5361	001	0	1	31	11	R5361_001_0	3			1		06/28/2017	2018.03	06/28/2017 10:54:56 AM Eastern Daylight Time	08/04/2017 02:39:10 PM Eastern Daylight Time				08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R5361-001 (Regional PPO)	11	31		1			R5361	001	0	2018	States of Illinois and Wisconsin		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R5361	002	0	1	31	11	R5361_002_0	3			1		07/12/2017	2018.03	07/12/2017 03:30:27 PM Eastern Daylight Time	08/04/2017 02:50:30 PM Eastern Daylight Time	08/04/2017 09:55:45 AM Eastern Daylight Time			08/06/2017 09:19:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R5361-002 (Regional PPO)	11	31		1			R5361	002	0	2018	States of Illinois and Wisconsin		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5361	801	0	1	31	11	R5361_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:46:25 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5361	801	0	2018	States of Illinois and Wisconsin		1	12588	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5361	802	0	1	31	11	R5361_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:45:26 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5361	802	0	2018	States of Illnois and Wisconsin		1	7452	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5361	803	0	1	31	11	R5361_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:45:48 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R5361	803	0	2018	States of Illnois and Wisconsin		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5495	001	0	1	31	11	R5495_001_0	3			1		08/02/2017	2018.03	08/02/2017 03:26:36 PM Eastern Daylight Time	08/04/2017 01:41:45 PM Eastern Daylight Time				08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R5495-001 (Regional PPO)	11	31		1			R5495	001	0	2018	State of Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R5495	002	0	1	31	11	R5495_002_0	2			1		06/02/2017	2018.03	06/02/2017 03:33:43 PM Eastern Daylight Time	08/04/2017 02:04:48 PM Eastern Daylight Time	08/04/2017 09:55:46 AM Eastern Daylight Time			08/06/2017 11:39:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R5495-002 (Regional PPO)	11	31		1			R5495	002	0	2018	State of Ohio		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5495	801	0	1	31	11	R5495_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:47:07 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5495	801	0	2018	State of Ohio		1	5148	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5495	802	0	1	31	11	R5495_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:47:23 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5495	802	0	2018	State of Ohio		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5495	803	0	1	31	11	R5495_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:47:43 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R5495	803	0	2018	State of Ohio		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5826	005	0	1	31	11	R5826_005_0	2			1		05/27/2017	2018.03	05/27/2017 12:03:23 PM Eastern Daylight Time	08/04/2017 05:28:17 PM Eastern Daylight Time	08/04/2017 09:55:46 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-005 (Regional PPO)	11	31		1			R5826	005	0	2018	State of Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5826	018	0	1	31	11	R5826_018_0	3			1		08/06/2017	2018.03	08/06/2017 09:01:36 AM Eastern Daylight Time	08/04/2017 05:51:50 PM Eastern Daylight Time				08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-018 (Regional PPO)	11	31		1			R5826	018	0	2018	State of Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R5826	074	0	1	31	11	R5826_074_0	3			1		06/02/2017	2018.03	06/02/2017 01:11:56 PM Eastern Daylight Time	08/04/2017 06:20:35 PM Eastern Daylight Time	08/04/2017 09:55:47 AM Eastern Daylight Time			08/06/2017 10:03:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-074 (Regional PPO)	11	31		1			R5826	074	0	2018	State of Florida		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5826	805	0	1	31	11	R5826_805_0	2			1		06/13/2017	2018.03	06/13/2017 10:48:17 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5826	805	0	2018	State of Florida		1	13872	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5826	819	0	1	31	11	R5826_819_0	2			1		06/13/2017	2018.03	06/13/2017 10:49:11 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R5826	819	0	2018	State of Florida		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5826	834	0	1	31	11	R5826_834_0	2			1		06/13/2017	2018.03	06/13/2017 10:49:27 AM Eastern Daylight Time					06/13/2017 01:03:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R5826	834	0	2018	State of Florida		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R5941	013	0	1	31	11	R5941_013_0	5			1		06/12/2017	2018.03	06/12/2017 10:21:36 AM Pacific Daylight Time	08/07/2017 06:02:13 AM Pacific Daylight Time				08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Core (Regional PPO)	11	31		1			R5941	013	0	2018	Ohio		2	28380	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(800)467-1199		(800)467-1199		(800)797-0560		(800)797-0560										(711)-		(711)-		(711)-		(711)-										2					2						2			
R5941	014	0	1	31	11	R5941_014_0	3			1		06/12/2017	2018.03	06/12/2017 10:22:11 AM Pacific Daylight Time	08/07/2017 06:02:14 AM Pacific Daylight Time	08/06/2017 12:11:02 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Basic (Regional PPO)	11	31		1			R5941	014	0	2018	Ohio		2	350508	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(800)467-1199		(800)467-1199		(800)797-0560		(800)797-0560		(800)467-1199		(800)467-1199		(844)364-2126		(844)364-2126		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R5941	015	0	1	31	11	R5941_015_0	3			1		06/12/2017	2018.03	06/12/2017 10:22:38 AM Pacific Daylight Time	08/07/2017 06:02:14 AM Pacific Daylight Time	08/06/2017 12:11:03 PM Pacific Daylight Time			08/07/2017 12:26:57 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/shop	Anthem MediBlue Access Basic (Regional PPO)	11	31		1			R5941	015	0	2018	Indiana and Kentucky		2	570108	2			2						www.anthem.com/medicare	www.anthem.com/medicare	www.anthem.com	(800)467-1199		(800)467-1199		(800)797-0560		(800)797-0560		(800)467-1199		(800)467-1199		(844)364-2126		(844)364-2126		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6694	003	0	1	31	11	R6694_003_0	4			1		06/27/2017	2018.03	06/27/2017 07:51:19 PM Eastern Daylight Time	08/03/2017 10:05:19 AM Eastern Daylight Time	07/31/2017 06:03:04 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare OH Connect Gold (Regional PPO)	11	31		1			R6694	003	0	2018	Ohio		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6694	005	0	1	31	11	R6694_005_0	3			1		06/27/2017	2018.03	06/27/2017 07:51:31 PM Eastern Daylight Time	08/03/2017 10:08:23 AM Eastern Daylight Time	07/31/2017 06:03:26 PM Eastern Daylight Time			08/04/2017 05:23:33 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare OH Connect Gold 2 (Regional PPO)	11	31		1			R6694	005	0	2018	Ohio		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6694	006	0	1	31	11	R6694_006_0	4			1		08/02/2017	2018.03	08/02/2017 10:58:22 AM Eastern Daylight Time	08/02/2017 06:53:58 PM Central Daylight Time	07/31/2017 04:55:41 PM Central Daylight Time			08/04/2017 04:28:26 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare NJ Silver Plan (Regional PPO)	11	31		1			R6694	006	0	2018	New Jersey		2		2			2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary	www.aetnamedicaredocfind.com	(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(800)282-5366		(800)282-5366		(855)338-7027		(855)338-7027		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6801	008	0	1	31	11	R6801_008_0	4		1	1		08/04/2017	2018.03	08/04/2017 08:54:39 AM Central Daylight Time	08/03/2017 01:36:52 PM Central Daylight Time	08/01/2017 11:48:58 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R6801	008	0	2018	Texas		2		2			1	4			00000000000000000100		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6801	009	0	1	31	11	R6801_009_0	4		1	1		06/28/2017	2018.03	06/28/2017 10:17:48 AM Central Daylight Time	08/03/2017 01:37:24 PM Central Daylight Time	08/01/2017 11:49:25 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R6801	009	0	2018	Texas		2		2			1	4			00000000000000000010		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6801	011	0	1	31	11	R6801_011_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 02:36:50 PM Central Daylight Time	08/03/2017 01:37:57 PM Central Daylight Time	08/01/2017 11:49:53 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Dual Advantage (Regional PPO SNP)	11	31		1			R6801	011	0	2018	Texas		2		2			1	3		1		1	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R6801	012	0	1	31	11	R6801_012_0	4			1		06/28/2017	2018.03	06/28/2017 10:21:21 AM Central Daylight Time	08/03/2017 01:38:30 PM Central Daylight Time	08/01/2017 11:50:19 AM Central Daylight Time			08/04/2017 02:56:59 PM Central Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R6801	012	0	2018	Texas		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7220	001	0	1	31	11	R7220_001_0	2			1		06/02/2017	2018.03	06/02/2017 03:03:33 PM Eastern Daylight Time	08/04/2017 01:16:52 PM Eastern Daylight Time				08/06/2017 09:23:49 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R7220-001 (Regional PPO)	11	31		1			R7220	001	0	2018	State of Arizona		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R7220	002	0	1	31	11	R7220_002_0	2			1		06/02/2017	2018.03	06/02/2017 03:09:19 PM Eastern Daylight Time	08/04/2017 01:17:55 PM Eastern Daylight Time	08/04/2017 09:55:47 AM Eastern Daylight Time			08/06/2017 09:23:49 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R7220-002 (Regional PPO)	11	31		1			R7220	002	0	2018	State of Arizona		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7220	801	0	1	31	11	R7220_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:49:53 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R7220	801	0	2018	State of Arizona		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7220	802	0	1	31	11	R7220_802_0	3			1		06/13/2017	2018.03	06/13/2017 10:50:11 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R7220	802	0	2018	State of Arizona		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7220	803	0	1	31	11	R7220_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:50:44 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R7220	803	0	2018	State of Arizona		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7315	001	0	1	31	11	R7315_001_0	3			1		06/02/2017	2018.03	06/02/2017 03:51:00 PM Eastern Daylight Time	08/04/2017 01:53:19 PM Eastern Daylight Time				08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R7315-001 (Regional PPO)	11	31		1			R7315	001	0	2018	States of Alabama and Tennessee		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364										(711)-		(711)-		(711)-		(711)-										2					2						2			
R7315	002	0	1	31	11	R7315_002_0	3			1		06/02/2017	2018.03	06/02/2017 03:53:46 PM Eastern Daylight Time	08/04/2017 02:19:46 PM Eastern Daylight Time	08/04/2017 09:55:48 AM Eastern Daylight Time			08/06/2017 10:25:14 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	HumanaChoice R7315-002 (Regional PPO)	11	31		1			R7315	002	0	2018	States of Alabama and Tennessee		2		2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(800)457-4708		(800)457-4708		(800)833-2364		(800)833-2364		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7315	801	0	1	31	11	R7315_801_0	2			1		06/13/2017	2018.03	06/13/2017 10:51:05 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R7315	801	0	2018	States of Alabama and Tennessee		1	3492	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7315	802	0	1	31	11	R7315_802_0	2			1		06/13/2017	2018.03	06/13/2017 10:51:15 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (Regional PPO)	11	31		1			R7315	802	0	2018	States of Alabama and Tennessee		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-										1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7315	803	0	1	31	11	R7315_803_0	2			1		06/13/2017	2018.03	06/13/2017 10:51:31 AM Eastern Daylight Time					06/13/2017 01:06:41 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer Non-CY (Regional PPO)	11	31		1			R7315	803	0	2018	States of Alabama and Tennessee		1	1200	2			2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/	www.humana.com/members/tools	(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242		(888)396-8810		(888)396-8810		(888)396-8810		(888)396-8810		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		1	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;10a;11a;11b;11c;12;14a;14d;14e1;14e2;14e3;15;16b;17a;17b;18a;	1	1a;1b;2;3-1;3-2;3-3;5;6;7b;7c;7d;7e;7f;7g;7h;7i;8a;8b1;8b2;8b3;9a;9b;9c;9d;12;14a;14d;14e1;14e2;14e3;16b;17a;17b;18a;	1									
R7444	001	0	1	31	11	R7444_001_0	3			1		06/01/2017	2018.03	06/01/2017 09:12:57 AM Central Daylight Time	08/03/2017 02:04:55 PM Central Daylight Time	08/01/2017 11:50:45 AM Central Daylight Time			08/04/2017 12:23:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (Regional PPO)	11	31		1			R7444	001	0	2018	New England		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	003	0	1	31	11	R7444_003_0	3			1		08/03/2017	2018.03	08/03/2017 09:49:56 AM Central Daylight Time	08/03/2017 02:05:25 PM Central Daylight Time	08/01/2017 11:51:11 AM Central Daylight Time			08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (Regional PPO)	11	31		1			R7444	003	0	2018	State of Florida		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	004	0	1	31	11	R7444_004_0	3			1		05/23/2017	2018.03	05/23/2017 12:10:35 PM Central Daylight Time	08/03/2017 02:05:54 PM Central Daylight Time				08/04/2017 12:41:27 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Essential (Regional PPO)	11	31		1			R7444	004	0	2018	State of Florida		2		2			2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	(800)643-4845		(800)643-4845		(800)555-5757		(800)555-5757										(711)-		(711)-		(711)-		(711)-										2					2						2			
R7444	008	0	1	31	11	R7444_008_0	3			1		08/03/2017	2018.03	08/03/2017 01:18:43 PM Central Daylight Time	08/03/2017 02:06:25 PM Central Daylight Time	08/01/2017 11:51:37 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R7444	008	0	2018	Georgia and South Carolina		2		2			2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	009	0	1	31	11	R7444_009_0	3		1	1		08/04/2017	2018.03	08/04/2017 08:50:59 AM Central Daylight Time	08/04/2017 10:37:56 AM Central Daylight Time	08/03/2017 09:11:15 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R7444	009	0	2018	Georgia and South Carolina		2		2			1	4			00000000000000000100		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	010	0	1	31	11	R7444_010_0	3		1	1		08/03/2017	2018.03	08/03/2017 08:48:31 AM Central Daylight Time	08/03/2017 02:06:57 PM Central Daylight Time	08/01/2017 11:52:22 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R7444	010	0	2018	Georgia and South Carolina		2		2			1	4			00000000000000000010		www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	011	0	1	31	11	R7444_011_0	3		1	1	2	08/03/2017	2018.03	08/03/2017 01:18:52 PM Central Daylight Time	08/03/2017 02:07:29 PM Central Daylight Time	08/01/2017 11:52:49 AM Central Daylight Time			08/04/2017 12:44:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCMedicareSolutions.com	Care Improvement Plus Dual Advantage (Regional PPO SNP)	11	31		1			R7444	011	0	2018	Georgia and South Carolina		2		2			1	3		1		1	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(800)204-1002		(800)204-1002		(800)555-5757		(800)555-5757		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	012	0	1	31	11	R7444_012_0	4		1	1	2	08/02/2017	2018.03	08/02/2017 01:39:56 PM Central Daylight Time	08/03/2017 02:07:59 PM Central Daylight Time	08/01/2017 11:53:16 AM Central Daylight Time			08/04/2017 12:06:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R7444	012	0	2018	State of Florida		2		2			1	3		2		2	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(866)818-4270		(866)818-4270		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
R7444	013	0	1	31	11	R7444_013_0	5		1	1	2	08/04/2017	2018.03	08/04/2017 12:59:22 PM Central Daylight Time	08/03/2017 02:08:29 PM Central Daylight Time	08/01/2017 11:53:43 AM Central Daylight Time			08/04/2017 01:02:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCCommunityPlan.com	UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)	11	31		1			R7444	013	0	2018	State of Florida		2		2			1	3		1		1	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	www.UHCCommunityPlan.com	(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(800)643-4845		(800)643-4845		(888)834-3721		(888)834-3721		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		(711)-		2					2						2			
S0522	001	0		29	10	S0522_001_0	1			1		05/26/2017	2018.03	05/26/2017 09:04:12 PM Central Daylight Time		05/31/2017 11:12:00 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	001	0	2018	IL		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	002	0		29	10	S0522_002_0	1			1		05/26/2017	2018.03	05/26/2017 09:24:55 PM Central Daylight Time		05/31/2017 11:12:24 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	002	0	2018	NH ME		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	004	0		29	10	S0522_004_0	1			1		05/26/2017	2018.03	05/26/2017 09:25:33 PM Central Daylight Time		05/31/2017 11:12:50 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	004	0	2018	NJ		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	006	0		29	10	S0522_006_0	1			1		05/19/2017	2018.03	05/19/2017 07:29:10 PM Central Daylight Time		05/31/2017 11:13:16 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	006	0	2018	DE DC MD		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	008	0		29	10	S0522_008_0	1			1		05/26/2017	2018.03	05/26/2017 09:28:11 PM Central Daylight Time		05/31/2017 11:13:40 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	008	0	2018	VA		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	010	0		29	10	S0522_010_0	1			1		05/26/2017	2018.03	05/26/2017 09:30:54 PM Central Daylight Time		05/31/2017 11:14:12 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	010	0	2018	NC		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	012	0		29	10	S0522_012_0	1			1		05/26/2017	2018.03	05/26/2017 09:36:15 PM Central Daylight Time		05/31/2017 11:14:40 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	012	0	2018	SC		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	014	0		29	10	S0522_014_0	1			1		05/26/2017	2018.03	05/26/2017 09:39:34 PM Central Daylight Time		05/31/2017 11:15:10 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	014	0	2018	GA		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	016	0		29	10	S0522_016_0	1			1		05/26/2017	2018.03	05/26/2017 09:42:05 PM Central Daylight Time		05/31/2017 11:15:34 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	016	0	2018	AL TN		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	018	0		29	10	S0522_018_0	1			1		05/19/2017	2018.03	05/19/2017 10:20:12 PM Central Daylight Time		05/31/2017 11:16:00 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	018	0	2018	MI		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	020	0		29	10	S0522_020_0	1			1		05/26/2017	2018.03	05/26/2017 09:44:35 PM Central Daylight Time		05/31/2017 11:16:26 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	020	0	2018	OH		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	022	0		29	10	S0522_022_0	1			1		05/26/2017	2018.03	05/26/2017 09:47:18 PM Central Daylight Time		05/31/2017 11:16:52 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	022	0	2018	IN KY		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	024	0		29	10	S0522_024_0	1			1		05/26/2017	2018.03	05/26/2017 09:50:10 PM Central Daylight Time		05/31/2017 11:17:16 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	024	0	2018	MS		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	026	0		29	10	S0522_026_0	1			1		05/26/2017	2018.03	05/26/2017 09:54:04 PM Central Daylight Time		05/31/2017 11:17:46 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	026	0	2018	LA		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	028	0		29	10	S0522_028_0	1			1		05/26/2017	2018.03	05/26/2017 09:59:44 PM Central Daylight Time		05/31/2017 11:18:12 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	028	0	2018	CO		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	030	0		29	10	S0522_030_0	1			1		05/26/2017	2018.03	05/26/2017 10:01:56 PM Central Daylight Time		05/31/2017 11:18:36 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	030	0	2018	OR WA		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	032	0		29	10	S0522_032_0	1			1		05/26/2017	2018.03	05/26/2017 10:05:14 PM Central Daylight Time		05/31/2017 11:19:02 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	032	0	2018	ID UT		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	034	0		29	10	S0522_034_0	1			1		05/19/2017	2018.03	05/19/2017 07:40:12 PM Central Daylight Time		05/31/2017 11:19:28 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	034	0	2018	CA		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	036	0		29	10	S0522_036_0	1			1		05/26/2017	2018.03	05/26/2017 10:08:05 PM Central Daylight Time		05/31/2017 11:19:56 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	036	0	2018	WI		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	037	0		29	10	S0522_037_0	1			1		05/26/2017	2018.03	05/26/2017 10:10:40 PM Central Daylight Time		05/31/2017 11:20:22 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	037	0	2018	MO		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	038	0		29	10	S0522_038_0	1			1		05/26/2017	2018.03	05/26/2017 10:13:36 PM Central Daylight Time		05/31/2017 11:20:48 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	038	0	2018	AR		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	039	0		29	10	S0522_039_0	1			1		05/19/2017	2018.03	05/19/2017 07:36:00 PM Central Daylight Time		05/31/2017 11:21:12 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	039	0	2018	TX		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	040	0		29	10	S0522_040_0	1			1		05/26/2017	2018.03	05/26/2017 10:23:04 PM Central Daylight Time		05/31/2017 11:21:38 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	040	0	2018	OK		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	041	0		29	10	S0522_041_0	1			1		05/26/2017	2018.03	05/26/2017 10:25:56 PM Central Daylight Time		05/31/2017 11:22:08 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	041	0	2018	KS		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	042	0		29	10	S0522_042_0	1			1		05/26/2017	2018.03	05/26/2017 10:28:01 PM Central Daylight Time		05/31/2017 11:22:32 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	042	0	2018	IA MN MT NE ND SD WY		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	043	0		29	10	S0522_043_0	1			1		05/26/2017	2018.03	05/26/2017 10:30:42 PM Central Daylight Time		05/31/2017 11:23:02 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	043	0	2018	NM		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	044	0		29	10	S0522_044_0	1			1		05/26/2017	2018.03	05/26/2017 10:33:09 PM Central Daylight Time		05/31/2017 11:23:28 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	044	0	2018	AZ		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	045	0		29	10	S0522_045_0	1			1		05/26/2017	2018.03	05/26/2017 10:35:20 PM Central Daylight Time		05/31/2017 11:23:54 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	045	0	2018	NV		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	046	0		29	10	S0522_046_0	1			1		05/19/2017	2018.03	05/19/2017 10:49:58 PM Central Daylight Time		05/31/2017 11:24:18 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	046	0	2018	HI		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	047	0		29	10	S0522_047_0	1			1		05/19/2017	2018.03	05/19/2017 10:43:12 PM Central Daylight Time		05/31/2017 11:24:44 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	047	0	2018	AK		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	078	0		29	10	S0522_078_0	1			1		05/19/2017	2018.03	05/19/2017 09:28:18 PM Central Daylight Time		05/31/2017 11:25:10 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	078	0	2018	PA WV		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	079	0		29	10	S0522_079_0	1			1		05/19/2017	2018.03	05/19/2017 08:28:33 PM Central Daylight Time		05/31/2017 11:25:36 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Value Rx (PDP)	10	29					S0522	079	0	2018	Central New England - CT MA RI VT		2					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com									(888)867-5575		(888)867-5575		(855)283-2958		(855)283-2958										(711)-		(711)-		(711)-		(711)-																
S0522	801	0		29	10	S0522_801_0	1			1		05/23/2017	2018.03	05/23/2017 02:40:50 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	SYMPHONIX HEALTH INSURANCE, INC.	UnitedHealthcare	www.UHCMedicareSolutions.com	Symphonix Protect Rx Drug Plan (PDP)	10	29					S0522	801	0	2018	All states except NY and FL		1					2						www.UHCMedicareSolutions.com	www.UHCMedicareSolutions.com										(855)355-2280		(855)355-2280		(855)355-2280		(855)355-2280										(711)-		(711)-		(711)-		(711)-																
S0586	801	0		29	10	S0586_801_0	1			1		04/12/2017	2018.03	04/12/2017 03:15:49 PM Eastern Daylight Time					06/04/2017 06:38:54 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP Health Care	www.mvphealthcare.com	MVP RxCare - Employer Group (PDP)	10	29					S0586	801	0	2018	United States and Puerto Rico		1					2						www.mvphealthcare.com/medicare/PartD/partd_index.html	www.mvphealthcare.com/medicare/PartD/partd_index.html										(866)494-8829		(866)494-8829		(800)324-3899		(800)324-3899										(711)-		(711)-		(800)662-1220		(800)662-1220																
S0655	801	0		29	10	S0655_801_0	4			1		05/26/2017	2018.03	05/26/2017 05:31:58 PM Eastern Daylight Time					06/05/2017 02:48:05 PM Eastern Daylight Time	TUFTS INSURANCE COMPANY	Tufts Health Plan	tuftsmedicarepreferred.org/plans/employer-plans	Tufts Medicare Preferred PDP Group (PDP)	10	29					S0655	801	0	2018	Massachusetts and Nationwide		1					2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage										(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977																
S0655	802	0		29	10	S0655_802_0	4			1		04/17/2017	2018.03	04/17/2017 06:06:39 PM Eastern Daylight Time					06/05/2017 02:48:05 PM Eastern Daylight Time	TUFTS INSURANCE COMPANY	Tufts Health Plan	tuftsmedicarepreferred.org/plans/employer-plans	Tufts Medicare Preferred PDP Group (PDP)	10	29					S0655	802	0	2018	Massachusetts and Nationwide		1					2						tuftsmedicarepreferred.org/find-doctor	tuftsmedicarepreferred.org/drug-coverage										(800)701-9000		(800)701-9000		(877)218-4835		(877)218-4835										(800)208-9562		(800)208-9562		(888)899-8977		(888)899-8977																
S1030	001	0		29	10	S1030_001_0	2			1		06/04/2017	2018.03	06/04/2017 12:42:39 PM Central Daylight Time		06/04/2017 12:01:26 PM Central Daylight Time			06/04/2017 02:15:32 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Option II (PDP)	10	29					S1030	001	0	2018	State of Alabama, State of Tennessee		2					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1030	006	0		29	10	S1030_006_0	2			1		06/04/2017	2018.03	06/04/2017 01:25:46 PM Central Daylight Time		06/04/2017 12:01:53 PM Central Daylight Time			06/04/2017 02:20:30 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Option I (PDP)	10	29					S1030	006	0	2018	State of Alabama, State of Tennessee		2					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1030	801	0		29	10	S1030_801_0	2			1		05/26/2017	2018.03	05/26/2017 01:48:15 PM Central Daylight Time					06/04/2017 02:20:30 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Employer Group Plan 801 (PDP)	10	29					S1030	801	0	2018	State of Alabama, State of Tennessee		1					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1030	802	0		29	10	S1030_802_0	2			1		05/10/2017	2018.03	05/10/2017 10:41:55 AM Central Daylight Time					06/04/2017 02:15:32 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Employer Group Plan 802 (PDP)	10	29					S1030	802	0	2018	State of Alabama, State of Tennessee		1					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1030	803	0		29	10	S1030_803_0	3			1		05/25/2017	2018.03	05/25/2017 01:04:06 PM Central Daylight Time					06/04/2017 02:20:30 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Employer Group Plan 803 (PDP)	10	29					S1030	803	0	2018	State of Alabama, State of Tennessee		1					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1030	804	0		29	10	S1030_804_0	2			1		05/10/2017	2018.03	05/10/2017 10:42:01 AM Central Daylight Time					06/04/2017 02:15:32 PM Central Daylight Time	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	BlueRx (PDP)	www.bluerxalatenn.com	BlueRx Employer Group Plan 804 (PDP)	10	29					S1030	804	0	2018	State of Alabama, State of Tennessee		1					2						www.bluerxalatenn.com	www.bluerxalatenn.com										(800)327-3998		(800)327-3998		(877)233-3555		(877)233-3555										(711)-		(711)-		(711)-		(711)-																
S1140	801	0		29	10	S1140_801_0	1			1		06/05/2017	2018.03	06/05/2017 10:41:33 AM Eastern Daylight Time					06/05/2017 10:47:29 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	Group PDP (PDP)	10	29					S1140	801	0	2018	New York State		1					2						www.nymedicare.com	www.nymedicare.com	www.nymedicare.com									(888)787-2390		(888)787-2390		(888)989-9905		(888)989-9905										(711)-		(711)-		(711)-		(711)-																
S1140	802	0		29	10	S1140_802_0	1			1		06/05/2017	2018.03	06/05/2017 10:41:49 AM Eastern Daylight Time					06/05/2017 10:47:29 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.nymedicare.com	Group PDP Enhanced (PDP)	10	29					S1140	802	0	2018	New York State		1					2						www.nymedicare.com	www.nymedicare.com	www.nymedicare.com									(888)787-2390		(888)787-2390		(888)989-9905		(888)989-9905										(711)-		(711)-		(711)-		(711)-																
S1822	801	0		29	10	S1822_801_0	3			1		05/25/2017	2018.03	05/25/2017 09:17:44 AM Central Daylight Time					05/31/2017 01:21:52 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners National PDP	healthpartners.com/medicare	HealthPartners Retiree National Choice CY (PDP)	10	29					S1822	801	0	2018	Nationwide		1					2						healthpartners.com/medicare	healthpartners.com/medicarerx										(877)816-9539		(952)883-7373		(866)993-7428		(952)883-7428										(711)-		(711)-		(711)-		(711)-																
S1822	802	0		29	10	S1822_802_0	3			1		05/25/2017	2018.03	05/25/2017 09:15:57 AM Central Daylight Time					05/31/2017 01:21:52 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners National PDP	healthpartners.com/medicare	HealthPartners Retiree National Choice NCY (PDP)	10	29					S1822	802	0	2018	Nationwide		1					2						healthpartners.com/medicare	healthpartners.com/medicarerx										(877)816-9539		(952)883-7373		(866)993-7428		(952)883-7428										(711)-		(711)-		(711)-		(711)-																
S2468	003	0		29	10	S2468_003_0	2			1		07/03/2017	2018.03	07/03/2017 10:50:40 AM Pacific Daylight Time		06/01/2017 06:36:46 PM Pacific Daylight Time			07/03/2017 10:52:04 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Rx Plus (PDP)	10	29					S2468	003	0	2018	State of California		2					2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary										(888)239-6469		(888)239-6469		(800)488-8000		(800)488-8000										(711)-		(711)-		(711)-		(711)-																
S2468	004	0		29	10	S2468_004_0	2			1		07/03/2017	2018.03	07/03/2017 10:51:04 AM Pacific Daylight Time		06/01/2017 06:37:09 PM Pacific Daylight Time			07/03/2017 10:58:10 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Rx Enhanced (PDP)	10	29					S2468	004	0	2018	State of California		2					2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary										(888)239-6469		(888)239-6469		(800)488-8000		(800)488-8000										(711)-		(711)-		(711)-		(711)-																
S2468	801	0		29	10	S2468_801_0	1			1		05/23/2017	2018.03	05/23/2017 09:53:47 AM Pacific Daylight Time					05/31/2017 02:47:40 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield of California Medicare Rx Plan (PDP)	10	29					S2468	801	0	2018	PDP Employer Group Plan		1					2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary										(888)239-6469		(888)239-6469		(888)239-6469		(888)239-6469										(711)-		(711)-		(711)-		(711)-																
S2468	802	0		29	10	S2468_802_0	1			1		04/17/2017	2018.03	04/17/2017 04:33:51 PM Pacific Daylight Time					05/31/2017 02:50:26 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield of California Medicare Rx Plan (PDP)	10	29					S2468	802	0	2018	PDP Employer Group Plan		1					2						www.blueshieldca.com/med_pharmacy	www.blueshieldca.com/med_formulary										(888)239-6469		(888)239-6469		(888)239-6469		(888)239-6469										(711)-		(711)-		(711)-		(711)-																
S2668	005	0		29	10	S2668_005_0	2			1		05/29/2017	2018.03	05/29/2017 08:07:21 PM Central Daylight Time		06/01/2017 04:07:34 PM Central Daylight Time			06/02/2017 08:37:14 AM Central Daylight Time	MEMBERS HEALTH INSURANCE COMPANY	Farm Bureau Health Plans	www.fbhealthplans.com	Farm Bureau Essential Rx (PDP)	10	29					S2668	005	0	2018	Alabama and Tennessee		2					2						fbhealthplans.com placeholder	fbhealthplans.com placeholder										(866)643-6924		(866)643-6924		(866)643-6924		(866)643-6924										(711)-		(711)-		(711)-		(711)-																
S2668	006	0		29	10	S2668_006_0	3			1		05/29/2017	2018.03	05/29/2017 08:08:51 PM Central Daylight Time		06/01/2017 04:07:44 PM Central Daylight Time			06/02/2017 08:51:15 AM Central Daylight Time	MEMBERS HEALTH INSURANCE COMPANY	Farm Bureau Health Plans	www.fbhealthplans.com	Farm Bureau Select Rx (PDP)	10	29					S2668	006	0	2018	Alabama and Tennessee		2					2						fbhealthplans.com placeholder	fbhealthplans.com placeholder										(866)643-6924		(866)643-6924		(866)643-6924		(866)643-6924										(711)-		(711)-		(711)-		(711)-																
S2874	001	0		29	10	S2874_001_0	4			1		07/17/2017	2018.03	07/17/2017 02:49:38 PM Eastern Daylight Time		05/23/2017 04:25:14 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S2874	001	0	2018	Puerto Rico - Island Wide		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625										(711)-		(711)-		(711)-		(711)-																
S2874	004	0		29	10	S2874_004_0	2			1		05/19/2017	2018.03	05/19/2017 05:23:59 PM Eastern Daylight Time		05/23/2017 04:25:56 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S2874	004	0	2018	Puerto Rico - Island Wide		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(866)773-5959		(866)773-5959		(800)681-3625		(800)681-3625										(711)-		(711)-		(711)-		(711)-																
S2874	801	0		29	10	S2874_801_0	5			1		05/05/2017	2018.03	05/05/2017 03:08:20 PM Eastern Daylight Time					06/05/2017 01:35:42 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana.com/medicare	Humana Medicare Employer (PDP)	10	29					S2874	801	0	2018	Puerto Rico - Island Wide		1					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(866)773-5959		(866)773-5959		(866)773-5959		(866)773-5959										(711)-		(711)-		(711)-		(711)-																
S2893	001	0		29	10	S2893_001_0	5			1		06/05/2017	2018.03	06/05/2017 09:06:53 AM Eastern Daylight Time		07/13/2017 03:19:59 PM Eastern Daylight Time			07/13/2017 03:22:54 PM Eastern Daylight Time	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx Value Plus (PDP)	10	29					S2893	001	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.rxmedicareplans.com	www.rxmedicareplans.com										(888)543-4917		(888)543-4917		(877)479-2227		(877)479-2227										(711)-		(711)-		(711)-		(711)-																
S2893	003	0		29	10	S2893_003_0	5			1		05/30/2017	2018.03	05/30/2017 09:59:03 AM Eastern Daylight Time		07/13/2017 03:20:04 PM Eastern Daylight Time			07/13/2017 03:22:54 PM Eastern Daylight Time	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx Premier (PDP)	10	29					S2893	003	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.rxmedicareplans.com	www.rxmedicareplans.com										(888)543-4917		(888)543-4917		(877)479-2227		(877)479-2227										(711)-		(711)-		(711)-		(711)-																
S2893	801	0		29	10	S2893_801_0	1			1		05/30/2017	2018.03	05/30/2017 10:28:13 AM Eastern Daylight Time					05/30/2017 10:45:33 AM Eastern Daylight Time	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	Blue MedicareRx	Groups.RxMedicareplans.com	Blue MedicareRx (PDP)	10	29					S2893	801	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		1					2						www.rxmedicareplans.com	www.rxmedicareplans.com										(888)543-4917		(888)543-4917		(877)479-2227		(877)479-2227										(711)-		(711)-		(711)-		(711)-																
S2893	802	0		29	10	S2893_802_0	1			1		05/30/2017	2018.03	05/30/2017 11:07:22 AM Eastern Daylight Time					05/30/2017 11:07:32 AM Eastern Daylight Time	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	Blue MedicareRx	Groups.RxMedicareplans.com	Blue MedicareRx (PDP)	10	29					S2893	802	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		1					2						www.rxmedicareplans.com	www.rxmedicareplans.com										(888)543-4917		(888)543-4917		(877)479-2227		(877)479-2227										(711)-		(711)-		(711)-		(711)-																
S3389	802	0		29	10	S3389_802_0	2			1		06/01/2017	2018.03	06/01/2017 05:28:51 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PDP)	10	29					S3389	802	0	2018	States of Pennsylvania and West Virginia		1					2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/										(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765										(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629																
S3389	803	0		29	10	S3389_803_0	2			1		06/01/2017	2018.03	06/01/2017 02:28:32 PM Eastern Daylight Time					06/05/2017 01:56:07 PM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PDP)	10	29					S3389	803	0	2018	States of Pennsylvania and West Virginia		1					2						https://www.upmchealthplan.com/medicare/documents-and-forms/	https://www.upmchealthplan.com/medicare/documents-and-forms/										(877)539-3080		(877)539-3080		(877)381-3765		(877)381-3765										(800)361-2629		(800)361-2629		(800)361-2629		(800)361-2629																
S3521	801	0		29	10	S3521_801_0	2			1		05/31/2017	2018.03	05/31/2017 03:32:45 PM Eastern Daylight Time					05/31/2017 05:14:41 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.SimplyPrescriptions.com	Simply Prescriptions- Employer Group (PDP)	10	29					S3521	801	0	2018	National and US Territories		1					2						www.SimplyPrescriptions.com	www.SimplyPrescriptions.com	www.SimplyPrescriptions.com									(877)883-9577		(877)883-9577		(877)883-9577		(877)883-9577										(800)421-1220		(800)421-1220		(800)421-1220		(800)421-1220																
S3875	802	0		29	10	S3875_802_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:13 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance (PDP)	10	29					S3875	802	0	2018	Granite Alliance National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	803	0		29	10	S3875_803_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:17 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance non-CY (PDP)	10	29					S3875	803	0	2018	Granite Alliance non-CY National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	804	0		29	10	S3875_804_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:21 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other (PDP)	10	29					S3875	804	0	2018	Granite Alliance - Other National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	805	0		29	10	S3875_805_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:28 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other non-CY (PDP)	10	29					S3875	805	0	2018	Granite Alliance - Other Non-CY National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	806	0		29	10	S3875_806_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:35 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other (PDP)	10	29					S3875	806	0	2018	Granite Alliance - Other National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	807	0		29	10	S3875_807_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:32 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other Non-CY (PDP)	10	29					S3875	807	0	2018	Granite Alliance - Other Non-CY National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	808	0		29	10	S3875_808_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:39 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other (PDP)	10	29					S3875	808	0	2018	Granite Alliance - Other National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	809	0		29	10	S3875_809_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:42 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other Non-CY (PDP)	10	29					S3875	809	0	2018	Granite Alliance - Other Non-CY National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	810	0		29	10	S3875_810_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:46 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other (PDP)	10	29					S3875	810	0	2018	Granite Alliance - Other National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3875	811	0		29	10	S3875_811_0	1			1		06/01/2017	2018.03	06/01/2017 04:00:49 PM Mountain Daylight Time					06/01/2017 04:59:00 PM Mountain Daylight Time	GRANITE ALLIANCE INSURANCE COMPANY	Granite Alliance	www.mygraniterx.com	Granite Alliance - Other Non-CY (PDP)	10	29					S3875	811	0	2018	Granite Alliance - Other Non-CY National EGWP		1					2						www.mygraniterx.com	www.mygraniterx.com										(855)586-2573		(855)586-2573		(855)586-2573		(855)586-2573										(711)-		(711)-		(711)-		(711)-																
S3994	801	0		29	10	S3994_801_0	1			1		04/17/2017	2018.03	04/17/2017 08:12:44 AM Hawaiian Standard Time					06/03/2017 02:58:37 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSAs Medicare Rx Plan	www.hmsa.com	Medicare Rx EGWP CY (PDP)	10	29					S3994	801	0	2018	National		1					2						www.hmsa.com	www.hmsa.com										(800)660-4672		(808)948-6000		(800)620-4672		(808)948-5555										(711)-		(711)-		(711)-		(711)-																
S3994	802	0		29	10	S3994_802_0	1			1		04/17/2017	2018.03	04/17/2017 08:14:37 AM Hawaiian Standard Time					06/03/2017 03:03:05 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSAs Medicare Rx Plan	www.hmsa.com	Medicare Rx EGWP NCY (PDP)	10	29					S3994	802	0	2018	National		1					2						www.hmsa.com	www.hmsa.com										(800)660-4672		(808)948-6000		(800)620-4672		(808)948-5555										(711)-		(711)-		(711)-		(711)-																
S4054	001	0		29	10	S4054_001_0	9			1		06/25/2017	2018.03	06/25/2017 10:43:23 AM Pacific Daylight Time		07/26/2017 01:12:39 PM Pacific Daylight Time			07/26/2017 01:18:00 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Medicare Rx Standard (PDP)	10	29					S4054	001	0	2018	State of Nevada		2					2						www.SeniorCarePlus.com	www.SeniorCarePlus.com	www.SeniorCarePlus.com									(800)681-9585		(800)681-9585		(888)775-7003		(775)982-3112										(711)-		(711)-		(711)-		(711)-																
S4219	801	0		29	10	S4219_801_0	1			1		04/26/2017	2018.03	04/26/2017 08:38:59 AM Central Daylight Time					06/03/2017 09:24:48 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medicare Prescription Plan	www.Healthalliancemedicare.org	Health Alliance Group Medicare Prescription Plan (PDP)	10	29					S4219	801	0	2018	United States		1					2						www.Healthalliancemedicare.org	www.Healthalliancemedicare.org	www.Healthalliancemedicare.org									(855)291-9311		(855)291-9311		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-																
S4219	802	0		29	10	S4219_802_0	1			1		04/26/2017	2018.03	04/26/2017 08:39:02 AM Central Daylight Time					06/03/2017 09:24:48 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medicare Prescription Plan	www.Healthalliancemedicare.org	Medicare Employer PDP (PDP) - non calendar year (PDP)	10	29					S4219	802	0	2018	United States		1					2						www.Healthalliancemedicare.org	www.Healthalliancemedicare.org	www.Healthalliancemedicare.org									(855)291-9311		(855)291-9311		(888)382-9771		(888)382-9771										(711)-		(711)-		(711)-		(711)-																
S4501	801	0		29	10	S4501_801_0	2			1		06/02/2017	2018.03	06/02/2017 02:48:44 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Pharmacy Benefit Dimensions PDP	independenthealth.com/medicare	Pharmacy Benefit Dimensions PDP-1 (LMHF) (PDP)	10	29					S4501	801	0	2018	Western New York		1					2						www.pbdrx.com	www.independenthealth.com										(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840																
S4501	802	0		29	10	S4501_802_0	2			1		06/02/2017	2018.03	06/02/2017 02:49:00 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Pharmacy Benefit Dimensions PDP	www.independenthealth.com	Pharmacy Benefit Dimensions PDP-2 (PDP)	10	29					S4501	802	0	2018	All regions except MT, WY, ND, SD, NE, MN, IA		1					2						www.pbdrx.com	www.independenthealth.com										(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840																
S4501	803	0		29	10	S4501_803_0	2			1		05/26/2017	2018.03	05/26/2017 01:38:54 PM Eastern Daylight Time					06/04/2017 11:02:18 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Pharmacy Benefit Dimensions PDP	independenthealth.com	Pharmacy Benefit Dimensions PDP-3 (PDP)	10	29					S4501	803	0	2018	All regions except: MT, WY, ND, SD, NE, MN, IA		1					2						www.pbdrx.com	www.independenthealth.com										(800)665-1502		(716)250-4401		(800)958-4405		(716)635-4900										(800)432-1110		(716)631-3108		(888)357-9167		(716)635-4840																
S4607	001	0		29	10	S4607_001_0	2			1		06/03/2017	2018.03	06/03/2017 06:18:45 PM Eastern Daylight Time		06/04/2017 03:48:08 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	001	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	002	0		29	10	S4607_002_0	3			1		06/03/2017	2018.03	06/03/2017 06:19:09 PM Eastern Daylight Time		06/04/2017 03:49:38 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	002	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	003	0		29	10	S4607_003_0	2			1		06/03/2017	2018.03	06/03/2017 06:19:34 PM Eastern Daylight Time		06/04/2017 03:55:40 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	003	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	008	0		29	10	S4607_008_0	2			1		06/03/2017	2018.03	06/03/2017 06:20:11 PM Eastern Daylight Time		06/04/2017 03:55:12 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	008	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	009	0		29	10	S4607_009_0	2			1		06/03/2017	2018.03	06/03/2017 06:21:56 PM Eastern Daylight Time		06/04/2017 03:54:10 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	009	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	010	0		29	10	S4607_010_0	2			1		06/03/2017	2018.03	06/03/2017 06:22:21 PM Eastern Daylight Time		06/04/2017 03:53:18 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	010	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	011	0		29	10	S4607_011_0	2			1		06/03/2017	2018.03	06/03/2017 06:23:05 PM Eastern Daylight Time		06/04/2017 03:52:32 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	011	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	012	0		29	10	S4607_012_0	2			1		06/03/2017	2018.03	06/03/2017 06:23:28 PM Eastern Daylight Time		06/04/2017 03:52:02 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	012	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	013	0		29	10	S4607_013_0	2			1		06/03/2017	2018.03	06/03/2017 06:23:55 PM Eastern Daylight Time		06/04/2017 03:51:36 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	013	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	014	0		29	10	S4607_014_0	2			1		06/03/2017	2018.03	06/03/2017 06:24:41 PM Eastern Daylight Time		06/04/2017 03:50:06 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	014	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	015	0		29	10	S4607_015_0	2			1		06/03/2017	2018.03	06/03/2017 06:25:20 PM Eastern Daylight Time		06/04/2017 03:56:28 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	015	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	016	0		29	10	S4607_016_0	2			1		06/03/2017	2018.03	06/03/2017 06:25:40 PM Eastern Daylight Time		06/04/2017 03:58:54 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	016	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	017	0		29	10	S4607_017_0	2			1		06/03/2017	2018.03	06/03/2017 06:26:12 PM Eastern Daylight Time		06/04/2017 04:03:40 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	017	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	018	0		29	10	S4607_018_0	2			1		06/03/2017	2018.03	06/03/2017 06:26:43 PM Eastern Daylight Time		06/04/2017 04:03:00 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	018	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	019	0		29	10	S4607_019_0	2			1		06/03/2017	2018.03	06/03/2017 06:27:01 PM Eastern Daylight Time		06/04/2017 04:02:36 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	019	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	020	0		29	10	S4607_020_0	2			1		06/03/2017	2018.03	06/03/2017 06:27:32 PM Eastern Daylight Time		06/04/2017 04:02:12 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	020	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	021	0		29	10	S4607_021_0	2			1		06/03/2017	2018.03	06/03/2017 06:28:02 PM Eastern Daylight Time		06/04/2017 04:01:46 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	021	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	022	0		29	10	S4607_022_0	2			1		06/03/2017	2018.03	06/03/2017 06:28:25 PM Eastern Daylight Time		06/04/2017 04:01:12 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	022	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	023	0		29	10	S4607_023_0	2			1		06/03/2017	2018.03	06/03/2017 06:28:47 PM Eastern Daylight Time		06/04/2017 04:00:06 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	023	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	024	0		29	10	S4607_024_0	2			1		06/03/2017	2018.03	06/03/2017 06:29:13 PM Eastern Daylight Time		06/04/2017 04:00:38 PM Eastern Daylight Time			06/05/2017 09:26:38 AM Eastern Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	024	0	2018	Magellan Rx Medicare Basic (PDP)		2					2						medicare.magellanrx.com	medicare.magellanrx.com	medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	801	0		29	10	S4607_801_0	1			1		06/02/2017	2018.03	06/02/2017 05:49:48 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	801	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	802	0		29	10	S4607_802_0	1			1		06/02/2017	2018.03	06/02/2017 05:49:54 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	802	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	803	0		29	10	S4607_803_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:00 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	803	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	804	0		29	10	S4607_804_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:07 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	804	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	805	0		29	10	S4607_805_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:13 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	805	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	806	0		29	10	S4607_806_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:17 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	806	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	807	0		29	10	S4607_807_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:23 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	807	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	808	0		29	10	S4607_808_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:35 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	808	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	809	0		29	10	S4607_809_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:31 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	809	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4607	810	0		29	10	S4607_810_0	1			1		06/02/2017	2018.03	06/02/2017 05:50:44 PM Central Daylight Time					06/02/2017 05:51:14 PM Central Daylight Time	MERIT HEALTH INSURANCE COMPANY	Magellan Rx Medicare	https://medicare.magellanrx.com	Magellan Rx Medicare Basic (PDP)	10	29					S4607	810	0	2018	Magellan Rx Medicare Basic (PDP)		1					2						https://medicare.magellanrx.com	https://medicare.magellanrx.com	https://medicare.magellanrx.com									(800)424-5870		(800)424-5870		(800)424-5759		(800)424-5759										(711)-		(711)-		(711)-		(711)-																
S4802	012	0		29	10	S4802_012_0	4			1		06/01/2017	2018.03	06/01/2017 02:00:16 PM Eastern Daylight Time		06/02/2017 04:06:13 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	012	0	2018	Louisiana		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	013	0		29	10	S4802_013_0	2			1		05/31/2017	2018.03	05/31/2017 07:09:28 AM Eastern Daylight Time		06/02/2017 04:07:05 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	013	0	2018	Texas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	014	0		29	10	S4802_014_0	2			1		06/02/2017	2018.03	06/02/2017 08:33:32 AM Eastern Daylight Time		06/02/2017 04:07:57 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	014	0	2018	Oklahoma		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	020	0		29	10	S4802_020_0	2			1		05/30/2017	2018.03	05/30/2017 09:27:10 AM Eastern Daylight Time		06/02/2017 04:08:49 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	020	0	2018	Oregon and Washington		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	021	0		29	10	S4802_021_0	2			1		05/31/2017	2018.03	05/31/2017 07:13:27 AM Eastern Daylight Time		06/02/2017 04:09:41 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	021	0	2018	Idaho and Utah		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	069	0		29	10	S4802_069_0	3			1		05/26/2017	2018.03	05/26/2017 02:17:53 PM Eastern Daylight Time		06/02/2017 04:10:32 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	069	0	2018	Virginia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	070	0		29	10	S4802_070_0	2			1		06/01/2017	2018.03	06/01/2017 11:37:05 AM Eastern Daylight Time		06/02/2017 04:11:22 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	070	0	2018	South Carolina		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	071	0		29	10	S4802_071_0	2			1		05/26/2017	2018.03	05/26/2017 02:18:50 PM Eastern Daylight Time		06/02/2017 04:12:14 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	071	0	2018	Alabama, Tennessee		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	072	0		29	10	S4802_072_0	2			1		06/02/2017	2018.03	06/02/2017 08:34:56 AM Eastern Daylight Time		06/02/2017 04:13:04 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	072	0	2018	Missouri		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	073	0		29	10	S4802_073_0	2			1		05/31/2017	2018.03	05/31/2017 07:15:41 AM Eastern Daylight Time		06/02/2017 04:13:57 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	073	0	2018	Arkansas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	074	0		29	10	S4802_074_0	2			1		05/31/2017	2018.03	05/31/2017 07:18:31 AM Eastern Daylight Time		06/02/2017 04:14:51 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	074	0	2018	Mississippi		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	075	0		29	10	S4802_075_0	2			1		05/26/2017	2018.03	05/26/2017 02:19:54 PM Eastern Daylight Time		06/02/2017 04:15:42 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	075	0	2018	Maine, New Hampshire		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	076	0		29	10	S4802_076_0	2			1		05/26/2017	2018.03	05/26/2017 02:21:43 PM Eastern Daylight Time		06/02/2017 04:16:33 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	076	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	077	0		29	10	S4802_077_0	2			1		05/30/2017	2018.03	05/30/2017 09:31:13 AM Eastern Daylight Time		06/02/2017 04:17:26 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	077	0	2018	New York		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	078	0		29	10	S4802_078_0	2			1		05/26/2017	2018.03	05/26/2017 02:24:09 PM Eastern Daylight Time		06/02/2017 04:18:17 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	078	0	2018	New Jersey		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	079	0		29	10	S4802_079_0	2			1		05/26/2017	2018.03	05/26/2017 02:25:14 PM Eastern Daylight Time		06/02/2017 04:19:06 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	079	0	2018	District of Columbia, Delaware, Maryland		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	080	0		29	10	S4802_080_0	2			1		06/01/2017	2018.03	06/01/2017 01:30:07 PM Eastern Daylight Time		06/02/2017 04:19:56 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	080	0	2018	Pennsylvania, West Virginia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	081	0		29	10	S4802_081_0	2			1		05/26/2017	2018.03	05/26/2017 02:27:22 PM Eastern Daylight Time		06/02/2017 04:20:46 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	081	0	2018	North Carolina		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	082	0		29	10	S4802_082_0	2			1		06/02/2017	2018.03	06/02/2017 10:05:33 AM Eastern Daylight Time		06/02/2017 04:21:37 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	082	0	2018	Georgia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	083	0		29	10	S4802_083_0	3			1		06/01/2017	2018.03	06/01/2017 11:35:21 AM Eastern Daylight Time		06/02/2017 04:22:29 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	083	0	2018	Florida		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	084	0		29	10	S4802_084_0	2			1		05/26/2017	2018.03	05/26/2017 02:28:29 PM Eastern Daylight Time		06/02/2017 04:23:21 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	084	0	2018	Michigan		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	085	0		29	10	S4802_085_0	2			1		05/26/2017	2018.03	05/26/2017 02:29:28 PM Eastern Daylight Time		06/02/2017 04:24:12 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	085	0	2018	Ohio		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	086	0		29	10	S4802_086_0	2			1		05/26/2017	2018.03	05/26/2017 02:30:34 PM Eastern Daylight Time		06/02/2017 04:25:03 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	086	0	2018	Indiana, Kentucky		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	087	0		29	10	S4802_087_0	2			1		05/31/2017	2018.03	05/31/2017 07:22:47 AM Eastern Daylight Time		06/02/2017 04:25:54 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	087	0	2018	Illinois		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	088	0		29	10	S4802_088_0	2			1		05/26/2017	2018.03	05/26/2017 02:31:34 PM Eastern Daylight Time		06/02/2017 04:26:44 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	088	0	2018	Kansas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	089	0		29	10	S4802_089_0	3			1		05/26/2017	2018.03	05/26/2017 02:32:34 PM Eastern Daylight Time		06/02/2017 04:27:36 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	089	0	2018	IA, MN, MT, NE, ND, SD, WY		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	090	0		29	10	S4802_090_0	2			1		05/26/2017	2018.03	05/26/2017 02:33:32 PM Eastern Daylight Time		06/02/2017 04:28:27 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	090	0	2018	New Mexico		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	091	0		29	10	S4802_091_0	2			1		06/02/2017	2018.03	06/02/2017 10:04:11 AM Eastern Daylight Time		06/02/2017 04:29:19 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	091	0	2018	Colorado		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	092	0		29	10	S4802_092_0	3			1		05/26/2017	2018.03	05/26/2017 02:34:31 PM Eastern Daylight Time		06/02/2017 04:30:12 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	092	0	2018	Arizona		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	093	0		29	10	S4802_093_0	2			1		05/26/2017	2018.03	05/26/2017 02:35:25 PM Eastern Daylight Time		06/02/2017 04:31:03 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	093	0	2018	Nevada		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	094	0		29	10	S4802_094_0	2			1		05/27/2017	2018.03	05/27/2017 01:34:27 PM Eastern Daylight Time		06/02/2017 04:31:58 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	094	0	2018	California		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	095	0		29	10	S4802_095_0	3			1		05/31/2017	2018.03	05/31/2017 07:27:40 AM Eastern Daylight Time		06/05/2017 01:06:47 PM Eastern Daylight Time			06/05/2017 01:36:02 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	095	0	2018	Hawaii		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	096	0		29	10	S4802_096_0	2			1		05/27/2017	2018.03	05/27/2017 01:49:13 PM Eastern Daylight Time		06/02/2017 04:33:40 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	096	0	2018	Alaska		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	097	0		29	10	S4802_097_0	2			1		05/26/2017	2018.03	05/26/2017 02:36:24 PM Eastern Daylight Time		06/02/2017 04:34:30 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S4802	097	0	2018	Wisconsin		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	098	0		29	10	S4802_098_0	2			1		06/02/2017	2018.03	06/02/2017 08:24:03 AM Eastern Daylight Time		06/02/2017 04:35:21 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	098	0	2018	Maine, New Hampshire		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	099	0		29	10	S4802_099_0	2			1		06/02/2017	2018.03	06/02/2017 08:26:27 AM Eastern Daylight Time		06/02/2017 04:36:11 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	099	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	100	0		29	10	S4802_100_0	3			1		06/29/2017	2018.03	06/29/2017 08:03:38 AM Eastern Daylight Time		06/28/2017 03:55:20 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	100	0	2018	New York		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	101	0		29	10	S4802_101_0	3			1		06/29/2017	2018.03	06/29/2017 08:05:34 AM Eastern Daylight Time		06/28/2017 03:56:09 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	101	0	2018	New Jersey		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	102	0		29	10	S4802_102_0	3			1		06/29/2017	2018.03	06/29/2017 08:09:32 AM Eastern Daylight Time		06/28/2017 03:56:58 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	102	0	2018	District of Columbia, Delaware, Maryland		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	103	0		29	10	S4802_103_0	3			1		06/29/2017	2018.03	06/29/2017 08:10:59 AM Eastern Daylight Time		06/28/2017 03:57:47 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	103	0	2018	Pennsylvania, West Virginia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	104	0		29	10	S4802_104_0	2			1		06/02/2017	2018.03	06/02/2017 08:41:35 AM Eastern Daylight Time		06/02/2017 04:40:23 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	104	0	2018	Virginia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	105	0		29	10	S4802_105_0	2			1		06/02/2017	2018.03	06/02/2017 08:43:32 AM Eastern Daylight Time		06/02/2017 04:41:14 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	105	0	2018	North Carolina		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	106	0		29	10	S4802_106_0	2			1		06/02/2017	2018.03	06/02/2017 08:44:52 AM Eastern Daylight Time		06/02/2017 04:42:08 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	106	0	2018	South Carolina		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	107	0		29	10	S4802_107_0	3			1		06/29/2017	2018.03	06/29/2017 08:13:39 AM Eastern Daylight Time		06/28/2017 03:58:38 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	107	0	2018	Georgia		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	108	0		29	10	S4802_108_0	3			1		06/29/2017	2018.03	06/29/2017 08:14:57 AM Eastern Daylight Time		06/28/2017 03:59:28 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	108	0	2018	Florida		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	109	0		29	10	S4802_109_0	3			1		06/29/2017	2018.03	06/29/2017 08:16:35 AM Eastern Daylight Time		06/28/2017 04:00:17 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	109	0	2018	Alabama, Tennessee		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	110	0		29	10	S4802_110_0	3			1		06/29/2017	2018.03	06/29/2017 08:18:30 AM Eastern Daylight Time		06/28/2017 04:01:07 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	110	0	2018	Michigan		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	111	0		29	10	S4802_111_0	3			1		06/29/2017	2018.03	06/29/2017 08:21:00 AM Eastern Daylight Time		06/28/2017 04:01:57 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	111	0	2018	Ohio		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	112	0		29	10	S4802_112_0	2			1		06/02/2017	2018.03	06/02/2017 08:54:05 AM Eastern Daylight Time		06/02/2017 04:47:13 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	112	0	2018	Indiana, Kentucky		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	113	0		29	10	S4802_113_0	3			1		06/29/2017	2018.03	06/29/2017 08:35:44 AM Eastern Daylight Time		06/28/2017 04:02:49 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	113	0	2018	Illinois		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	114	0		29	10	S4802_114_0	2			1		06/02/2017	2018.03	06/02/2017 09:00:59 AM Eastern Daylight Time		06/02/2017 04:48:55 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	114	0	2018	Missouri		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	115	0		29	10	S4802_115_0	3			1		06/29/2017	2018.03	06/29/2017 08:37:21 AM Eastern Daylight Time		06/28/2017 04:03:39 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	115	0	2018	Arkansas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	116	0		29	10	S4802_116_0	3			1		06/29/2017	2018.03	06/29/2017 08:39:13 AM Eastern Daylight Time		06/28/2017 04:04:29 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	116	0	2018	Mississippi		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(866)537-1812		(866)537-1812										(888)816-5252		(888)816-5252		(711)-		(711)-																
S4802	118	0		29	10	S4802_118_0	2			1		06/02/2017	2018.03	06/02/2017 09:06:58 AM Eastern Daylight Time		06/02/2017 04:51:27 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	118	0	2018	Texas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	119	0		29	10	S4802_119_0	3			1		06/29/2017	2018.03	06/29/2017 08:41:08 AM Eastern Daylight Time		06/28/2017 04:05:23 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	119	0	2018	Oklahoma		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	120	0		29	10	S4802_120_0	3			1		06/29/2017	2018.03	06/29/2017 08:43:04 AM Eastern Daylight Time		06/28/2017 04:06:14 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	120	0	2018	Kansas		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	121	0		29	10	S4802_121_0	2			1		06/02/2017	2018.03	06/02/2017 09:11:31 AM Eastern Daylight Time		06/02/2017 04:54:07 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	121	0	2018	IA, MN, MT, NE, ND, SD, WY		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	122	0		29	10	S4802_122_0	3			1		06/29/2017	2018.03	06/29/2017 08:45:01 AM Eastern Daylight Time		06/28/2017 04:07:04 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	122	0	2018	New Mexico		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	123	0		29	10	S4802_123_0	3			1		06/29/2017	2018.03	06/29/2017 08:53:36 AM Eastern Daylight Time		06/28/2017 04:07:51 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	123	0	2018	Colorado		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	125	0		29	10	S4802_125_0	2			1		06/02/2017	2018.03	06/02/2017 09:16:32 AM Eastern Daylight Time		06/02/2017 04:56:37 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	125	0	2018	Nevada		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	127	0		29	10	S4802_127_0	3			1		06/02/2017	2018.03	06/02/2017 09:18:22 AM Eastern Daylight Time		06/05/2017 01:07:38 PM Eastern Daylight Time			06/05/2017 01:36:02 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	127	0	2018	Idaho, Utah		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	128	0		29	10	S4802_128_0	3			1		06/29/2017	2018.03	06/29/2017 09:07:16 AM Eastern Daylight Time		06/28/2017 04:08:40 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	128	0	2018	California		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	129	0		29	10	S4802_129_0	3			1		06/29/2017	2018.03	06/29/2017 09:12:47 AM Eastern Daylight Time		06/28/2017 04:09:26 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	129	0	2018	Hawaii		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	130	0		29	10	S4802_130_0	3			1		06/29/2017	2018.03	06/29/2017 09:16:01 AM Eastern Daylight Time		06/28/2017 04:10:13 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Extra (PDP)	10	29					S4802	130	0	2018	Alaska		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	132	0		29	10	S4802_132_0	3			1		06/29/2017	2018.03	06/29/2017 09:18:23 AM Eastern Daylight Time		06/28/2017 04:43:20 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Value Script (PDP)	10	29					S4802	132	0	2018	Wisconsin		2					2						www.wellcarepdp.com	www.WellCarePDP.com/medication_guide	www.wellcarepdp.com									(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	133	0		29	10	S4802_133_0	2			1		05/28/2017	2018.03	05/28/2017 03:29:25 PM Eastern Daylight Time		06/02/2017 05:53:36 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Value Script (PDP)	10	29					S4802	133	0	2018	Louisiana		2					2						www.wellcarepdp.com	www.wellcarepdp.com										(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	134	0		29	10	S4802_134_0	3			1		06/29/2017	2018.03	06/29/2017 09:19:44 AM Eastern Daylight Time		06/28/2017 04:11:48 PM Eastern Daylight Time			07/05/2017 01:29:21 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Value Script (PDP)	10	29					S4802	134	0	2018	Arizona		2					2						www.wellcarepdp.com	www.WellCarePDP.com/medication_guide	www.wellcarepdp.com									(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S4802	135	0		29	10	S4802_135_0	2			1		05/28/2017	2018.03	05/28/2017 03:37:46 PM Eastern Daylight Time		06/02/2017 05:55:16 PM Eastern Daylight Time			06/02/2017 06:02:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Value Script (PDP)	10	29					S4802	135	0	2018	Oregon, Washington		2					2						www.wellcarepdp.com	www.WellCarePDP.com/medication_guide	www.wellcarepdp.com									(888)550-5252		(888)550-5252		(888)293-5151		(888)293-5151										(888)816-5252		(888)816-5252		(877)247-6272		(877)247-6272																
S5450	801	0		29	10	S5450_801_0	2			1		05/15/2017	2018.03	05/15/2017 02:04:56 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	801	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	802	0		29	10	S5450_802_0	2			1		05/15/2017	2018.03	05/15/2017 02:05:25 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	802	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	803	0		29	10	S5450_803_0	2			1		05/15/2017	2018.03	05/15/2017 02:05:41 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	803	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	804	0		29	10	S5450_804_0	2			1		05/15/2017	2018.03	05/15/2017 02:05:55 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	804	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	805	0		29	10	S5450_805_0	2			1		05/15/2017	2018.03	05/15/2017 02:06:08 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	805	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	806	0		29	10	S5450_806_0	2			1		05/15/2017	2018.03	05/15/2017 02:06:30 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	806	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5450	807	0		29	10	S5450_807_0	2			1		05/15/2017	2018.03	05/15/2017 02:06:47 PM Eastern Daylight Time					06/05/2017 03:52:47 PM Eastern Daylight Time	SECURITYCARE OF TENNESSEE, INC.	SecurityCare of Tennessee	bcbstmedicare.com	BlueScripts (PDP)	10	29					S5450	807	0	2018	38 PDP Regions		1					2						bcbstmedicare.com	bcbstmedicare.com										(800)818-0962		(800)818-0962		(888)476-5072		(888)476-5072										(711)-		(711)-		(711)-		(711)-																
S5540	002	0		29	10	S5540_002_0	5			1		05/30/2017	2018.03	05/30/2017 03:29:40 PM Eastern Daylight Time		07/10/2017 09:39:18 AM Eastern Daylight Time			07/10/2017 11:26:51 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx Standard (PDP)	10	29					S5540	002	0	2018	North Carolina		2					2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm										(888)247-4142		(888)247-4142		(800)661-5518		(800)661-5518										(888)247-4145		(888)247-4145		(800)922-3140		(800)922-3140																
S5540	004	0		29	10	S5540_004_0	5			1		05/30/2017	2018.03	05/30/2017 08:04:47 AM Eastern Daylight Time		07/10/2017 09:39:19 AM Eastern Daylight Time			07/10/2017 11:26:51 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx Enhanced (PDP)	10	29					S5540	004	0	2018	North Carolina		2					2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm										(888)247-4142		(888)247-4142		(800)661-5518		(800)661-5518										(888)247-4145		(888)247-4145		(800)922-3140		(800)922-3140																
S5540	801	0		29	10	S5540_801_0	4			1		05/30/2017	2018.03	05/30/2017 01:28:25 PM Eastern Daylight Time					06/01/2017 04:06:51 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx EGWP (PDP)	10	29					S5540	801	0	2018	National Employer Group Retirees		1					2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm										(888)247-4142		(888)247-4142		(800)661-5518		(800)661-5518										(888)247-4145		(888)247-4145		(800)922-3140		(800)922-3140																
S5540	802	0		29	10	S5540_802_0	4			1		06/01/2017	2018.03	06/01/2017 03:29:16 PM Eastern Daylight Time					06/01/2017 04:06:51 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx EGWP Value (PDP)	10	29					S5540	802	0	2018	NC Employer Groups		1					2						www.myprime.com/MyRx/MyPrime/MedicareD/pharmacy/BCBSNC	www.bcbsnc.com/content/medicare/formulary-home.htm	www.bcbsnc.com/medicare									(888)247-4142		(888)247-4142		(800)661-5518		(800)661-5518										(888)247-4145		(888)247-4145		(800)922-3140		(800)922-3140																
S5552	003	0		29	10	S5552_003_0	4			1		07/17/2017	2018.03	07/17/2017 02:51:22 PM Eastern Daylight Time		05/23/2017 04:26:42 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5552	003	0	2018	State of New York		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5552	004	0		29	10	S5552_004_0	2			1		05/19/2017	2018.03	05/19/2017 10:29:52 PM Eastern Daylight Time		05/23/2017 04:27:28 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5552	004	0	2018	State of New York		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5552	005	0		29	10	S5552_005_0	3			1		05/19/2017	2018.03	05/19/2017 11:57:47 PM Eastern Daylight Time		05/23/2017 04:28:12 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5552	005	0	2018	State of New York		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5552	801	0		29	10	S5552_801_0	4			1		05/31/2017	2018.03	05/31/2017 09:48:44 AM Eastern Daylight Time					06/05/2017 01:35:42 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana.com/medicare	Humana Medicare Employer (PDP)	10	29					S5552	801	0	2018	State of New York		1					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-																
S5584	001	0		29	10	S5584_001_0	5			1		05/31/2017	2018.03	05/31/2017 10:39:54 AM Eastern Daylight Time		06/06/2017 02:20:23 AM Eastern Daylight Time			06/06/2017 02:32:53 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Option A (PDP)	10	29					S5584	001	0	2018	State of Michigan		2					2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare										(800)565-1770		(800)565-1770		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-																
S5584	002	0		29	10	S5584_002_0	5			1		05/26/2017	2018.03	05/26/2017 11:10:18 AM Eastern Daylight Time		06/06/2017 02:23:03 AM Eastern Daylight Time			06/06/2017 02:32:53 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Option B (PDP)	10	29					S5584	002	0	2018	State of Michigan		2					2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare										(800)565-1770		(800)565-1770		(888)563-3307		(888)563-3307										(711)-		(711)-		(711)-		(711)-																
S5584	801	0		29	10	S5584_801_0	5			1		05/31/2017	2018.03	05/31/2017 08:13:59 AM Eastern Daylight Time					06/06/2017 02:32:53 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Employer Plan CY (PDP)	10	29					S5584	801	0	2018	State of Michigan		1					2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare										(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-																
S5584	802	0		29	10	S5584_802_0	5			1		05/31/2017	2018.03	05/31/2017 08:13:07 AM Eastern Daylight Time					06/06/2017 02:32:53 AM Eastern Daylight Time	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Employer Plan non-CY (PDP)	10	29					S5584	802	0	2018	State of Michigan		1					2						www.bcbsm.com/pharmaciesmedicare	www.bcbsm.com/formularymedicare										(866)684-8216		(866)684-8216		(866)684-8216		(866)684-8216										(711)-		(711)-		(711)-		(711)-																
S5588	802	0		29	10	S5588_802_0	1			1		05/19/2017	2018.03	05/19/2017 09:29:54 AM Eastern Daylight Time					05/24/2017 09:51:12 AM Eastern Daylight Time	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	Paramount Std. Prescription Drug Plan Empl (PDP)	10	29					S5588	802	0	2018	Paramount Standard Prescription Drug Plan (Ohio)		1					2						www.paramounthealthcare.com/medicareplans	www.paramounthealthcare.com/medicareplans										(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525										(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670																
S5588	803	0		29	10	S5588_803_0	1			1		05/19/2017	2018.03	05/19/2017 09:32:13 AM Eastern Daylight Time					05/24/2017 09:51:12 AM Eastern Daylight Time	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	Paramount Enh. Prescription Drug Plan Empl (PDP)	10	29					S5588	803	0	2018	Paramount Enhanced Prescription Drug Plan (Ohio)		1					2						www.paramounthealthcare.com/medicareplans	www.paramounthealthcare.com/medicareplans										(800)462-3589		(419)887-2525		(800)462-3589		(419)887-2525										(888)740-5670		(888)740-5670		(888)740-5670		(888)740-5670																
S5593	002	0		29	10	S5593_002_0	7			1		06/30/2017	2018.03	06/30/2017 03:05:09 PM Eastern Daylight Time		06/29/2017 08:00:13 AM Eastern Daylight Time			06/30/2017 04:01:02 PM Eastern Daylight Time	HM HEALTH INSURANCE COMPANY	HM Health Insurance Company	www.highmarkblueshield.com/medicare	Blue Rx PDP Plus (PDP)	10	29					S5593	002	0	2018	Pennsylvania  and West Virginia		2					2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare										(800)290-3914		(800)290-3914		(866)435-1047		(866)435-1047										(711)-		(711)-		(711)-		(711)-																
S5593	003	0		29	10	S5593_003_0	6			1		06/04/2017	2018.03	06/04/2017 08:18:15 AM Eastern Daylight Time		06/04/2017 07:41:07 AM Eastern Daylight Time			06/04/2017 02:31:56 PM Eastern Daylight Time	HM HEALTH INSURANCE COMPANY	HM Health Insurance Company	www.highmarkblueshield.com/medicare	Blue Rx PDP Complete (PDP)	10	29					S5593	003	0	2018	Pennsylvania  and West Virginia		2					2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare										(800)290-3914		(800)290-3914		(866)435-1047		(866)435-1047										(711)-		(711)-		(711)-		(711)-																
S5593	801	0		29	10	S5593_801_0	6			1		05/15/2017	2018.03	05/15/2017 02:02:02 PM Eastern Daylight Time					06/04/2017 02:31:56 PM Eastern Daylight Time	HM HEALTH INSURANCE COMPANY	HM Health Insurance Company	www.highmarkblueshield.com/medicare	Blue Rx PDP Employer Group Calendar (PDP)	10	29					S5593	801	0	2018	National		1					2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare										(800)290-3914		(800)290-3914		(866)435-1047		(866)435-1047										(711)-		(711)-		(711)-		(711)-																
S5593	802	0		29	10	S5593_802_0	6			1		05/26/2017	2018.03	05/26/2017 04:07:04 PM Eastern Daylight Time					06/04/2017 02:31:56 PM Eastern Daylight Time	HM HEALTH INSURANCE COMPANY	HM Health Insurance Company	www.highmarkblueshield.com/medicare	Blue Rx PDP Employer Group Non-Calendar (PDP)	10	29					S5593	802	0	2018	National		1					2						www.highmarkblueshield.com/medicare	www.highmarkblueshield.com/medicare										(800)290-3914		(800)290-3914		(866)435-1047		(866)435-1047										(711)-		(711)-		(711)-		(711)-																
S5596	001	0		29	10	S5596_001_0	1			1		06/02/2017	2018.03	06/02/2017 04:13:25 PM Eastern Daylight Time		06/01/2017 01:14:56 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	001	0	2018	Maine and New Hampshire		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	003	0		29	10	S5596_003_0	1			1		06/01/2017	2018.03	06/01/2017 01:51:25 PM Eastern Daylight Time		06/01/2017 01:15:48 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	003	0	2018	Maine and New Hampshire		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	005	0		29	10	S5596_005_0	2			1		06/01/2017	2018.03	06/01/2017 01:52:22 PM Eastern Daylight Time		06/01/2017 01:16:38 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	005	0	2018	Virginia		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	006	0		29	10	S5596_006_0	1			1		06/01/2017	2018.03	06/01/2017 01:53:09 PM Eastern Daylight Time		06/01/2017 01:17:29 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	006	0	2018	Virginia		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	007	0		29	10	S5596_007_0	1			1		06/01/2017	2018.03	06/01/2017 01:54:39 PM Eastern Daylight Time		06/01/2017 01:18:19 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	007	0	2018	Virginia		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	009	0		29	10	S5596_009_0	1			1		06/01/2017	2018.03	06/01/2017 01:56:12 PM Eastern Daylight Time		06/01/2017 01:19:10 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bcbsga.com/shop	BCBSGa Blue MedicareRx Standard (PDP)	10	29					S5596	009	0	2018	Georgia		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	010	0		29	10	S5596_010_0	1			1		06/01/2017	2018.03	06/01/2017 01:56:47 PM Eastern Daylight Time		06/01/2017 01:19:59 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bcbsga.com/shop	BCBSGa Blue MedicareRx Plus (PDP)	10	29					S5596	010	0	2018	Georgia		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	011	0		29	10	S5596_011_0	1			1		06/01/2017	2018.03	06/01/2017 01:57:54 PM Eastern Daylight Time		06/01/2017 01:20:51 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bcbsga.com/shop	BCBSGa Blue MedicareRx Premier (PDP)	10	29					S5596	011	0	2018	Georgia		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	013	0		29	10	S5596_013_0	1			1		06/02/2017	2018.03	06/02/2017 09:55:42 AM Eastern Daylight Time		06/01/2017 01:21:42 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	013	0	2018	Ohio		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	014	0		29	10	S5596_014_0	1			1		06/01/2017	2018.03	06/01/2017 01:59:41 PM Eastern Daylight Time		06/01/2017 01:22:35 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	014	0	2018	Ohio		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	015	0		29	10	S5596_015_0	1			1		06/01/2017	2018.03	06/01/2017 02:00:50 PM Eastern Daylight Time		06/01/2017 01:23:24 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	015	0	2018	Ohio		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	017	0		29	10	S5596_017_0	1			1		06/01/2017	2018.03	06/01/2017 02:01:41 PM Eastern Daylight Time		06/01/2017 01:24:14 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	017	0	2018	Indiana and Kentucky		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	018	0		29	10	S5596_018_0	1			1		06/01/2017	2018.03	06/01/2017 02:02:16 PM Eastern Daylight Time		06/01/2017 01:25:05 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	018	0	2018	Indiana and Kentucky		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	019	0		29	10	S5596_019_0	1			1		06/01/2017	2018.03	06/01/2017 02:03:11 PM Eastern Daylight Time		06/01/2017 01:25:55 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	019	0	2018	Indiana and Kentucky		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	033	0		29	10	S5596_033_0	1			1		06/01/2017	2018.03	06/01/2017 02:03:42 PM Eastern Daylight Time		06/01/2017 01:26:48 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/ca/shop	Anthem Blue Cross MedicareRx Standard (PDP)	10	29					S5596	033	0	2018	California		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	034	0		29	10	S5596_034_0	2			1		06/02/2017	2018.03	06/02/2017 09:34:35 AM Eastern Daylight Time		06/01/2017 01:27:38 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/ca/shop	Anthem Blue Cross MedicareRx Plus (PDP)	10	29					S5596	034	0	2018	California		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	035	0		29	10	S5596_035_0	1			1		06/02/2017	2018.03	06/02/2017 09:35:25 AM Eastern Daylight Time		06/01/2017 01:28:28 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/ca/shop	Anthem Blue Cross MedicareRx Gold (PDP)	10	29					S5596	035	0	2018	California		2					2						www.anthem.com/shop	www.anthem.com/shop										(800)928-6201		(800)928-6201		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	043	0		29	10	S5596_043_0	1			1		06/01/2017	2018.03	06/01/2017 02:05:32 PM Eastern Daylight Time		06/01/2017 01:29:17 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Blue MedicareRx Value (PDP)	10	29					S5596	043	0	2018	Missouri		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	044	0		29	10	S5596_044_0	1			1		06/01/2017	2018.03	06/01/2017 02:06:07 PM Eastern Daylight Time		06/01/2017 01:30:08 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Blue MedicareRx Plus (PDP)	10	29					S5596	044	0	2018	Missouri		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	045	0		29	10	S5596_045_0	1			1		06/02/2017	2018.03	06/02/2017 09:36:29 AM Eastern Daylight Time		06/01/2017 01:30:57 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Blue MedicareRx Premier (PDP)	10	29					S5596	045	0	2018	Missouri		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	046	0		29	10	S5596_046_0	1			1		06/01/2017	2018.03	06/01/2017 02:07:27 PM Eastern Daylight Time		06/01/2017 01:31:51 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	046	0	2018	Maine and New Hampshire		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	056	0		29	10	S5596_056_0	1			1		06/01/2017	2018.03	06/01/2017 02:08:00 PM Eastern Daylight Time		06/01/2017 01:32:41 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	056	0	2018	Wisconsin		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	057	0		29	10	S5596_057_0	1			1		06/01/2017	2018.03	06/01/2017 02:08:45 PM Eastern Daylight Time		06/01/2017 01:33:32 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	057	0	2018	Wisconsin		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	058	0		29	10	S5596_058_0	1			1		06/01/2017	2018.03	06/01/2017 02:10:46 PM Eastern Daylight Time		06/01/2017 01:34:22 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	058	0	2018	Wisconsin		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	059	0		29	10	S5596_059_0	1			1		06/01/2017	2018.03	06/01/2017 02:11:25 PM Eastern Daylight Time		06/01/2017 01:35:12 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	059	0	2018	Colorado		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	060	0		29	10	S5596_060_0	1			1		06/01/2017	2018.03	06/01/2017 02:12:03 PM Eastern Daylight Time		06/01/2017 01:36:02 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	060	0	2018	Colorado		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	061	0		29	10	S5596_061_0	1			1		06/01/2017	2018.03	06/01/2017 02:13:35 PM Eastern Daylight Time		06/01/2017 01:36:55 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	061	0	2018	Colorado		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	062	0		29	10	S5596_062_0	1			1		06/01/2017	2018.03	06/01/2017 02:14:20 PM Eastern Daylight Time		06/01/2017 01:37:45 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Standard (PDP)	10	29					S5596	062	0	2018	Nevada		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	063	0		29	10	S5596_063_0	1			1		06/01/2017	2018.03	06/01/2017 02:15:20 PM Eastern Daylight Time		06/01/2017 01:38:36 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Plus (PDP)	10	29					S5596	063	0	2018	Nevada		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	064	0		29	10	S5596_064_0	1			1		06/01/2017	2018.03	06/01/2017 02:17:47 PM Eastern Daylight Time		06/01/2017 10:35:32 AM Eastern Daylight Time			06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Anthem Blue MedicareRx Premier (PDP)	10	29					S5596	064	0	2018	Nevada		2					2						www.anthem.com/shop	www.anthem.com/shop										(866)755-2776		(866)755-2776		(800)261-8667		(800)261-8667										(711)-		(711)-		(711)-		(711)-																
S5596	803	0		29	10	S5596_803_0	1			1		06/02/2017	2018.03	06/02/2017 04:27:48 PM Eastern Daylight Time					06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Blue MedicareRx (PDP)	10	29					S5596	803	0	2018	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1					2						www.anthem.com/shop	www.anthem.com/shop										(866)470-6265		(866)470-6265		(866)646-2436		(866)646-2436										(711)-		(711)-		(711)-		(711)-																
S5596	804	0		29	10	S5596_804_0	1			1		06/02/2017	2018.03	06/02/2017 04:27:54 PM Eastern Daylight Time					06/02/2017 04:30:24 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.anthem.com/shop	Blue MedicareRx (PDP)	10	29					S5596	804	0	2018	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1					2						www.anthem.com/shop	www.anthem.com/shop										(866)470-6265		(866)470-6265		(866)646-2436		(866)646-2436										(711)-		(711)-		(711)-		(711)-																
S5601	002	0		29	10	S5601_002_0	2			1		06/02/2017	2018.03	06/02/2017 09:14:51 AM Eastern Daylight Time		06/01/2017 04:48:52 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	002	0	2018	Northern New England SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	003	0		29	10	S5601_003_0	3			1		06/05/2017	2018.03	06/05/2017 09:00:13 AM Eastern Daylight Time		06/01/2017 05:50:02 PM Eastern Daylight Time			06/05/2017 09:03:37 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	003	0	2018	Northern New England SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	004	0		29	10	S5601_004_0	1			1		05/31/2017	2018.03	05/31/2017 12:33:08 PM Eastern Daylight Time		06/01/2017 04:50:37 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	004	0	2018	Central New England SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	005	0		29	10	S5601_005_0	1			1		06/01/2017	2018.03	06/01/2017 01:21:51 PM Eastern Daylight Time		06/01/2017 05:51:48 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	005	0	2018	Central New England SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	006	0		29	10	S5601_006_0	1			1		05/31/2017	2018.03	05/31/2017 09:07:41 AM Eastern Daylight Time		06/01/2017 04:52:26 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	006	0	2018	New York SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	007	0		29	10	S5601_007_0	1			1		06/01/2017	2018.03	06/01/2017 01:22:03 PM Eastern Daylight Time		06/01/2017 05:53:33 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	007	0	2018	New York SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	008	0		29	10	S5601_008_0	1			1		05/31/2017	2018.03	05/31/2017 09:08:11 AM Eastern Daylight Time		06/01/2017 04:54:13 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	008	0	2018	New Jersey SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	009	0		29	10	S5601_009_0	1			1		06/01/2017	2018.03	06/01/2017 01:22:16 PM Eastern Daylight Time		06/01/2017 05:55:18 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	009	0	2018	New Jersey SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	010	0		29	10	S5601_010_0	1			1		05/31/2017	2018.03	05/31/2017 09:08:47 AM Eastern Daylight Time		06/01/2017 04:56:02 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	010	0	2018	Mid-Atlantic SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	011	0		29	10	S5601_011_0	1			1		06/01/2017	2018.03	06/01/2017 01:23:00 PM Eastern Daylight Time		06/01/2017 05:57:05 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	011	0	2018	Mid-Atlantic SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	012	0		29	10	S5601_012_0	1			1		05/31/2017	2018.03	05/31/2017 09:09:17 AM Eastern Daylight Time		06/01/2017 04:57:53 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	012	0	2018	Pennsylvania, West Virginia SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	013	0		29	10	S5601_013_0	1			1		06/01/2017	2018.03	06/01/2017 01:23:11 PM Eastern Daylight Time		06/01/2017 05:58:50 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	013	0	2018	Pennsylvania, West Virginia SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	014	0		29	10	S5601_014_0	1			1		05/31/2017	2018.03	05/31/2017 09:09:47 AM Eastern Daylight Time		06/01/2017 04:59:41 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	014	0	2018	Virginia SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	015	0		29	10	S5601_015_0	1			1		06/01/2017	2018.03	06/01/2017 01:23:23 PM Eastern Daylight Time		06/01/2017 06:00:34 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	015	0	2018	Virginia SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	016	0		29	10	S5601_016_0	1			1		05/31/2017	2018.03	05/31/2017 09:10:17 AM Eastern Daylight Time		06/01/2017 05:01:27 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	016	0	2018	North Carolina SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	017	0		29	10	S5601_017_0	1			1		06/01/2017	2018.03	06/01/2017 01:24:32 PM Eastern Daylight Time		06/01/2017 06:02:21 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	017	0	2018	North Carolina SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	018	0		29	10	S5601_018_0	1			1		05/31/2017	2018.03	05/31/2017 09:10:44 AM Eastern Daylight Time		06/01/2017 05:03:15 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	018	0	2018	South Carolina SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	019	0		29	10	S5601_019_0	1			1		06/01/2017	2018.03	06/01/2017 01:24:43 PM Eastern Daylight Time		06/01/2017 06:04:05 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	019	0	2018	South Carolina SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	020	0		29	10	S5601_020_0	1			1		05/31/2017	2018.03	05/31/2017 09:11:24 AM Eastern Daylight Time		06/01/2017 05:05:01 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	020	0	2018	Georgia SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	021	0		29	10	S5601_021_0	1			1		06/01/2017	2018.03	06/01/2017 01:24:55 PM Eastern Daylight Time		06/01/2017 06:05:51 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	021	0	2018	Georgia SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	022	0		29	10	S5601_022_0	1			1		05/31/2017	2018.03	05/31/2017 09:11:50 AM Eastern Daylight Time		06/01/2017 05:06:52 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	022	0	2018	Florida SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	023	0		29	10	S5601_023_0	1			1		06/01/2017	2018.03	06/01/2017 01:25:06 PM Eastern Daylight Time		06/01/2017 06:07:37 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	023	0	2018	Florida SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	024	0		29	10	S5601_024_0	1			1		05/31/2017	2018.03	05/31/2017 09:12:21 AM Eastern Daylight Time		06/01/2017 05:08:39 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	024	0	2018	Alabama, Tennessee SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	025	0		29	10	S5601_025_0	1			1		06/01/2017	2018.03	06/01/2017 01:25:20 PM Eastern Daylight Time		06/01/2017 06:09:24 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	025	0	2018	Alabama, Tennessee SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	026	0		29	10	S5601_026_0	1			1		05/31/2017	2018.03	05/31/2017 09:12:53 AM Eastern Daylight Time		06/01/2017 05:10:28 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	026	0	2018	Michigan SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	027	0		29	10	S5601_027_0	1			1		06/01/2017	2018.03	06/01/2017 01:25:31 PM Eastern Daylight Time		06/01/2017 06:11:10 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	027	0	2018	Michigan SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	028	0		29	10	S5601_028_0	1			1		05/31/2017	2018.03	05/31/2017 09:25:57 AM Eastern Daylight Time		06/01/2017 05:12:17 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	028	0	2018	Ohio SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	029	0		29	10	S5601_029_0	1			1		06/01/2017	2018.03	06/01/2017 01:25:42 PM Eastern Daylight Time		06/01/2017 06:12:56 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	029	0	2018	Ohio SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	030	0		29	10	S5601_030_0	1			1		05/31/2017	2018.03	05/31/2017 09:26:24 AM Eastern Daylight Time		06/01/2017 05:14:04 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	030	0	2018	Indiana, Kentucky SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	031	0		29	10	S5601_031_0	1			1		06/01/2017	2018.03	06/01/2017 01:25:54 PM Eastern Daylight Time		06/01/2017 06:14:41 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	031	0	2018	Indiana, Kentucky SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	032	0		29	10	S5601_032_0	1			1		05/31/2017	2018.03	05/31/2017 09:26:51 AM Eastern Daylight Time		06/01/2017 05:15:52 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	032	0	2018	Wisconsin SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	033	0		29	10	S5601_033_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:05 PM Eastern Daylight Time		06/01/2017 06:16:26 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	033	0	2018	Wisconsin SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	034	0		29	10	S5601_034_0	1			1		05/31/2017	2018.03	05/31/2017 09:27:25 AM Eastern Daylight Time		06/01/2017 05:17:39 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	034	0	2018	Illinois SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	035	0		29	10	S5601_035_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:16 PM Eastern Daylight Time		06/01/2017 06:18:12 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	035	0	2018	Illinois SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	036	0		29	10	S5601_036_0	1			1		05/31/2017	2018.03	05/31/2017 09:27:53 AM Eastern Daylight Time		06/01/2017 05:19:26 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	036	0	2018	Missouri SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	037	0		29	10	S5601_037_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:27 PM Eastern Daylight Time		06/01/2017 06:19:58 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	037	0	2018	Missouri SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	038	0		29	10	S5601_038_0	1			1		05/31/2017	2018.03	05/31/2017 03:22:56 PM Eastern Daylight Time		06/01/2017 05:21:11 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	038	0	2018	Arkansas SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	040	0		29	10	S5601_040_0	1			1		05/31/2017	2018.03	05/31/2017 09:28:48 AM Eastern Daylight Time		06/01/2017 05:23:14 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	040	0	2018	Mississippi SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	041	0		29	10	S5601_041_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:37 PM Eastern Daylight Time		06/01/2017 06:23:29 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	041	0	2018	Mississippi SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	042	0		29	10	S5601_042_0	1			1		05/31/2017	2018.03	05/31/2017 09:29:18 AM Eastern Daylight Time		06/01/2017 05:25:04 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	042	0	2018	Louisiana SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	044	0		29	10	S5601_044_0	1			1		05/31/2017	2018.03	05/31/2017 09:29:45 AM Eastern Daylight Time		06/01/2017 05:26:51 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	044	0	2018	Texas SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	045	0		29	10	S5601_045_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:48 PM Eastern Daylight Time		06/01/2017 06:27:02 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	045	0	2018	Texas SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	046	0		29	10	S5601_046_0	1			1		05/31/2017	2018.03	05/31/2017 09:30:13 AM Eastern Daylight Time		06/01/2017 05:28:38 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	046	0	2018	Oklahoma SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	048	0		29	10	S5601_048_0	1			1		05/31/2017	2018.03	05/31/2017 09:30:43 AM Eastern Daylight Time		06/01/2017 05:30:25 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	048	0	2018	Kansas SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	049	0		29	10	S5601_049_0	1			1		06/01/2017	2018.03	06/01/2017 01:26:58 PM Eastern Daylight Time		06/01/2017 06:30:34 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	049	0	2018	Kansas SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	050	0		29	10	S5601_050_0	1			1		05/31/2017	2018.03	05/31/2017 09:31:10 AM Eastern Daylight Time		06/01/2017 05:32:12 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	050	0	2018	Upper Midwest and N. Plains SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	051	0		29	10	S5601_051_0	1			1		06/01/2017	2018.03	06/01/2017 01:27:11 PM Eastern Daylight Time		06/01/2017 06:32:21 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	051	0	2018	Upper Midwest and N. Plains SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	052	0		29	10	S5601_052_0	1			1		05/31/2017	2018.03	05/31/2017 09:59:10 AM Eastern Daylight Time		06/01/2017 05:33:58 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	052	0	2018	New Mexico SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	053	0		29	10	S5601_053_0	1			1		06/01/2017	2018.03	06/01/2017 01:27:21 PM Eastern Daylight Time		06/01/2017 06:34:05 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	053	0	2018	New Mexico SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	054	0		29	10	S5601_054_0	1			1		05/31/2017	2018.03	05/31/2017 09:32:04 AM Eastern Daylight Time		06/01/2017 05:35:44 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	054	0	2018	Colorado SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	055	0		29	10	S5601_055_0	1			1		06/01/2017	2018.03	06/01/2017 01:27:32 PM Eastern Daylight Time		06/01/2017 06:35:54 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	055	0	2018	Colorado SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	056	0		29	10	S5601_056_0	1			1		05/31/2017	2018.03	05/31/2017 09:32:33 AM Eastern Daylight Time		06/01/2017 05:37:32 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	056	0	2018	Arizona SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	057	0		29	10	S5601_057_0	1			1		06/01/2017	2018.03	06/01/2017 01:27:42 PM Eastern Daylight Time		06/01/2017 06:37:41 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	057	0	2018	Arizona SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	058	0		29	10	S5601_058_0	1			1		05/31/2017	2018.03	05/31/2017 09:33:00 AM Eastern Daylight Time		06/01/2017 05:39:18 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	058	0	2018	Nevada SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	059	0		29	10	S5601_059_0	1			1		06/01/2017	2018.03	06/01/2017 01:27:53 PM Eastern Daylight Time		06/01/2017 06:39:27 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	059	0	2018	Nevada SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	060	0		29	10	S5601_060_0	1			1		05/31/2017	2018.03	05/31/2017 09:33:28 AM Eastern Daylight Time		06/01/2017 05:41:05 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	060	0	2018	Oregon, Washington SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	061	0		29	10	S5601_061_0	1			1		06/01/2017	2018.03	06/01/2017 01:28:02 PM Eastern Daylight Time		06/01/2017 06:41:15 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	061	0	2018	Oregon, Washington SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	062	0		29	10	S5601_062_0	1			1		05/31/2017	2018.03	05/31/2017 09:33:55 AM Eastern Daylight Time		06/01/2017 05:42:53 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	062	0	2018	Idaho, Utah SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	063	0		29	10	S5601_063_0	1			1		06/01/2017	2018.03	06/01/2017 01:28:13 PM Eastern Daylight Time		06/01/2017 06:43:01 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	063	0	2018	Idaho, Utah SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	064	0		29	10	S5601_064_0	1			1		05/31/2017	2018.03	05/31/2017 09:34:23 AM Eastern Daylight Time		06/01/2017 05:44:40 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	064	0	2018	California SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	065	0		29	10	S5601_065_0	1			1		06/01/2017	2018.03	06/01/2017 01:28:24 PM Eastern Daylight Time		06/01/2017 06:44:46 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	065	0	2018	California SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	066	0		29	10	S5601_066_0	1			1		05/31/2017	2018.03	05/31/2017 09:34:56 AM Eastern Daylight Time		06/01/2017 05:46:28 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	066	0	2018	Hawaii SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	067	0		29	10	S5601_067_0	2			1		06/05/2017	2018.03	06/05/2017 08:59:48 AM Eastern Daylight Time		06/01/2017 06:46:36 PM Eastern Daylight Time			06/05/2017 09:03:37 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	067	0	2018	Hawaii SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	068	0		29	10	S5601_068_0	1			1		06/02/2017	2018.03	06/02/2017 10:44:53 AM Eastern Daylight Time		06/01/2017 05:48:16 PM Eastern Daylight Time			06/02/2017 10:50:12 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Choice (PDP)	10	29					S5601	068	0	2018	Alaska SilverScript Choice		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	107	0		29	10	S5601_107_0	1			1		06/01/2017	2018.03	06/01/2017 01:28:46 PM Eastern Daylight Time		06/01/2017 06:21:43 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	107	0	2018	Arkansas SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	108	0		29	10	S5601_108_0	1			1		06/01/2017	2018.03	06/01/2017 01:28:56 PM Eastern Daylight Time		06/01/2017 06:25:16 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	108	0	2018	Louisiana SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	109	0		29	10	S5601_109_0	1			1		06/01/2017	2018.03	06/01/2017 01:29:07 PM Eastern Daylight Time		06/01/2017 06:28:49 PM Eastern Daylight Time			06/02/2017 10:57:20 AM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Plus (PDP)	10	29					S5601	109	0	2018	Oklahoma SilverScript Plus		2					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	801	0		29	10	S5601_801_0	1			1		06/02/2017	2018.03	06/02/2017 12:23:51 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Calendar (PDP)	10	29					S5601	801	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	802	0		29	10	S5601_802_0	1			1		06/02/2017	2018.03	06/02/2017 12:23:56 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Non-Calendar (PDP)	10	29					S5601	802	0	2018	National SilverScript Group - Non-Calendar		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	803	0		29	10	S5601_803_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:01 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript FI Group - 5 Tier - Calendar (PDP)	10	29					S5601	803	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	804	0		29	10	S5601_804_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:06 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript FI Group - 5 Tier - Calendar (PDP)	10	29					S5601	804	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	805	0		29	10	S5601_805_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:11 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	805	0	2018	National		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	806	0		29	10	S5601_806_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:15 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	806	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	807	0		29	10	S5601_807_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:19 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Calendar (PDP)	10	29					S5601	807	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	808	0		29	10	S5601_808_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:23 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Non Calendar (PDP)	10	29					S5601	808	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	809	0		29	10	S5601_809_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:27 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Calendar (PDP)	10	29					S5601	809	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	810	0		29	10	S5601_810_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:31 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - 5 Tier - Non Calendar (PDP)	10	29					S5601	810	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	811	0		29	10	S5601_811_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:36 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript Group - State of NY (PDP)	10	29					S5601	811	0	2018	National		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	812	0		29	10	S5601_812_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:40 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	812	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	813	0		29	10	S5601_813_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:43 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	813	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	814	0		29	10	S5601_814_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:47 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	814	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5601	815	0		29	10	S5601_815_0	1			1		06/02/2017	2018.03	06/02/2017 12:24:51 PM Eastern Daylight Time					06/02/2017 12:25:14 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript	https://www.silverscript.com	SilverScript SF Group - 5 Tier - Calendar (PDP)	10	29					S5601	815	0	2018	National SilverScript Group		1					2						www.SilverScript.com	www.SilverScript.com										(866)235-5660		(866)235-5660		(866)552-6106		(866)552-6106										(711)-		(711)-		(711)-		(711)-																
S5609	001	0		29	10	S5609_001_0	7			1		05/18/2017	2018.03	05/18/2017 04:25:38 PM Mountain Daylight Time		06/04/2017 02:25:04 PM Mountain Daylight Time			06/04/2017 10:43:30 PM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris Medicare Script Basic (PDP)	10	29					S5609	001	0	2018	Region of Oregon and Washington		2					2						www.asuris.com/medicare	www.asuris.com/medicare										(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172										(711)-		(711)-		(711)-		(711)-																
S5609	002	0		29	10	S5609_002_0	7			1		05/12/2017	2018.03	05/12/2017 12:09:05 PM Mountain Daylight Time		06/04/2017 02:26:01 PM Mountain Daylight Time			06/04/2017 10:43:30 PM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris Medicare Script Enhanced (PDP)	10	29					S5609	002	0	2018	Region of Oregon and Washington		2					2						www.asuris.com/medicare	www.asuris.com/medicare										(800)541-8981		(800)541-8981		(888)369-3172		(888)369-3172										(711)-		(711)-		(711)-		(711)-																
S5609	802	0		29	10	S5609_802_0	3			1		05/15/2017	2018.03	05/15/2017 03:18:04 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicare	Asuris Medicare Script (PDP)	10	29					S5609	802	0	2018	Nationwide except territories		1					2						www.asuris.com/medicare	www.asuris.com/medicare										(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-																
S5617	003	0		29	10	S5617_003_0	5			1		05/17/2017	2018.03	05/17/2017 02:17:31 PM Central Daylight Time		06/02/2017 12:04:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	003	0	2018	New Hampshire and Maine		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	008	0		29	10	S5617_008_0	3			1		05/18/2017	2018.03	05/18/2017 10:38:50 AM Central Daylight Time		06/02/2017 12:05:24 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	008	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	013	0		29	10	S5617_013_0	3			1		05/17/2017	2018.03	05/17/2017 04:31:39 PM Central Daylight Time		06/02/2017 12:05:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	013	0	2018	New York		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	018	0		29	10	S5617_018_0	3			1		05/17/2017	2018.03	05/17/2017 02:48:15 PM Central Daylight Time		06/02/2017 12:06:16 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	018	0	2018	New Jersey		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	053	0		29	10	S5617_053_0	3			1		05/18/2017	2018.03	05/18/2017 11:33:26 AM Central Daylight Time		06/02/2017 12:06:42 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	053	0	2018	Florida		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	068	0		29	10	S5617_068_0	3			1		05/17/2017	2018.03	05/17/2017 02:29:30 PM Central Daylight Time		06/02/2017 12:07:08 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	068	0	2018	Ohio		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	088	0		29	10	S5617_088_0	3			1		05/18/2017	2018.03	05/18/2017 11:48:09 AM Central Daylight Time		06/02/2017 12:07:34 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	088	0	2018	Missouri		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	103	0		29	10	S5617_103_0	3			1		05/17/2017	2018.03	05/17/2017 02:51:08 PM Central Daylight Time		06/02/2017 12:08:00 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	103	0	2018	Louisiana		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	108	0		29	10	S5617_108_0	3			1		05/17/2017	2018.03	05/17/2017 04:35:38 PM Central Daylight Time		06/02/2017 12:08:28 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	108	0	2018	Texas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	113	0		29	10	S5617_113_0	3			1		05/17/2017	2018.03	05/17/2017 02:52:29 PM Central Daylight Time		06/02/2017 12:08:54 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	113	0	2018	Oklahoma		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	118	0		29	10	S5617_118_0	3			1		05/17/2017	2018.03	05/17/2017 04:09:54 PM Central Daylight Time		06/02/2017 12:09:20 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	118	0	2018	Kansas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	123	0		29	10	S5617_123_0	3			1		05/17/2017	2018.03	05/17/2017 03:01:50 PM Central Daylight Time		06/02/2017 12:09:48 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	123	0	2018	IA, MN, MT, ND, NE, SD, WY		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	128	0		29	10	S5617_128_0	3			1		05/17/2017	2018.03	05/17/2017 02:32:43 PM Central Daylight Time		06/02/2017 12:10:14 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	128	0	2018	New Mexico		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	133	0		29	10	S5617_133_0	3			1		05/18/2017	2018.03	05/18/2017 12:20:43 PM Central Daylight Time		06/02/2017 12:10:40 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	133	0	2018	Colorado		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	138	0		29	10	S5617_138_0	3			1		05/17/2017	2018.03	05/17/2017 04:38:24 PM Central Daylight Time		06/02/2017 12:11:06 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	138	0	2018	Arizona		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	143	0		29	10	S5617_143_0	3			1		05/18/2017	2018.03	05/18/2017 12:25:47 PM Central Daylight Time		06/02/2017 12:11:32 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	143	0	2018	Nevada		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	148	0		29	10	S5617_148_0	4			1		05/17/2017	2018.03	05/17/2017 02:30:42 PM Central Daylight Time		07/21/2017 02:35:25 PM Central Daylight Time			07/21/2017 02:50:51 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	148	0	2018	Oregon and Washington		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	153	0		29	10	S5617_153_0	3			1		05/17/2017	2018.03	05/17/2017 02:53:42 PM Central Daylight Time		06/02/2017 12:12:24 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	153	0	2018	Idaho and Utah		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	158	0		29	10	S5617_158_0	3			1		05/17/2017	2018.03	05/17/2017 04:14:04 PM Central Daylight Time		06/02/2017 12:12:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	158	0	2018	California		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	163	0		29	10	S5617_163_0	3			1		05/17/2017	2018.03	05/17/2017 04:42:13 PM Central Daylight Time		06/02/2017 12:13:16 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	163	0	2018	Hawaii		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	214	0		29	10	S5617_214_0	3			1		05/17/2017	2018.03	05/17/2017 05:08:37 PM Central Daylight Time		06/02/2017 12:13:42 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	214	0	2018	Delaware, Maryland and District of Columbia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	215	0		29	10	S5617_215_0	3			1		05/17/2017	2018.03	05/17/2017 02:35:08 PM Central Daylight Time		06/02/2017 12:14:08 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	215	0	2018	Pennsylvania and West Virginia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	216	0		29	10	S5617_216_0	3			1		05/17/2017	2018.03	05/17/2017 02:37:47 PM Central Daylight Time		06/02/2017 12:14:36 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	216	0	2018	Virginia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	217	0		29	10	S5617_217_0	3			1		05/17/2017	2018.03	05/17/2017 02:56:04 PM Central Daylight Time		06/02/2017 12:15:04 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	217	0	2018	North Carolina		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	218	0		29	10	S5617_218_0	3			1		05/17/2017	2018.03	05/17/2017 02:57:14 PM Central Daylight Time		06/02/2017 12:15:32 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	218	0	2018	South Carolina		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	219	0		29	10	S5617_219_0	3			1		05/18/2017	2018.03	05/18/2017 12:49:29 PM Central Daylight Time		06/02/2017 12:15:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	219	0	2018	Georgia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	220	0		29	10	S5617_220_0	3			1		05/17/2017	2018.03	05/17/2017 02:58:55 PM Central Daylight Time		06/02/2017 12:16:26 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	220	0	2018	Alabama and Tennessee		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	221	0		29	10	S5617_221_0	3			1		05/17/2017	2018.03	05/17/2017 02:40:07 PM Central Daylight Time		06/02/2017 12:16:54 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	221	0	2018	Michigan		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	222	0		29	10	S5617_222_0	3			1		05/17/2017	2018.03	05/17/2017 02:39:06 PM Central Daylight Time		06/02/2017 12:17:22 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	222	0	2018	Indiana and Kentucky		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	223	0		29	10	S5617_223_0	3			1		05/17/2017	2018.03	05/17/2017 04:15:38 PM Central Daylight Time		06/02/2017 12:17:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	223	0	2018	Wisconsin		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	224	0		29	10	S5617_224_0	3			1		05/17/2017	2018.03	05/17/2017 05:10:34 PM Central Daylight Time		06/02/2017 12:18:16 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	224	0	2018	Illinois		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	225	0		29	10	S5617_225_0	3			1		05/17/2017	2018.03	05/17/2017 04:16:37 PM Central Daylight Time		06/02/2017 12:18:40 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	225	0	2018	Arkansas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	226	0		29	10	S5617_226_0	3			1		05/17/2017	2018.03	05/17/2017 02:43:51 PM Central Daylight Time		06/02/2017 12:19:06 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	226	0	2018	Mississippi		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	227	0		29	10	S5617_227_0	3			1		05/17/2017	2018.03	05/17/2017 05:12:40 PM Central Daylight Time		06/02/2017 12:19:32 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure (PDP)	10	29					S5617	227	0	2018	Alaska		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	246	0		29	10	S5617_246_0	4			1		05/17/2017	2018.03	05/17/2017 10:26:43 PM Central Daylight Time		06/02/2017 12:19:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	246	0	2018	New Hampshire and Maine		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	247	0		29	10	S5617_247_0	2			1		05/17/2017	2018.03	05/17/2017 10:28:45 PM Central Daylight Time		06/02/2017 12:20:24 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	247	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	248	0		29	10	S5617_248_0	2			1		05/17/2017	2018.03	05/17/2017 10:29:21 PM Central Daylight Time		06/02/2017 12:20:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	248	0	2018	New York		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	249	0		29	10	S5617_249_0	2			1		05/17/2017	2018.03	05/17/2017 10:30:00 PM Central Daylight Time		06/02/2017 12:21:16 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	249	0	2018	New Jersey		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	250	0		29	10	S5617_250_0	2			1		05/17/2017	2018.03	05/17/2017 10:30:32 PM Central Daylight Time		06/02/2017 12:21:42 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	250	0	2018	Delaware, Maryland and District of Columbia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	251	0		29	10	S5617_251_0	2			1		05/17/2017	2018.03	05/17/2017 10:31:09 PM Central Daylight Time		06/02/2017 12:22:06 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	251	0	2018	Pennsylvania and West Virginia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	252	0		29	10	S5617_252_0	2			1		05/17/2017	2018.03	05/17/2017 10:31:40 PM Central Daylight Time		06/02/2017 12:22:32 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	252	0	2018	Virginia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	253	0		29	10	S5617_253_0	2			1		05/17/2017	2018.03	05/17/2017 10:32:09 PM Central Daylight Time		06/02/2017 12:22:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	253	0	2018	North Carolina		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	254	0		29	10	S5617_254_0	2			1		05/17/2017	2018.03	05/17/2017 10:32:46 PM Central Daylight Time		06/02/2017 12:23:22 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	254	0	2018	South Carolina		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	255	0		29	10	S5617_255_0	2			1		05/17/2017	2018.03	05/17/2017 10:33:19 PM Central Daylight Time		06/02/2017 12:23:48 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	255	0	2018	Georgia		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	256	0		29	10	S5617_256_0	2			1		05/17/2017	2018.03	05/17/2017 10:33:48 PM Central Daylight Time		06/02/2017 12:24:14 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	256	0	2018	Florida		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	257	0		29	10	S5617_257_0	2			1		05/17/2017	2018.03	05/17/2017 10:34:26 PM Central Daylight Time		06/02/2017 12:24:40 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	257	0	2018	Alabama and Tennessee		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	258	0		29	10	S5617_258_0	2			1		05/17/2017	2018.03	05/17/2017 10:34:56 PM Central Daylight Time		06/02/2017 12:25:06 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	258	0	2018	Michigan		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	259	0		29	10	S5617_259_0	2			1		05/17/2017	2018.03	05/17/2017 10:35:34 PM Central Daylight Time		06/02/2017 12:25:32 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	259	0	2018	Ohio		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	260	0		29	10	S5617_260_0	2			1		05/17/2017	2018.03	05/17/2017 10:36:06 PM Central Daylight Time		06/02/2017 12:25:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	260	0	2018	Indiana and Kentucky		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	261	0		29	10	S5617_261_0	2			1		05/17/2017	2018.03	05/17/2017 10:36:42 PM Central Daylight Time		06/02/2017 12:26:24 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	261	0	2018	Wisconsin		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	262	0		29	10	S5617_262_0	2			1		05/17/2017	2018.03	05/17/2017 10:37:20 PM Central Daylight Time		06/02/2017 12:26:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	262	0	2018	Illinois		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	263	0		29	10	S5617_263_0	2			1		05/17/2017	2018.03	05/17/2017 10:37:49 PM Central Daylight Time		06/02/2017 12:27:16 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	263	0	2018	Missouri		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	264	0		29	10	S5617_264_0	2			1		05/17/2017	2018.03	05/17/2017 10:38:23 PM Central Daylight Time		06/02/2017 12:27:42 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	264	0	2018	Arkansas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	265	0		29	10	S5617_265_0	2			1		05/17/2017	2018.03	05/17/2017 10:38:50 PM Central Daylight Time		06/02/2017 12:28:10 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	265	0	2018	Mississippi		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	266	0		29	10	S5617_266_0	2			1		05/17/2017	2018.03	05/17/2017 10:39:22 PM Central Daylight Time		06/02/2017 12:28:38 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	266	0	2018	Louisiana		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	267	0		29	10	S5617_267_0	2			1		05/17/2017	2018.03	05/17/2017 10:39:53 PM Central Daylight Time		06/02/2017 12:29:06 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	267	0	2018	Texas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	268	0		29	10	S5617_268_0	2			1		05/17/2017	2018.03	05/17/2017 10:40:42 PM Central Daylight Time		06/02/2017 12:29:34 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	268	0	2018	Oklahoma		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	269	0		29	10	S5617_269_0	2			1		05/17/2017	2018.03	05/17/2017 10:41:15 PM Central Daylight Time		06/02/2017 12:30:02 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	269	0	2018	Kansas		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	270	0		29	10	S5617_270_0	2			1		05/17/2017	2018.03	05/17/2017 10:41:48 PM Central Daylight Time		06/02/2017 12:30:30 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	270	0	2018	IA, MN, MT, ND, SD, NE, WY		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	271	0		29	10	S5617_271_0	2			1		05/17/2017	2018.03	05/17/2017 10:42:24 PM Central Daylight Time		06/02/2017 12:31:00 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	271	0	2018	New Mexico		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	272	0		29	10	S5617_272_0	2			1		05/17/2017	2018.03	05/17/2017 10:42:54 PM Central Daylight Time		06/02/2017 12:31:30 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	272	0	2018	Colorado		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	273	0		29	10	S5617_273_0	2			1		05/17/2017	2018.03	05/17/2017 10:43:34 PM Central Daylight Time		06/02/2017 12:31:58 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	273	0	2018	Arizona		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	274	0		29	10	S5617_274_0	2			1		05/17/2017	2018.03	05/17/2017 10:44:12 PM Central Daylight Time		06/02/2017 12:32:26 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	274	0	2018	Nevada		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	275	0		29	10	S5617_275_0	2			1		05/17/2017	2018.03	05/17/2017 10:44:42 PM Central Daylight Time		06/02/2017 12:32:54 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	275	0	2018	Oregon and Washington		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	276	0		29	10	S5617_276_0	2			1		05/17/2017	2018.03	05/17/2017 10:45:06 PM Central Daylight Time		06/02/2017 12:33:22 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	276	0	2018	Idaho and Utah		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	277	0		29	10	S5617_277_0	2			1		05/17/2017	2018.03	05/17/2017 10:45:40 PM Central Daylight Time		06/02/2017 12:33:50 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	277	0	2018	California		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	278	0		29	10	S5617_278_0	2			1		05/17/2017	2018.03	05/17/2017 10:46:20 PM Central Daylight Time		06/02/2017 12:34:18 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	278	0	2018	Hawaii		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	279	0		29	10	S5617_279_0	2			1		05/17/2017	2018.03	05/17/2017 10:47:12 PM Central Daylight Time		06/02/2017 12:34:46 PM Central Daylight Time			06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Cigna-HealthSpring Rx Secure-Extra (PDP)	10	29					S5617	279	0	2018	Alaska		2					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)222-6700		(800)222-6700		(800)735-1459		(800)735-1459										(711)-		(711)-		(711)-		(711)-																
S5617	801	0		29	10	S5617_801_0	2			1		04/17/2017	2018.03	04/17/2017 02:33:56 PM Central Daylight Time					06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Employer Plan CY (PDP)	10	29					S5617	801	0	2018	Nationwide		1					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)558-9562		(800)558-9562		(800)558-9562		(800)558-9562										(711)-		(711)-		(711)-		(711)-																
S5617	802	0		29	10	S5617_802_0	2			1		04/17/2017	2018.03	04/17/2017 02:34:01 PM Central Daylight Time					06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Employer Plan NCY (PDP)	10	29					S5617	802	0	2018	Nationwide		1					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)558-9562		(800)558-9562		(800)558-9562		(800)558-9562										(711)-		(711)-		(711)-		(711)-																
S5617	805	0		29	10	S5617_805_0	2			1		04/17/2017	2018.03	04/17/2017 02:34:07 PM Central Daylight Time					06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Employer Plan CY (PDP)	10	29					S5617	805	0	2018	Nationwide		1					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)558-9562		(800)558-9562		(800)558-9562		(800)558-9562										(711)-		(711)-		(711)-		(711)-																
S5617	806	0		29	10	S5617_806_0	2			1		04/17/2017	2018.03	04/17/2017 02:34:12 PM Central Daylight Time					06/02/2017 04:05:21 PM Central Daylight Time	CIGNA HEALTH AND LIFE INSURANCE COMPANY	Cigna-HealthSpring Rx	www.cignahealthspring.com	Employer Plan NCY (PDP)	10	29					S5617	806	0	2018	Nationwide		1					2						www.cignahealthspring.com/PDPpharmacy	www.cignahealthspring.com/PDPformulary	www.cignahealthspring.com/PDPpharmacy									(800)558-9562		(800)558-9562		(800)558-9562		(800)558-9562										(711)-		(711)-		(711)-		(711)-																
S5660	104	0		29	10	S5660_104_0	1			1		05/29/2017	2018.03	05/29/2017 11:45:49 AM Eastern Daylight Time		05/31/2017 03:57:06 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	104	0	2018	Northern New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	105	0		29	10	S5660_105_0	1			1		05/26/2017	2018.03	05/26/2017 11:27:22 PM Eastern Daylight Time		05/31/2017 03:58:36 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	105	0	2018	Central New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	106	0		29	10	S5660_106_0	2			1		05/26/2017	2018.03	05/26/2017 11:55:43 PM Eastern Daylight Time		05/31/2017 03:59:54 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	106	0	2018	State of New Jersey		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	107	0		29	10	S5660_107_0	1			1		05/26/2017	2018.03	05/26/2017 11:26:36 PM Eastern Daylight Time		05/31/2017 05:09:28 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	107	0	2018	Mid-Atlantic		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	108	0		29	10	S5660_108_0	1			1		05/26/2017	2018.03	05/26/2017 11:26:14 PM Eastern Daylight Time		05/31/2017 04:01:10 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	108	0	2018	States of Pennsylvania and West Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	109	0		29	10	S5660_109_0	1			1		05/30/2017	2018.03	05/30/2017 11:41:40 AM Eastern Daylight Time		05/31/2017 04:01:58 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	109	0	2018	State of Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	110	0		29	10	S5660_110_0	1			1		05/30/2017	2018.03	05/30/2017 11:42:03 AM Eastern Daylight Time		05/31/2017 04:02:48 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	110	0	2018	State of North Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	111	0		29	10	S5660_111_0	1			1		05/26/2017	2018.03	05/26/2017 11:28:19 PM Eastern Daylight Time		05/31/2017 04:05:50 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	111	0	2018	State of South Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	112	0		29	10	S5660_112_0	1			1		05/30/2017	2018.03	05/30/2017 11:44:40 AM Eastern Daylight Time		05/31/2017 04:06:40 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	112	0	2018	State of Georgia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	113	0		29	10	S5660_113_0	1			1		05/26/2017	2018.03	05/26/2017 08:31:01 PM Eastern Daylight Time		05/31/2017 04:07:34 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	113	0	2018	State of Florida		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	114	0		29	10	S5660_114_0	1			1		05/26/2017	2018.03	05/26/2017 08:38:50 PM Eastern Daylight Time		05/31/2017 04:08:20 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	114	0	2018	States of Alabama and Tennessee		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	115	0		29	10	S5660_115_0	1			1		05/26/2017	2018.03	05/26/2017 08:46:06 PM Eastern Daylight Time		05/31/2017 04:09:26 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	115	0	2018	State of Michigan		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	116	0		29	10	S5660_116_0	1			1		05/26/2017	2018.03	05/26/2017 09:26:23 PM Eastern Daylight Time		05/31/2017 04:10:20 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	116	0	2018	State of Ohio		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	117	0		29	10	S5660_117_0	1			1		05/26/2017	2018.03	05/26/2017 09:32:45 PM Eastern Daylight Time		05/31/2017 04:11:14 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	117	0	2018	States of Indiana and Kentucky		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	118	0		29	10	S5660_118_0	1			1		05/26/2017	2018.03	05/26/2017 09:44:30 PM Eastern Daylight Time		05/31/2017 04:12:06 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	118	0	2018	State of Wisconsin		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	119	0		29	10	S5660_119_0	1			1		05/26/2017	2018.03	05/26/2017 09:46:06 PM Eastern Daylight Time		05/31/2017 04:12:54 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	119	0	2018	State of Illinois		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	120	0		29	10	S5660_120_0	1			1		05/26/2017	2018.03	05/26/2017 09:49:31 PM Eastern Daylight Time		05/31/2017 04:16:56 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	120	0	2018	State of Missouri		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	121	0		29	10	S5660_121_0	1			1		05/26/2017	2018.03	05/26/2017 09:54:40 PM Eastern Daylight Time		05/31/2017 04:17:52 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	121	0	2018	State of Arkansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	122	0		29	10	S5660_122_0	1			1		05/26/2017	2018.03	05/26/2017 10:03:24 PM Eastern Daylight Time		05/31/2017 04:18:44 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	122	0	2018	State of Mississippi		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	123	0		29	10	S5660_123_0	1			1		05/26/2017	2018.03	05/26/2017 10:07:33 PM Eastern Daylight Time		05/31/2017 04:19:32 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	123	0	2018	State of Louisiana		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	124	0		29	10	S5660_124_0	1			1		05/26/2017	2018.03	05/26/2017 10:11:05 PM Eastern Daylight Time		05/31/2017 04:20:22 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	124	0	2018	State of Texas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	125	0		29	10	S5660_125_0	1			1		05/26/2017	2018.03	05/26/2017 10:19:36 PM Eastern Daylight Time		05/31/2017 04:21:14 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	125	0	2018	State of Oklahoma		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	126	0		29	10	S5660_126_0	1			1		05/26/2017	2018.03	05/26/2017 10:24:46 PM Eastern Daylight Time		05/31/2017 04:22:08 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	126	0	2018	State of Kansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	127	0		29	10	S5660_127_0	1			1		05/26/2017	2018.03	05/26/2017 10:27:55 PM Eastern Daylight Time		05/31/2017 04:22:54 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	127	0	2018	Upper Midwest and Northern Plains		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	128	0		29	10	S5660_128_0	1			1		05/26/2017	2018.03	05/26/2017 10:31:43 PM Eastern Daylight Time		05/31/2017 04:23:44 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	128	0	2018	State of New Mexico		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	129	0		29	10	S5660_129_0	1			1		05/26/2017	2018.03	05/26/2017 10:37:16 PM Eastern Daylight Time		05/31/2017 04:25:28 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	129	0	2018	State of Colorado		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	130	0		29	10	S5660_130_0	1			1		05/26/2017	2018.03	05/26/2017 10:39:51 PM Eastern Daylight Time		05/31/2017 04:26:16 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	130	0	2018	State of Arizona		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	131	0		29	10	S5660_131_0	1			1		05/26/2017	2018.03	05/26/2017 10:43:22 PM Eastern Daylight Time		05/31/2017 04:27:04 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	131	0	2018	State of Nevada		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	132	0		29	10	S5660_132_0	1			1		05/26/2017	2018.03	05/26/2017 10:46:47 PM Eastern Daylight Time		05/31/2017 04:27:54 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	132	0	2018	States of Oregon and Washington		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	133	0		29	10	S5660_133_0	1			1		05/26/2017	2018.03	05/26/2017 10:58:23 PM Eastern Daylight Time		05/31/2017 04:28:48 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	133	0	2018	States of Idaho and Utah		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	134	0		29	10	S5660_134_0	1			1		05/26/2017	2018.03	05/26/2017 11:02:13 PM Eastern Daylight Time		05/31/2017 04:29:34 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	134	0	2018	State of California		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	135	0		29	10	S5660_135_0	1			1		05/26/2017	2018.03	05/26/2017 11:05:09 PM Eastern Daylight Time		05/31/2017 05:05:42 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	135	0	2018	State of Hawaii		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	136	0		29	10	S5660_136_0	1			1		05/26/2017	2018.03	05/26/2017 11:07:44 PM Eastern Daylight Time		05/31/2017 05:06:38 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	136	0	2018	State of Alaska		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	137	0		29	10	S5660_137_0	1			1		05/26/2017	2018.03	05/26/2017 11:09:58 PM Eastern Daylight Time		05/31/2017 05:07:30 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5660	137	0	2018	Puerto Rico		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	172	0		29	10	S5660_172_0	1			1		05/28/2017	2018.03	05/28/2017 05:34:41 PM Eastern Daylight Time		05/31/2017 05:12:04 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	172	0	2018	Northern New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	176	0		29	10	S5660_176_0	1			1		05/28/2017	2018.03	05/28/2017 05:34:58 PM Eastern Daylight Time		05/31/2017 05:13:22 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	176	0	2018	States of Pennsylvania and West Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	180	0		29	10	S5660_180_0	1			1		05/29/2017	2018.03	05/29/2017 11:46:48 AM Eastern Daylight Time		05/31/2017 05:14:18 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	180	0	2018	State of Georgia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	181	0		29	10	S5660_181_0	1			1		05/28/2017	2018.03	05/28/2017 05:36:56 PM Eastern Daylight Time		05/31/2017 05:15:08 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	181	0	2018	State of Florida		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	182	0		29	10	S5660_182_0	1			1		05/28/2017	2018.03	05/28/2017 05:37:14 PM Eastern Daylight Time		05/31/2017 05:16:08 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	182	0	2018	States of Alabama and Tennessee		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	183	0		29	10	S5660_183_0	1			1		05/28/2017	2018.03	05/28/2017 05:37:32 PM Eastern Daylight Time		05/31/2017 05:16:58 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	183	0	2018	State of Michigan		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	184	0		29	10	S5660_184_0	1			1		05/28/2017	2018.03	05/28/2017 05:38:51 PM Eastern Daylight Time		05/31/2017 05:18:04 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	184	0	2018	State of Ohio		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	185	0		29	10	S5660_185_0	1			1		05/28/2017	2018.03	05/28/2017 05:41:00 PM Eastern Daylight Time		05/31/2017 05:18:56 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	185	0	2018	States of Indiana and Kentucky		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	186	0		29	10	S5660_186_0	1			1		05/28/2017	2018.03	05/28/2017 05:41:51 PM Eastern Daylight Time		05/31/2017 05:20:40 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	186	0	2018	State of Wisconsin		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	187	0		29	10	S5660_187_0	1			1		05/28/2017	2018.03	05/28/2017 05:43:08 PM Eastern Daylight Time		05/31/2017 05:21:32 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	187	0	2018	State of Illinois		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	190	0		29	10	S5660_190_0	1			1		05/28/2017	2018.03	05/28/2017 05:43:21 PM Eastern Daylight Time		05/31/2017 05:22:56 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	190	0	2018	State of Mississippi		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	192	0		29	10	S5660_192_0	1			1		05/28/2017	2018.03	05/28/2017 05:46:35 PM Eastern Daylight Time		05/31/2017 05:23:46 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	192	0	2018	State of Texas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	194	0		29	10	S5660_194_0	1			1		05/28/2017	2018.03	05/28/2017 05:46:48 PM Eastern Daylight Time		05/31/2017 05:26:34 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	194	0	2018	State of Kansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	195	0		29	10	S5660_195_0	1			1		05/28/2017	2018.03	05/28/2017 05:47:01 PM Eastern Daylight Time		05/31/2017 05:27:28 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	195	0	2018	Upper Midwest and Northern Plains		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	196	0		29	10	S5660_196_0	1			1		05/28/2017	2018.03	05/28/2017 05:47:14 PM Eastern Daylight Time		05/31/2017 05:28:22 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	196	0	2018	State of New Mexico		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	197	0		29	10	S5660_197_0	1			1		05/28/2017	2018.03	05/28/2017 05:47:27 PM Eastern Daylight Time		05/31/2017 05:29:16 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	197	0	2018	State of Colorado		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	198	0		29	10	S5660_198_0	1			1		05/28/2017	2018.03	05/28/2017 05:47:40 PM Eastern Daylight Time		05/31/2017 05:30:06 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	198	0	2018	State of Arizona		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	199	0		29	10	S5660_199_0	1			1		05/28/2017	2018.03	05/28/2017 05:52:29 PM Eastern Daylight Time		05/31/2017 05:30:56 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	199	0	2018	State of Nevada		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	202	0		29	10	S5660_202_0	1			1		05/28/2017	2018.03	05/28/2017 05:48:12 PM Eastern Daylight Time		05/31/2017 05:31:44 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	202	0	2018	State of California		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	203	0		29	10	S5660_203_0	1			1		05/28/2017	2018.03	05/28/2017 05:48:25 PM Eastern Daylight Time		05/31/2017 05:32:34 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	203	0	2018	State of Hawaii		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	204	0		29	10	S5660_204_0	1			1		05/28/2017	2018.03	05/28/2017 05:48:37 PM Eastern Daylight Time		05/31/2017 05:33:20 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	204	0	2018	State of Alaska		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	206	0		29	10	S5660_206_0	1			1		05/28/2017	2018.03	05/28/2017 05:48:49 PM Eastern Daylight Time		05/31/2017 05:34:10 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	206	0	2018	Central New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	207	0		29	10	S5660_207_0	1			1		05/28/2017	2018.03	05/28/2017 05:49:01 PM Eastern Daylight Time		05/31/2017 05:35:00 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	207	0	2018	State of New Jersey		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	208	0		29	10	S5660_208_0	1			1		05/28/2017	2018.03	05/28/2017 05:49:19 PM Eastern Daylight Time		05/31/2017 05:35:48 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	208	0	2018	Mid-Atlantic		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	209	0		29	10	S5660_209_0	1			1		05/28/2017	2018.03	05/28/2017 05:49:31 PM Eastern Daylight Time		05/31/2017 05:36:40 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	209	0	2018	State of North Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	210	0		29	10	S5660_210_0	1			1		05/28/2017	2018.03	05/28/2017 05:49:45 PM Eastern Daylight Time		05/31/2017 05:37:34 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	210	0	2018	State of South Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	211	0		29	10	S5660_211_0	1			1		05/28/2017	2018.03	05/28/2017 05:49:59 PM Eastern Daylight Time		05/31/2017 05:39:04 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	211	0	2018	State of Missouri		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	212	0		29	10	S5660_212_0	1			1		05/28/2017	2018.03	05/28/2017 05:50:11 PM Eastern Daylight Time		05/31/2017 05:39:54 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	212	0	2018	State of Arkansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	213	0		29	10	S5660_213_0	1			1		05/28/2017	2018.03	05/28/2017 05:50:25 PM Eastern Daylight Time		05/31/2017 05:40:46 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	213	0	2018	State of Louisiana		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	214	0		29	10	S5660_214_0	1			1		05/28/2017	2018.03	05/28/2017 05:50:40 PM Eastern Daylight Time		05/31/2017 05:41:36 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	214	0	2018	State of Oklahoma		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	215	0		29	10	S5660_215_0	1			1		05/28/2017	2018.03	05/28/2017 05:51:23 PM Eastern Daylight Time		05/31/2017 05:42:24 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	215	0	2018	States of Oregon and Washington		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	216	0		29	10	S5660_216_0	1			1		05/28/2017	2018.03	05/28/2017 05:51:37 PM Eastern Daylight Time		05/31/2017 05:43:16 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	216	0	2018	States of Idaho and Utah		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	217	0		29	10	S5660_217_0	1			1		05/29/2017	2018.03	05/29/2017 10:27:05 AM Eastern Daylight Time		05/31/2017 05:44:08 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5660	217	0	2018	State of Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	218	0		29	10	S5660_218_0	1			1		05/31/2017	2018.03	05/31/2017 11:54:46 AM Eastern Daylight Time		06/01/2017 03:49:18 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	218	0	2018	Northern New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	219	0		29	10	S5660_219_0	1			1		05/31/2017	2018.03	05/31/2017 11:59:32 AM Eastern Daylight Time		06/01/2017 03:50:44 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	219	0	2018	Central New England		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	220	0		29	10	S5660_220_0	1			1		05/31/2017	2018.03	05/31/2017 12:37:32 PM Eastern Daylight Time		06/01/2017 03:51:40 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	220	0	2018	State of New Jersey		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	221	0		29	10	S5660_221_0	1			1		05/31/2017	2018.03	05/31/2017 12:40:19 PM Eastern Daylight Time		06/01/2017 03:52:34 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	221	0	2018	Mid-Atlantic		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	222	0		29	10	S5660_222_0	1			1		05/31/2017	2018.03	05/31/2017 12:51:35 PM Eastern Daylight Time		06/01/2017 03:53:24 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	222	0	2018	States of Pennsylvania and West Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	223	0		29	10	S5660_223_0	1			1		05/31/2017	2018.03	05/31/2017 12:53:21 PM Eastern Daylight Time		06/01/2017 03:54:16 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	223	0	2018	State of Virginia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	224	0		29	10	S5660_224_0	1			1		05/31/2017	2018.03	05/31/2017 01:25:29 PM Eastern Daylight Time		06/01/2017 03:55:04 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	224	0	2018	State of North Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	225	0		29	10	S5660_225_0	1			1		05/31/2017	2018.03	05/31/2017 01:27:10 PM Eastern Daylight Time		06/01/2017 03:55:52 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	225	0	2018	State of South Carolina		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	226	0		29	10	S5660_226_0	1			1		05/31/2017	2018.03	05/31/2017 01:28:57 PM Eastern Daylight Time		06/01/2017 03:56:44 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	226	0	2018	State of Georgia		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	227	0		29	10	S5660_227_0	1			1		05/31/2017	2018.03	05/31/2017 01:31:48 PM Eastern Daylight Time		06/01/2017 03:57:50 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	227	0	2018	State of Florida		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	228	0		29	10	S5660_228_0	1			1		05/31/2017	2018.03	05/31/2017 01:35:16 PM Eastern Daylight Time		06/01/2017 03:58:40 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	228	0	2018	States of Alabama and Tennessee		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	229	0		29	10	S5660_229_0	1			1		05/31/2017	2018.03	05/31/2017 01:37:52 PM Eastern Daylight Time		06/01/2017 03:59:28 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	229	0	2018	State of Michigan		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	230	0		29	10	S5660_230_0	1			1		05/31/2017	2018.03	05/31/2017 01:44:39 PM Eastern Daylight Time		06/01/2017 04:00:28 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	230	0	2018	State of Ohio		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	231	0		29	10	S5660_231_0	1			1		05/31/2017	2018.03	05/31/2017 01:48:01 PM Eastern Daylight Time		06/01/2017 04:01:18 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	231	0	2018	States of Indiana and Kentucky		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	232	0		29	10	S5660_232_0	1			1		05/31/2017	2018.03	05/31/2017 01:57:58 PM Eastern Daylight Time		06/01/2017 04:02:14 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	232	0	2018	State of Wisconsin		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	233	0		29	10	S5660_233_0	3			1		05/31/2017	2018.03	05/31/2017 02:03:21 PM Eastern Daylight Time		06/01/2017 04:03:00 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	233	0	2018	State of Illinois		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	234	0		29	10	S5660_234_0	1			1		05/31/2017	2018.03	05/31/2017 02:05:09 PM Eastern Daylight Time		06/01/2017 04:03:48 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	234	0	2018	State of Missouri		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	235	0		29	10	S5660_235_0	1			1		05/31/2017	2018.03	05/31/2017 02:07:55 PM Eastern Daylight Time		06/01/2017 04:04:38 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	235	0	2018	State of Arkansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	236	0		29	10	S5660_236_0	1			1		05/31/2017	2018.03	05/31/2017 02:08:54 PM Eastern Daylight Time		06/01/2017 04:05:30 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	236	0	2018	State of Mississippi		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	237	0		29	10	S5660_237_0	1			1		05/31/2017	2018.03	05/31/2017 02:19:10 PM Eastern Daylight Time		06/01/2017 04:06:18 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	237	0	2018	State of Louisiana		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	238	0		29	10	S5660_238_0	1			1		05/31/2017	2018.03	05/31/2017 02:20:25 PM Eastern Daylight Time		06/01/2017 04:07:08 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	238	0	2018	State of Texas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	239	0		29	10	S5660_239_0	1			1		05/31/2017	2018.03	05/31/2017 02:21:51 PM Eastern Daylight Time		06/01/2017 04:08:00 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	239	0	2018	State of Oklahoma		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	240	0		29	10	S5660_240_0	1			1		05/31/2017	2018.03	05/31/2017 02:22:51 PM Eastern Daylight Time		06/01/2017 04:09:04 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	240	0	2018	State of Kansas		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	241	0		29	10	S5660_241_0	1			1		05/31/2017	2018.03	05/31/2017 02:24:19 PM Eastern Daylight Time		06/01/2017 04:09:52 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	241	0	2018	Upper Midwest and Northern Plains		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	242	0		29	10	S5660_242_0	1			1		05/31/2017	2018.03	05/31/2017 02:26:04 PM Eastern Daylight Time		06/01/2017 04:10:46 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	242	0	2018	State of New Mexico		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	243	0		29	10	S5660_243_0	1			1		05/31/2017	2018.03	05/31/2017 02:27:29 PM Eastern Daylight Time		06/01/2017 04:11:36 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	243	0	2018	State of Colorado		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	244	0		29	10	S5660_244_0	1			1		05/31/2017	2018.03	05/31/2017 02:29:09 PM Eastern Daylight Time		06/01/2017 04:12:26 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	244	0	2018	State of Arizona		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	245	0		29	10	S5660_245_0	1			1		05/31/2017	2018.03	05/31/2017 02:30:23 PM Eastern Daylight Time		06/01/2017 04:13:16 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	245	0	2018	State of Nevada		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	246	0		29	10	S5660_246_0	1			1		05/31/2017	2018.03	05/31/2017 02:32:16 PM Eastern Daylight Time		06/01/2017 04:14:16 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	246	0	2018	States of Oregon and Washington		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	247	0		29	10	S5660_247_0	1			1		05/31/2017	2018.03	05/31/2017 02:33:26 PM Eastern Daylight Time		06/01/2017 04:15:04 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	247	0	2018	States of Idaho and Utah		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	248	0		29	10	S5660_248_0	1			1		05/31/2017	2018.03	05/31/2017 02:34:38 PM Eastern Daylight Time		06/01/2017 04:15:52 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	248	0	2018	State of California		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	249	0		29	10	S5660_249_0	1			1		05/31/2017	2018.03	05/31/2017 02:41:16 PM Eastern Daylight Time		06/01/2017 04:16:40 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	249	0	2018	State of Hawaii		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	250	0		29	10	S5660_250_0	1			1		05/31/2017	2018.03	05/31/2017 02:42:29 PM Eastern Daylight Time		06/01/2017 04:17:26 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	250	0	2018	State of Alaska		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	251	0		29	10	S5660_251_0	1			1		05/31/2017	2018.03	05/31/2017 02:44:03 PM Eastern Daylight Time		06/01/2017 04:18:14 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5660	251	0	2018	Puerto Rico		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	801	0		29	10	S5660_801_0	1			1		05/28/2017	2018.03	05/28/2017 06:01:09 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5660	801	0	2018	Premier Access Open 5 Tier		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	802	0		29	10	S5660_802_0	1			1		05/24/2017	2018.03	05/24/2017 04:44:10 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5660	802	0	2018	Premier Performance Closed 5 Tier		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	803	0		29	10	S5660_803_0	1			1		05/28/2017	2018.03	05/28/2017 06:01:15 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5660	803	0	2018	High Performance Closed 5 Tier		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	804	0		29	10	S5660_804_0	1			1		05/28/2017	2018.03	05/28/2017 06:01:19 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5660	804	0	2018	Premier Performance Closed 5 - Non Calendar		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5660	806	0		29	10	S5660_806_0	1			1		05/28/2017	2018.03	05/28/2017 06:01:22 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5660	806	0	2018	National - URMBT 3 Tier		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5715	001	0		29	10	S5715_001_0	5			1		05/31/2017	2018.03	05/31/2017 11:48:05 AM Central Daylight Time		07/13/2017 06:47:20 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueil.com/pdp	Blue Cross MedicareRx Value (PDP)	10	29					S5715	001	0	2018	State of Illinois		2					2						www.getblueil.com/pdp/pharmacies	www.getblueil.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	002	0		29	10	S5715_002_0	7			1		07/20/2017	2018.03	07/20/2017 12:37:50 PM Central Daylight Time		07/13/2017 06:49:31 PM Central Daylight Time			07/20/2017 01:13:14 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueil.com/pdp	Blue Cross MedicareRx Plus (PDP)	10	29					S5715	002	0	2018	State of Illinois		2					2						www.getblueil.com/pdp/pharmacies	www.getblueil.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	003	0		29	10	S5715_003_0	5			1		05/31/2017	2018.03	05/31/2017 12:22:01 PM Central Daylight Time		07/13/2017 06:51:41 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluenm.com/pdp	Blue Cross MedicareRx Value (PDP)	10	29					S5715	003	0	2018	State of New Mexico		2					2						www.getbluenm.com/pdp/pharmacies	www.getbluenm.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	004	0		29	10	S5715_004_0	7			1		07/20/2017	2018.03	07/20/2017 01:09:58 PM Central Daylight Time		07/13/2017 06:53:50 PM Central Daylight Time			07/20/2017 01:13:14 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluenm.com/pdp	Blue Cross MedicareRx Plus (PDP)	10	29					S5715	004	0	2018	State of New Mexico		2					2						www.getbluenm.com/pdp/pharmacies	www.getbluenm.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	005	0		29	10	S5715_005_0	5			1		05/31/2017	2018.03	05/31/2017 12:25:07 PM Central Daylight Time		07/13/2017 06:56:01 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluetx.com/pdp	Blue Cross MedicareRx Value (PDP)	10	29					S5715	005	0	2018	State of Texas		2					2						www.getbluetx.com/pdp/pharmacies	www.getbluetx.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	006	0		29	10	S5715_006_0	7			1		07/20/2017	2018.03	07/20/2017 01:10:37 PM Central Daylight Time		07/13/2017 06:58:17 PM Central Daylight Time			07/20/2017 01:13:14 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluetx.com/pdp	Blue Cross MedicareRx Plus (PDP)	10	29					S5715	006	0	2018	State of Texas		2					2						www.getbluetx.com/pdp/pharmacies	www.getbluetx.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	010	0		29	10	S5715_010_0	5			1		05/31/2017	2018.03	05/31/2017 12:31:06 PM Central Daylight Time		07/13/2017 07:00:29 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueok.com/pdp	Blue Cross MedicareRx Value (PDP)	10	29					S5715	010	0	2018	State of Oklahoma		2					2						www.getblueok.com/pdp/pharmacies	www.getblueok.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	011	0		29	10	S5715_011_0	7			1		07/20/2017	2018.03	07/20/2017 01:11:35 PM Central Daylight Time		07/13/2017 07:02:41 PM Central Daylight Time			07/20/2017 01:13:14 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueok.com/pdp	Blue Cross MedicareRx Plus (PDP)	10	29					S5715	011	0	2018	State of Oklahoma		2					2						www.getblueok.com/pdp/pharmacies	www.getblueok.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	012	0		29	10	S5715_012_0	6			1		05/31/2017	2018.03	05/31/2017 09:10:26 AM Central Daylight Time		07/13/2017 07:04:56 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueil.com/pdp	Blue Cross MedicareRx Basic (PDP)	10	29					S5715	012	0	2018	State of Illinois		2					2						www.getblueil.com/pdp/pharmacies	www.getblueil.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	013	0		29	10	S5715_013_0	6			1		05/31/2017	2018.03	05/31/2017 09:19:23 AM Central Daylight Time		07/13/2017 07:07:10 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluenm.com/pdp	Blue Cross MedicareRx Basic (PDP)	10	29					S5715	013	0	2018	State of New Mexico		2					2						www.getbluenm.com/pdp/pharmacies	www.getbluenm.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	014	0		29	10	S5715_014_0	6			1		05/31/2017	2018.03	05/31/2017 09:23:29 AM Central Daylight Time		07/13/2017 07:09:27 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getbluetx.com/pdp	Blue Cross MedicareRx Basic (PDP)	10	29					S5715	014	0	2018	State of Texas		2					2						www.getbluetx.com/pdp/pharmacies	www.getbluetx.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	015	0		29	10	S5715_015_0	5			1		05/31/2017	2018.03	05/31/2017 09:26:59 AM Central Daylight Time		07/13/2017 07:12:02 PM Central Daylight Time			07/19/2017 12:30:56 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.getblueok.com/pdp	Blue Cross MedicareRx Basic (PDP)	10	29					S5715	015	0	2018	State of Oklahoma		2					2						www.getblueok.com/pdp/pharmacies	www.getblueok.com/pdp/druglist										(888)285-2249		(888)285-2249		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	801	0		29	10	S5715_801_0	5			1		05/18/2017	2018.03	05/18/2017 10:23:15 AM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	801	0	2018	State of Illinois		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	802	0		29	10	S5715_802_0	5			1		04/10/2017	2018.03	04/10/2017 03:38:19 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	802	0	2018	State of New Mexico		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	803	0		29	10	S5715_803_0	5			1		05/23/2017	2018.03	05/23/2017 02:56:53 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	803	0	2018	State of Texas		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	807	0		29	10	S5715_807_0	5			1		04/10/2017	2018.03	04/10/2017 03:38:30 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	807	0	2018	State of Oklahoma		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	809	0		29	10	S5715_809_0	5			1		04/10/2017	2018.03	04/10/2017 03:38:35 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	809	0	2018	State of Oklahoma		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	811	0		29	10	S5715_811_0	5			1		04/17/2017	2018.03	04/17/2017 10:24:45 AM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	811	0	2018	State of Illinois		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	813	0		29	10	S5715_813_0	5			1		04/10/2017	2018.03	04/10/2017 03:38:48 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	813	0	2018	State of New Mexico		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5715	815	0		29	10	S5715_815_0	5			1		04/10/2017	2018.03	04/10/2017 03:38:53 PM Central Daylight Time					05/30/2017 12:15:53 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.hcsc.com	Blue Cross MedicareRx (PDP)	10	29					S5715	815	0	2018	State of Texas		1					2						www.myprime.com	www.myprime.com										(877)838-3833		(877)838-3833		(877)213-1817		(877)213-1817										(711)-		(711)-		(711)-		(711)-																
S5726	013	0		29	10	S5726_013_0	2			1		06/01/2017	2018.03	06/01/2017 12:16:29 PM Eastern Daylight Time		07/07/2017 04:30:09 PM Eastern Daylight Time			07/18/2017 12:59:53 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdkansas.com/shop	Blue MedicareRx Value (PDP)	10	29					S5726	013	0	2018	Kansas		2					2						www.PartDKansas.com/shop	www.PartDKansas.com/shop										(866)755-2776		(866)755-2776		(877)471-4121		(877)471-4121										(711)-		(711)-		(711)-		(711)-																
S5726	014	0		29	10	S5726_014_0	2			1		06/01/2017	2018.03	06/01/2017 12:20:40 PM Eastern Daylight Time		07/07/2017 04:30:59 PM Eastern Daylight Time			07/18/2017 12:59:53 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdkansas.com/shop	Blue MedicareRx Plus (PDP)	10	29					S5726	014	0	2018	Kansas		2					2						www.PartDKansas.com/shop	www.PartDKansas.com/shop										(866)755-2776		(866)755-2776		(877)471-4121		(877)471-4121										(711)-		(711)-		(711)-		(711)-																
S5726	015	0		29	10	S5726_015_0	3			1		06/01/2017	2018.03	06/01/2017 12:24:48 PM Eastern Daylight Time		07/07/2017 04:31:50 PM Eastern Daylight Time			07/18/2017 12:59:53 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdkansas.com/shop	Blue MedicareRx Premier (PDP)	10	29					S5726	015	0	2018	Kansas		2					2						www.PartDKansas.com/shop	www.PartDKansas.com/shop										(866)755-2776		(866)755-2776		(877)471-4121		(877)471-4121										(711)-		(711)-		(711)-		(711)-																
S5726	805	0		29	10	S5726_805_0	1			1		06/02/2017	2018.03	06/02/2017 04:06:44 PM Eastern Daylight Time					06/02/2017 04:12:40 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF KANSAS	Blue MedicareRx	www.PartDKansas.com/shop	Blue MedicareRx (PDP)	10	29					S5726	805	0	2018	Kansas		1					2						www.PartDKansas.com/shop	www.PartDKansas.com/shop										(866)830-0174		(866)830-0174		(866)830-0296		(866)830-0296										(711)-		(711)-		(711)-		(711)-																
S5743	001	0		29	10	S5743_001_0	2			1		05/31/2017	2018.03	05/31/2017 04:52:31 PM Central Daylight Time		06/02/2017 08:44:51 AM Central Daylight Time			06/02/2017 01:20:07 PM Central Daylight Time	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	MedicareBlue Rx	www.YourMedicareSolutions.com	MedicareBlue Rx Standard (PDP)	10	29					S5743	001	0	2018	States of IA, MN, MT, NE, ND, SD, WY		2					2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com										(888)832-0075		(888)832-0075		(866)434-2037		(866)434-2037										(711)-		(711)-		(711)-		(711)-																
S5743	004	0		29	10	S5743_004_0	2			1		06/02/2017	2018.03	06/02/2017 12:07:09 PM Central Daylight Time		06/02/2017 08:44:51 AM Central Daylight Time			06/02/2017 01:20:07 PM Central Daylight Time	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	MedicareBlue Rx	www.YourMedicareSolutions.com	MedicareBlue Rx Premier (PDP)	10	29					S5743	004	0	2018	States of IA, MN, MT, NE, ND, SD, WY		2					2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com										(888)832-0075		(888)832-0075		(866)434-2037		(866)434-2037										(711)-		(711)-		(711)-		(711)-																
S5743	802	0		29	10	S5743_802_0	1			1		05/26/2017	2018.03	05/26/2017 09:24:54 AM Central Daylight Time					06/02/2017 11:40:03 AM Central Daylight Time	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	MedicareBlue Rx	www.YourMedicareSolutions.com	Group MedicareBlue Rx (PDP)	10	29					S5743	802	0	2018	Nationwide		1					2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com										(877)838-3827		(877)838-3827		(866)456-2885		(866)456-2885										(711)-		(711)-		(711)-		(711)-																
S5743	805	0		29	10	S5743_805_0	1			1		05/26/2017	2018.03	05/26/2017 09:25:27 AM Central Daylight Time					06/02/2017 11:40:03 AM Central Daylight Time	WELLMARK  IA & SD, & BCBS MN, MT, NE, ND,& WY	MedicareBlue Rx	www.YourMedicareSolutions.com	Group MedicareBlue Rx Self-funded (PDP)	10	29					S5743	805	0	2018	Nationwide		1					2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com										(877)838-3827		(877)838-3827		(866)456-2885		(866)456-2885										(711)-		(711)-		(711)-		(711)-																
S5753	006	0		29	10	S5753_006_0	1			1		05/25/2017	2018.03	05/25/2017 06:24:12 PM Central Daylight Time		05/27/2017 03:10:15 PM Central Daylight Time			05/27/2017 03:25:15 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS MedicareRx Plan 1 (PDP)	10	29					S5753	006	0	2018	State of Wisconsin		2					2						www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com										(800)688-1604		(800)688-1604		(800)731-0459		(800)731-0459										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5753	007	0		29	10	S5753_007_0	1			1		05/25/2017	2018.03	05/25/2017 07:28:09 PM Central Daylight Time		05/27/2017 03:11:07 PM Central Daylight Time			05/27/2017 03:25:15 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS MedicareRx Plan 2 (PDP)	10	29					S5753	007	0	2018	State of Wisconsin		2					2						www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com										(800)688-1604		(800)688-1604		(800)731-0459		(800)731-0459										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5753	801	0		29	10	S5753_801_0	1			1		05/22/2017	2018.03	05/22/2017 11:01:13 AM Central Daylight Time					05/27/2017 03:25:15 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS Employer Plan - Calendar Year (PDP)	10	29					S5753	801	0	2018	National		1					2						www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com										(800)688-1604		(800)688-1604		(800)731-0459		(800)731-0459										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5753	803	0		29	10	S5753_803_0	1			1		05/22/2017	2018.03	05/22/2017 11:01:24 AM Central Daylight Time					05/27/2017 03:25:15 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS Employer Plan Non-Calendar Year (PDP)	10	29					S5753	803	0	2018	National		1					2						www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com										(800)688-1604		(800)688-1604		(800)731-0459		(800)731-0459										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5768	125	0		29	10	S5768_125_0	3			1		08/04/2017	2018.03	08/04/2017 09:09:27 AM Eastern Daylight Time		08/03/2017 12:49:22 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	125	0	2018	Northern New England (NH, ME)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	126	0		29	10	S5768_126_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:41 PM Eastern Daylight Time		05/24/2017 08:58:01 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	126	0	2018	Central New England  (CT,RI, MA,VT)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	127	0		29	10	S5768_127_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:44 PM Eastern Daylight Time		05/24/2017 08:58:28 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	127	0	2018	New Jersey		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	128	0		29	10	S5768_128_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:48 PM Eastern Daylight Time		05/24/2017 08:58:55 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	128	0	2018	Mid-Atlantic (DE,DC,MD)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	129	0		29	10	S5768_129_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:53 PM Eastern Daylight Time		05/24/2017 08:59:22 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	129	0	2018	Pennsylvania, West Virginia		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	130	0		29	10	S5768_130_0	1			1		05/24/2017	2018.03	05/24/2017 12:24:57 PM Eastern Daylight Time		05/24/2017 08:59:49 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	130	0	2018	Virginia		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	131	0		29	10	S5768_131_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:01 PM Eastern Daylight Time		05/24/2017 09:00:16 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	131	0	2018	North Carolina		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	132	0		29	10	S5768_132_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:05 PM Eastern Daylight Time		05/24/2017 09:00:43 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	132	0	2018	South Carolina		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	133	0		29	10	S5768_133_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:10 PM Eastern Daylight Time		05/24/2017 09:01:10 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	133	0	2018	Georgia		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	134	0		29	10	S5768_134_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:14 PM Eastern Daylight Time		05/24/2017 09:01:37 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	134	0	2018	Florida		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	135	0		29	10	S5768_135_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:17 PM Eastern Daylight Time		05/24/2017 09:02:04 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	135	0	2018	Alabama, Tennessee		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	136	0		29	10	S5768_136_0	3			1		08/04/2017	2018.03	08/04/2017 09:09:44 AM Eastern Daylight Time		08/03/2017 12:53:36 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	136	0	2018	Michigan		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	137	0		29	10	S5768_137_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:25 PM Eastern Daylight Time		05/24/2017 09:02:57 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	137	0	2018	Ohio		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	138	0		29	10	S5768_138_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:28 PM Eastern Daylight Time		05/24/2017 09:03:23 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	138	0	2018	Indiana, Kentucky		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	139	0		29	10	S5768_139_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:32 PM Eastern Daylight Time		05/24/2017 09:03:50 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	139	0	2018	Wisconsin		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	140	0		29	10	S5768_140_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:35 PM Eastern Daylight Time		05/24/2017 09:04:16 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	140	0	2018	Illinois		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	141	0		29	10	S5768_141_0	4			1		08/04/2017	2018.03	08/04/2017 09:10:00 AM Eastern Daylight Time		08/03/2017 12:55:29 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	141	0	2018	Missouri		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	142	0		29	10	S5768_142_0	4			1		08/04/2017	2018.03	08/04/2017 09:10:12 AM Eastern Daylight Time		08/03/2017 12:55:51 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	142	0	2018	Arkansas		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	143	0		29	10	S5768_143_0	3			1		08/04/2017	2018.03	08/04/2017 09:10:24 AM Eastern Daylight Time		08/03/2017 12:56:14 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	143	0	2018	Mississippi		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	144	0		29	10	S5768_144_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:52 PM Eastern Daylight Time		05/24/2017 09:06:03 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	144	0	2018	Louisiana		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	145	0		29	10	S5768_145_0	1			1		05/24/2017	2018.03	05/24/2017 12:25:55 PM Eastern Daylight Time		05/24/2017 09:06:29 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	145	0	2018	Texas		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	146	0		29	10	S5768_146_0	4			1		08/04/2017	2018.03	08/04/2017 09:10:37 AM Eastern Daylight Time		08/03/2017 12:57:21 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	146	0	2018	Oklahoma		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	147	0		29	10	S5768_147_0	3			1		08/04/2017	2018.03	08/04/2017 09:10:51 AM Eastern Daylight Time		08/03/2017 12:57:44 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	147	0	2018	Kansas		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	148	0		29	10	S5768_148_0	3			1		08/04/2017	2018.03	08/04/2017 09:11:03 AM Eastern Daylight Time		08/03/2017 12:58:07 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	148	0	2018	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	149	0		29	10	S5768_149_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:09 PM Eastern Daylight Time		05/24/2017 09:08:15 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	149	0	2018	New Mexico		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	150	0		29	10	S5768_150_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:12 PM Eastern Daylight Time		05/24/2017 09:08:42 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	150	0	2018	Colorado		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	151	0		29	10	S5768_151_0	1			1		05/24/2017	2018.03	05/24/2017 02:00:53 PM Eastern Daylight Time		05/24/2017 09:09:08 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	151	0	2018	Arizona		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	152	0		29	10	S5768_152_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:18 PM Eastern Daylight Time		05/24/2017 09:09:35 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	152	0	2018	Nevada		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	153	0		29	10	S5768_153_0	3			1		08/04/2017	2018.03	08/04/2017 09:11:18 AM Eastern Daylight Time		08/03/2017 12:59:58 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	153	0	2018	Oregon, Washington		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	154	0		29	10	S5768_154_0	4			1		08/04/2017	2018.03	08/04/2017 09:11:29 AM Eastern Daylight Time		08/03/2017 01:00:21 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	154	0	2018	Idaho, Utah		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	155	0		29	10	S5768_155_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:29 PM Eastern Daylight Time		05/24/2017 09:10:54 PM Eastern Daylight Time			05/31/2017 05:59:55 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	155	0	2018	California		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	175	0		29	10	S5768_175_0	3			1		08/04/2017	2018.03	08/04/2017 09:11:46 AM Eastern Daylight Time		08/03/2017 01:01:06 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	175	0	2018	Missouri		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	176	0		29	10	S5768_176_0	3			1		08/04/2017	2018.03	08/04/2017 09:11:58 AM Eastern Daylight Time		08/03/2017 01:01:29 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	176	0	2018	Arkansas		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	177	0		29	10	S5768_177_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:41 PM Eastern Daylight Time		05/24/2017 09:12:14 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	177	0	2018	Mississippi		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	180	0		29	10	S5768_180_0	3			1		08/04/2017	2018.03	08/04/2017 09:12:10 AM Eastern Daylight Time		08/03/2017 01:02:15 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	180	0	2018	Oklahoma		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	181	0		29	10	S5768_181_0	3			1		08/04/2017	2018.03	08/04/2017 09:12:22 AM Eastern Daylight Time		08/03/2017 01:02:38 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	181	0	2018	Kansas		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	182	0		29	10	S5768_182_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:50 PM Eastern Daylight Time		05/24/2017 09:13:33 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	182	0	2018	Colorado		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	184	0		29	10	S5768_184_0	1			1		05/24/2017	2018.03	05/24/2017 12:26:54 PM Eastern Daylight Time		05/24/2017 09:14:00 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	184	0	2018	Nevada		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	185	0		29	10	S5768_185_0	3			1		08/04/2017	2018.03	08/04/2017 09:12:34 AM Eastern Daylight Time		08/03/2017 01:03:45 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	185	0	2018	Northern New England (NH, ME)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	190	0		29	10	S5768_190_0	3			1		08/04/2017	2018.03	08/04/2017 09:12:50 AM Eastern Daylight Time		08/03/2017 01:04:07 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	190	0	2018	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	191	0		29	10	S5768_191_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:04 PM Eastern Daylight Time		05/24/2017 09:15:20 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	191	0	2018	New Mexico		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	192	0		29	10	S5768_192_0	3			1		08/04/2017	2018.03	08/04/2017 09:13:10 AM Eastern Daylight Time		08/03/2017 01:04:52 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	192	0	2018	Oregon, Washington		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	193	0		29	10	S5768_193_0	3			1		08/04/2017	2018.03	08/04/2017 09:13:24 AM Eastern Daylight Time		08/03/2017 01:05:14 PM Eastern Daylight Time			08/04/2017 09:22:00 AM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	193	0	2018	Idaho, Utah		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	195	0		29	10	S5768_195_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:14 PM Eastern Daylight Time		05/24/2017 09:16:39 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	195	0	2018	Hawaii		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	196	0		29	10	S5768_196_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:17 PM Eastern Daylight Time		05/24/2017 09:17:05 PM Eastern Daylight Time			05/31/2017 06:04:13 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5768	196	0	2018	Alaska		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	197	0		29	10	S5768_197_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:20 PM Eastern Daylight Time		05/24/2017 09:17:32 PM Eastern Daylight Time			05/31/2017 06:08:26 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	197	0	2018	Alaska		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	198	0		29	10	S5768_198_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:23 PM Eastern Daylight Time		05/24/2017 09:17:59 PM Eastern Daylight Time			05/31/2017 06:08:26 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	198	0	2018	Hawaii		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5768	200	0		29	10	S5768_200_0	1			1		05/24/2017	2018.03	05/24/2017 12:27:26 PM Eastern Daylight Time		05/24/2017 09:18:26 PM Eastern Daylight Time			05/31/2017 06:08:26 PM Eastern Daylight Time	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	200	0	2018	New York		2					2						http://www.FirstHealthPartD.com	http://www.FirstHealthPartD.com										(844)233-1938		(844)233-1938		(855)389-9688		(855)389-9688										(711)-		(711)-		(711)-		(711)-																
S5795	002	0		29	10	S5795_002_0	6			1		06/02/2017	2018.03	06/02/2017 12:53:33 PM Central Daylight Time		07/24/2017 02:51:37 PM Central Daylight Time			07/24/2017 02:52:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Rx Premier (PDP)	10	29					S5795	002	0	2018	State of Arkansas		2					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com/LookingForInsurance/MedicarePlans/default.aspx										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5795	003	0		29	10	S5795_003_0	6			1		06/05/2017	2018.03	06/05/2017 07:40:06 AM Central Daylight Time		07/24/2017 02:51:37 PM Central Daylight Time			07/24/2017 02:52:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Rx Basic (PDP)	10	29					S5795	003	0	2018	State of Arkansas		2					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com/LookingForInsurance/MedicarePlans/default.aspx										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5795	804	0		29	10	S5795_804_0	1			1		06/06/2017	2018.03	06/06/2017 12:31:44 PM Central Daylight Time					06/06/2017 12:32:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	Arkansas BCBS Std Def Employer CY 4 (PDP)	10	29					S5795	804	0	2018	Employer Group Plan		1					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5795	809	0		29	10	S5795_809_0	1			1		06/06/2017	2018.03	06/06/2017 12:31:52 PM Central Daylight Time					06/06/2017 12:32:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	Arkansas BCBS Std Def Employer NCY 4 (PDP)	10	29					S5795	809	0	2018	Employer Group Plan		1					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5795	811	0		29	10	S5795_811_0	1			1		06/06/2017	2018.03	06/06/2017 12:31:57 PM Central Daylight Time					06/06/2017 12:32:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	ABCBS Group Basic CY (PDP)	10	29					S5795	811	0	2018	Employer Group Plan		1					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5795	812	0		29	10	S5795_812_0	1			1		06/06/2017	2018.03	06/06/2017 12:32:03 PM Central Daylight Time					06/06/2017 12:32:24 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	ABCBS Group Basic PY (PDP)	10	29					S5795	812	0	2018	Employer Group Plan		1					2						http://www.arkansasbluecross.com	http://www.arkansasbluecross.com										(866)390-3369		(866)390-3369		(844)298-2444		(844)298-2444										(711)-		(711)-		(711)-		(711)-																
S5805	001	0		29	10	S5805_001_0	1			1		06/01/2017	2018.03	06/01/2017 09:02:27 AM Central Daylight Time		05/31/2017 11:26:04 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5805	001	0	2018	New York		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5805	803	0		29	10	S5805_803_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:12 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	803	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	804	0		29	10	S5805_804_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:16 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	804	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	807	0		29	10	S5805_807_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:19 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	807	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	808	0		29	10	S5805_808_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:26 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	808	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	809	0		29	10	S5805_809_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:30 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	809	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	810	0		29	10	S5805_810_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:35 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	810	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	811	0		29	10	S5805_811_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:39 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	811	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	812	0		29	10	S5805_812_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:44 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	812	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	813	0		29	10	S5805_813_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:49 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	813	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	814	0		29	10	S5805_814_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:54 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	814	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	815	0		29	10	S5805_815_0	1			1		05/23/2017	2018.03	05/23/2017 02:42:58 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	815	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	816	0		29	10	S5805_816_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:02 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	816	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	818	0		29	10	S5805_818_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:06 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	818	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	819	0		29	10	S5805_819_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:10 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	819	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	820	0		29	10	S5805_820_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:15 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	820	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	821	0		29	10	S5805_821_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:19 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	821	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	822	0		29	10	S5805_822_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:24 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	822	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	823	0		29	10	S5805_823_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:28 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	823	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	824	0		29	10	S5805_824_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:33 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	824	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	825	0		29	10	S5805_825_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:37 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	825	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	826	0		29	10	S5805_826_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:41 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	826	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	827	0		29	10	S5805_827_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:46 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	827	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	828	0		29	10	S5805_828_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:51 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	828	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	829	0		29	10	S5805_829_0	1			1		05/23/2017	2018.03	05/23/2017 02:43:57 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	829	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	830	0		29	10	S5805_830_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:01 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	830	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	831	0		29	10	S5805_831_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:06 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	831	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	832	0		29	10	S5805_832_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:10 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	832	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	833	0		29	10	S5805_833_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:15 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	833	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	834	0		29	10	S5805_834_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:20 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	834	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	835	0		29	10	S5805_835_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:24 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	835	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	836	0		29	10	S5805_836_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:28 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	836	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	837	0		29	10	S5805_837_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:33 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	837	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5805	838	0		29	10	S5805_838_0	1			1		05/23/2017	2018.03	05/23/2017 02:44:37 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	838	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5810	035	0		29	10	S5810_035_0	1			1		05/23/2017	2018.03	05/23/2017 05:03:02 PM Eastern Daylight Time		05/24/2017 09:18:52 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	035	0	2018	Northern New England (NH, ME)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	036	0		29	10	S5810_036_0	1			1		05/23/2017	2018.03	05/23/2017 05:05:30 PM Eastern Daylight Time		05/24/2017 09:19:19 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	036	0	2018	Central New England  (CT,RI, MA,VT)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	037	0		29	10	S5810_037_0	1			1		05/23/2017	2018.03	05/23/2017 05:06:19 PM Eastern Daylight Time		05/24/2017 09:19:46 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	037	0	2018	New  York		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	038	0		29	10	S5810_038_0	1			1		05/23/2017	2018.03	05/23/2017 05:07:04 PM Eastern Daylight Time		05/24/2017 09:20:12 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	038	0	2018	New Jersey		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	039	0		29	10	S5810_039_0	1			1		05/23/2017	2018.03	05/23/2017 05:07:53 PM Eastern Daylight Time		05/24/2017 09:20:39 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	039	0	2018	Mid-Atlantic (DE,DC,MD)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	040	0		29	10	S5810_040_0	1			1		05/23/2017	2018.03	05/23/2017 05:08:44 PM Eastern Daylight Time		05/24/2017 09:21:06 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	040	0	2018	Pennsylvania, West Virginia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	041	0		29	10	S5810_041_0	1			1		05/23/2017	2018.03	05/23/2017 05:09:24 PM Eastern Daylight Time		05/24/2017 09:21:33 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	041	0	2018	Virginia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	042	0		29	10	S5810_042_0	1			1		05/23/2017	2018.03	05/23/2017 05:10:17 PM Eastern Daylight Time		05/24/2017 09:21:59 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	042	0	2018	North Carolina		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	043	0		29	10	S5810_043_0	1			1		05/23/2017	2018.03	05/23/2017 05:10:56 PM Eastern Daylight Time		05/24/2017 09:22:26 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	043	0	2018	South Carolina		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	044	0		29	10	S5810_044_0	1			1		05/23/2017	2018.03	05/23/2017 05:11:44 PM Eastern Daylight Time		05/24/2017 09:22:53 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	044	0	2018	Georgia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	045	0		29	10	S5810_045_0	1			1		05/23/2017	2018.03	05/23/2017 05:12:23 PM Eastern Daylight Time		05/24/2017 09:23:19 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	045	0	2018	Florida		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	046	0		29	10	S5810_046_0	1			1		05/23/2017	2018.03	05/23/2017 05:13:00 PM Eastern Daylight Time		05/24/2017 09:23:44 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	046	0	2018	Alabama, Tennessee		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	047	0		29	10	S5810_047_0	1			1		05/23/2017	2018.03	05/23/2017 05:14:20 PM Eastern Daylight Time		05/24/2017 09:24:09 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	047	0	2018	Michigan		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	048	0		29	10	S5810_048_0	1			1		05/23/2017	2018.03	05/23/2017 05:15:01 PM Eastern Daylight Time		05/24/2017 09:24:36 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	048	0	2018	Ohio		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	049	0		29	10	S5810_049_0	1			1		05/23/2017	2018.03	05/23/2017 05:15:38 PM Eastern Daylight Time		05/24/2017 09:25:02 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	049	0	2018	Indiana, Kentucky		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	050	0		29	10	S5810_050_0	1			1		05/23/2017	2018.03	05/23/2017 05:16:24 PM Eastern Daylight Time		05/24/2017 09:25:27 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	050	0	2018	Wisconsin		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	051	0		29	10	S5810_051_0	1			1		05/23/2017	2018.03	05/23/2017 05:17:03 PM Eastern Daylight Time		05/24/2017 09:25:52 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	051	0	2018	Illinois		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	052	0		29	10	S5810_052_0	1			1		05/23/2017	2018.03	05/23/2017 05:17:45 PM Eastern Daylight Time		05/24/2017 09:26:16 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	052	0	2018	Missouri		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	053	0		29	10	S5810_053_0	1			1		05/23/2017	2018.03	05/23/2017 05:18:32 PM Eastern Daylight Time		05/24/2017 09:26:40 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	053	0	2018	Arkansas		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	054	0		29	10	S5810_054_0	1			1		05/23/2017	2018.03	05/23/2017 05:19:18 PM Eastern Daylight Time		05/24/2017 09:27:05 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	054	0	2018	Mississippi		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	055	0		29	10	S5810_055_0	1			1		05/23/2017	2018.03	05/23/2017 05:19:55 PM Eastern Daylight Time		05/24/2017 09:27:30 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	055	0	2018	Louisiana		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	056	0		29	10	S5810_056_0	1			1		05/23/2017	2018.03	05/23/2017 05:20:46 PM Eastern Daylight Time		05/24/2017 09:27:55 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	056	0	2018	Texas		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	057	0		29	10	S5810_057_0	1			1		05/23/2017	2018.03	05/23/2017 05:21:26 PM Eastern Daylight Time		05/24/2017 09:28:20 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	057	0	2018	Oklahoma		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	058	0		29	10	S5810_058_0	1			1		05/23/2017	2018.03	05/23/2017 05:22:11 PM Eastern Daylight Time		05/24/2017 09:28:45 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	058	0	2018	Kansas		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	059	0		29	10	S5810_059_0	1			1		05/23/2017	2018.03	05/23/2017 05:22:47 PM Eastern Daylight Time		05/24/2017 09:29:10 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	059	0	2018	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	060	0		29	10	S5810_060_0	1			1		05/23/2017	2018.03	05/23/2017 05:23:37 PM Eastern Daylight Time		05/24/2017 09:29:39 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	060	0	2018	New Mexico		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	061	0		29	10	S5810_061_0	1			1		05/23/2017	2018.03	05/23/2017 05:24:14 PM Eastern Daylight Time		05/24/2017 09:30:04 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	061	0	2018	Colorado		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	062	0		29	10	S5810_062_0	1			1		05/23/2017	2018.03	05/23/2017 05:25:02 PM Eastern Daylight Time		05/24/2017 09:30:29 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	062	0	2018	Arizona		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	063	0		29	10	S5810_063_0	1			1		05/23/2017	2018.03	05/23/2017 05:28:25 PM Eastern Daylight Time		05/24/2017 09:30:54 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	063	0	2018	Nevada		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	064	0		29	10	S5810_064_0	1			1		05/23/2017	2018.03	05/23/2017 05:29:13 PM Eastern Daylight Time		05/24/2017 09:31:18 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	064	0	2018	Oregon, Washington		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	065	0		29	10	S5810_065_0	1			1		05/23/2017	2018.03	05/23/2017 05:31:23 PM Eastern Daylight Time		05/24/2017 09:31:43 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	065	0	2018	Idaho, Utah		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	066	0		29	10	S5810_066_0	1			1		05/23/2017	2018.03	05/23/2017 05:32:03 PM Eastern Daylight Time		05/24/2017 09:32:09 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	066	0	2018	California		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	067	0		29	10	S5810_067_0	1			1		05/23/2017	2018.03	05/23/2017 05:33:54 PM Eastern Daylight Time		05/24/2017 09:32:34 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	067	0	2018	Hawaii		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	068	0		29	10	S5810_068_0	1			1		05/23/2017	2018.03	05/23/2017 05:33:33 PM Eastern Daylight Time		05/24/2017 09:32:59 PM Eastern Daylight Time			05/31/2017 05:44:08 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Saver (PDP)	10	29					S5810	068	0	2018	Alaska		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	276	0		29	10	S5810_276_0	5			1		08/04/2017	2018.03	08/04/2017 09:13:50 AM Eastern Daylight Time		08/03/2017 01:24:15 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	276	0	2018	Central New England (CT, RI, MA, VT)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	277	0		29	10	S5810_277_0	5			1		08/04/2017	2018.03	08/04/2017 09:14:03 AM Eastern Daylight Time		08/03/2017 01:24:39 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	277	0	2018	New York		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	278	0		29	10	S5810_278_0	5			1		08/04/2017	2018.03	08/04/2017 09:14:15 AM Eastern Daylight Time		08/03/2017 01:25:03 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	278	0	2018	New Jersey		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	279	0		29	10	S5810_279_0	4			1		08/04/2017	2018.03	08/04/2017 09:14:34 AM Eastern Daylight Time		08/03/2017 01:25:27 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	279	0	2018	Mid-Atlantic (DE, DC, MD)		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	280	0		29	10	S5810_280_0	4			1		08/04/2017	2018.03	08/04/2017 09:14:47 AM Eastern Daylight Time		08/03/2017 01:25:51 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	280	0	2018	Pennsylvania, West Virginia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	281	0		29	10	S5810_281_0	4			1		08/04/2017	2018.03	08/04/2017 09:14:59 AM Eastern Daylight Time		08/03/2017 01:26:16 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	281	0	2018	Virginia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	282	0		29	10	S5810_282_0	5			1		08/04/2017	2018.03	08/04/2017 09:15:14 AM Eastern Daylight Time		08/03/2017 01:26:40 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	282	0	2018	North Carolina		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	283	0		29	10	S5810_283_0	2			1		05/23/2017	2018.03	05/23/2017 06:44:35 PM Eastern Daylight Time		07/17/2017 08:31:32 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	283	0	2018	South Carolina		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	284	0		29	10	S5810_284_0	4			1		08/04/2017	2018.03	08/04/2017 09:15:26 AM Eastern Daylight Time		08/03/2017 01:27:29 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	284	0	2018	Georgia		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	285	0		29	10	S5810_285_0	2			1		05/23/2017	2018.03	05/23/2017 06:46:18 PM Eastern Daylight Time		07/17/2017 08:32:23 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	285	0	2018	Florida		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	286	0		29	10	S5810_286_0	5			1		08/10/2017	2018.03	08/10/2017 11:35:32 AM Eastern Daylight Time		08/08/2017 03:36:59 PM Eastern Daylight Time			08/10/2017 11:36:20 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	286	0	2018	Alabama, Tennessee		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	287	0		29	10	S5810_287_0	5			1		08/04/2017	2018.03	08/04/2017 09:15:57 AM Eastern Daylight Time		08/03/2017 02:21:18 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	287	0	2018	Michigan		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	288	0		29	10	S5810_288_0	2			1		05/30/2017	2018.03	05/30/2017 10:46:00 AM Eastern Daylight Time		07/17/2017 08:33:39 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	288	0	2018	Ohio		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	289	0		29	10	S5810_289_0	4			1		08/04/2017	2018.03	08/04/2017 09:16:09 AM Eastern Daylight Time		08/03/2017 02:22:05 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	289	0	2018	Indiana, Kentucky		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	290	0		29	10	S5810_290_0	2			1		05/23/2017	2018.03	05/23/2017 06:50:36 PM Eastern Daylight Time		07/17/2017 08:34:30 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	290	0	2018	Wisconsin		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	291	0		29	10	S5810_291_0	4			1		08/04/2017	2018.03	08/04/2017 09:16:21 AM Eastern Daylight Time		08/03/2017 02:22:53 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	291	0	2018	Illinois		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	292	0		29	10	S5810_292_0	5			1		08/04/2017	2018.03	08/04/2017 09:16:36 AM Eastern Daylight Time		08/03/2017 02:23:17 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	292	0	2018	Louisiana		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	293	0		29	10	S5810_293_0	2			1		05/23/2017	2018.03	05/23/2017 06:54:45 PM Eastern Daylight Time		07/17/2017 08:35:45 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	293	0	2018	Texas		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	294	0		29	10	S5810_294_0	2			1		05/23/2017	2018.03	05/23/2017 06:55:34 PM Eastern Daylight Time		07/17/2017 08:36:10 AM Eastern Daylight Time			07/17/2017 12:57:36 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	294	0	2018	Arizona		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	295	0		29	10	S5810_295_0	4			1		08/04/2017	2018.03	08/04/2017 09:16:47 AM Eastern Daylight Time		08/03/2017 02:24:30 PM Eastern Daylight Time			08/04/2017 09:27:37 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Select (PDP)	10	29					S5810	295	0	2018	California		2					2						www.aetnamedicare.com/findpharmacy	www.aetnamedicare.com/formulary										(877)238-6211		(877)238-6211		(855)338-7030		(855)338-7030										(711)-		(711)-		(711)-		(711)-																
S5810	801	0		29	10	S5810_801_0	1			1		05/31/2017	2018.03	05/31/2017 09:15:43 AM Eastern Daylight Time					06/01/2017 01:18:05 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Plan (PDP)	10	29					S5810	801	0	2018	Employer National		1					2						https://www.aetnamedicare.com/findpharmacy	www.aetnaretireeplans.com										(800)594-9390		(800)594-9390		(800)307-4830		(800)307-4830										(711)-		(711)-		(711)-		(711)-																
S5820	001	0		29	10	S5820_001_0	1			1		06/01/2017	2018.03	06/01/2017 09:06:53 AM Central Daylight Time		05/31/2017 11:26:30 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	001	0	2018	Northern New England (NH, ME)		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	002	0		29	10	S5820_002_0	1			1		06/01/2017	2018.03	06/01/2017 09:07:47 AM Central Daylight Time		05/31/2017 11:26:56 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	002	0	2018	Central New England (CT, MA, RI, VT)		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	003	0		29	10	S5820_003_0	1			1		06/01/2017	2018.03	06/01/2017 09:08:24 AM Central Daylight Time		05/31/2017 11:27:22 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	003	0	2018	New Jersey		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	004	0		29	10	S5820_004_0	1			1		06/01/2017	2018.03	06/01/2017 09:08:58 AM Central Daylight Time		05/31/2017 11:27:46 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	004	0	2018	Mid-Atlantic (DE, DC, MD)		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	005	0		29	10	S5820_005_0	1			1		06/01/2017	2018.03	06/01/2017 09:09:31 AM Central Daylight Time		05/31/2017 11:28:12 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	005	0	2018	Pennsylvania, West Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	006	0		29	10	S5820_006_0	1			1		06/01/2017	2018.03	06/01/2017 09:10:07 AM Central Daylight Time		05/31/2017 11:28:38 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	006	0	2018	Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	007	0		29	10	S5820_007_0	1			1		06/01/2017	2018.03	06/01/2017 09:10:42 AM Central Daylight Time		05/31/2017 11:29:02 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	007	0	2018	North Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	008	0		29	10	S5820_008_0	1			1		06/01/2017	2018.03	06/01/2017 09:13:55 AM Central Daylight Time		05/31/2017 11:29:28 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	008	0	2018	South Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	009	0		29	10	S5820_009_0	1			1		06/01/2017	2018.03	06/01/2017 09:14:29 AM Central Daylight Time		05/31/2017 11:29:54 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	009	0	2018	Georgia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	010	0		29	10	S5820_010_0	1			1		06/01/2017	2018.03	06/01/2017 09:15:04 AM Central Daylight Time		05/31/2017 11:30:20 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	010	0	2018	Florida		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	011	0		29	10	S5820_011_0	1			1		06/01/2017	2018.03	06/01/2017 09:15:45 AM Central Daylight Time		05/31/2017 11:30:44 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	011	0	2018	Alabama, Tennessee		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	012	0		29	10	S5820_012_0	1			1		06/01/2017	2018.03	06/01/2017 09:16:38 AM Central Daylight Time		05/31/2017 11:31:10 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	012	0	2018	Michigan		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	013	0		29	10	S5820_013_0	1			1		06/01/2017	2018.03	06/01/2017 09:17:12 AM Central Daylight Time		05/31/2017 11:31:36 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	013	0	2018	Ohio		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	014	0		29	10	S5820_014_0	1			1		06/01/2017	2018.03	06/01/2017 09:17:48 AM Central Daylight Time		05/31/2017 11:32:02 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	014	0	2018	Indiana, Kentucky		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	015	0		29	10	S5820_015_0	1			1		06/01/2017	2018.03	06/01/2017 09:18:37 AM Central Daylight Time		05/31/2017 11:32:26 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	015	0	2018	Wisconsin		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	016	0		29	10	S5820_016_0	1			1		06/01/2017	2018.03	06/01/2017 09:19:13 AM Central Daylight Time		05/31/2017 11:32:56 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	016	0	2018	Illinois		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	017	0		29	10	S5820_017_0	1			1		06/01/2017	2018.03	06/01/2017 09:19:44 AM Central Daylight Time		05/31/2017 11:33:22 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	017	0	2018	Missouri		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	018	0		29	10	S5820_018_0	1			1		06/01/2017	2018.03	06/01/2017 09:20:23 AM Central Daylight Time		05/31/2017 11:33:48 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	018	0	2018	Arkansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	019	0		29	10	S5820_019_0	1			1		06/01/2017	2018.03	06/01/2017 09:32:14 AM Central Daylight Time		05/31/2017 11:34:12 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	019	0	2018	Mississippi		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	020	0		29	10	S5820_020_0	1			1		06/01/2017	2018.03	06/01/2017 09:32:45 AM Central Daylight Time		05/31/2017 11:34:38 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	020	0	2018	Louisiana		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	021	0		29	10	S5820_021_0	1			1		06/01/2017	2018.03	06/01/2017 09:33:23 AM Central Daylight Time		05/31/2017 11:35:04 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	021	0	2018	Texas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	022	0		29	10	S5820_022_0	1			1		06/01/2017	2018.03	06/01/2017 09:33:59 AM Central Daylight Time		05/31/2017 11:35:28 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	022	0	2018	Oklahoma		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	023	0		29	10	S5820_023_0	1			1		06/01/2017	2018.03	06/01/2017 09:34:28 AM Central Daylight Time		05/31/2017 11:35:54 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	023	0	2018	Kansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	024	0		29	10	S5820_024_0	1			1		06/01/2017	2018.03	06/01/2017 09:35:07 AM Central Daylight Time		05/31/2017 11:36:24 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	024	0	2018	Upper Midwest and Northern Plains		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	025	0		29	10	S5820_025_0	1			1		06/01/2017	2018.03	06/01/2017 09:36:59 AM Central Daylight Time		05/31/2017 11:36:50 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	025	0	2018	New Mexico		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	026	0		29	10	S5820_026_0	1			1		06/01/2017	2018.03	06/01/2017 09:39:20 AM Central Daylight Time		05/31/2017 11:37:16 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	026	0	2018	Colorado		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	027	0		29	10	S5820_027_0	1			1		06/01/2017	2018.03	06/01/2017 09:41:51 AM Central Daylight Time		05/31/2017 11:37:40 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	027	0	2018	Arizona		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	028	0		29	10	S5820_028_0	1			1		06/01/2017	2018.03	06/01/2017 09:42:23 AM Central Daylight Time		05/31/2017 11:38:06 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	028	0	2018	Nevada		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	029	0		29	10	S5820_029_0	1			1		06/01/2017	2018.03	06/01/2017 09:43:21 AM Central Daylight Time		05/31/2017 11:38:32 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	029	0	2018	Oregon, Washington		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	030	0		29	10	S5820_030_0	1			1		06/01/2017	2018.03	06/01/2017 09:43:53 AM Central Daylight Time		05/31/2017 11:38:58 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	030	0	2018	Idaho, Utah		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	031	0		29	10	S5820_031_0	1			1		06/01/2017	2018.03	06/01/2017 09:44:31 AM Central Daylight Time		05/31/2017 11:39:26 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	031	0	2018	California		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	032	0		29	10	S5820_032_0	1			1		06/01/2017	2018.03	06/01/2017 09:45:29 AM Central Daylight Time		05/31/2017 11:39:52 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	032	0	2018	Hawaii		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	033	0		29	10	S5820_033_0	1			1		06/01/2017	2018.03	06/01/2017 09:46:03 AM Central Daylight Time		05/31/2017 11:40:18 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	033	0	2018	Alaska		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	034	0		29	10	S5820_034_0	1			1		06/01/2017	2018.03	06/01/2017 08:48:55 AM Central Daylight Time		05/31/2017 11:40:44 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	034	0	2018	American Samoa		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	035	0		29	10	S5820_035_0	1			1		05/26/2017	2018.03	05/26/2017 12:52:29 PM Central Daylight Time		05/31/2017 11:41:08 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	035	0	2018	Guam		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	036	0		29	10	S5820_036_0	1			1		05/26/2017	2018.03	05/26/2017 12:58:55 PM Central Daylight Time		05/31/2017 11:41:34 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	036	0	2018	Northern Mariana Islands		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	037	0		29	10	S5820_037_0	1			1		05/26/2017	2018.03	05/26/2017 01:04:47 PM Central Daylight Time		05/31/2017 11:42:04 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	037	0	2018	Puerto Rico		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	038	0		29	10	S5820_038_0	1			1		05/26/2017	2018.03	05/26/2017 01:02:11 PM Central Daylight Time		05/31/2017 11:42:30 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	038	0	2018	US Virgin Islands		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(888)867-5575		(888)867-5575		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5820	803	0		29	10	S5820_803_0	1			1		05/23/2017	2018.03	05/23/2017 02:09:40 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	803	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	804	0		29	10	S5820_804_0	1			1		05/23/2017	2018.03	05/23/2017 02:36:47 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	804	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	807	0		29	10	S5820_807_0	1			1		05/23/2017	2018.03	05/23/2017 02:36:53 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	807	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	808	0		29	10	S5820_808_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:02 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	808	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	810	0		29	10	S5820_810_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:10 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	810	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	811	0		29	10	S5820_811_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:16 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	811	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	812	0		29	10	S5820_812_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:23 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	812	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	813	0		29	10	S5820_813_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:30 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	813	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	814	0		29	10	S5820_814_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:35 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	814	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	815	0		29	10	S5820_815_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:43 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	815	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	816	0		29	10	S5820_816_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:48 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	816	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	817	0		29	10	S5820_817_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:53 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	817	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	818	0		29	10	S5820_818_0	1			1		05/23/2017	2018.03	05/23/2017 02:37:58 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	818	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	819	0		29	10	S5820_819_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:03 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	819	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	820	0		29	10	S5820_820_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:08 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	820	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	821	0		29	10	S5820_821_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:13 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	821	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	822	0		29	10	S5820_822_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:17 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	822	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	823	0		29	10	S5820_823_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:22 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	823	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	824	0		29	10	S5820_824_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:26 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	824	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	825	0		29	10	S5820_825_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:31 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	825	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	826	0		29	10	S5820_826_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:36 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	826	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	827	0		29	10	S5820_827_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:42 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	827	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	828	0		29	10	S5820_828_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:48 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	828	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	829	0		29	10	S5820_829_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:52 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	829	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	830	0		29	10	S5820_830_0	1			1		05/23/2017	2018.03	05/23/2017 02:38:57 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	830	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	831	0		29	10	S5820_831_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:02 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	831	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	832	0		29	10	S5820_832_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:06 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	832	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	833	0		29	10	S5820_833_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:11 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	833	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	834	0		29	10	S5820_834_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:17 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	834	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	835	0		29	10	S5820_835_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:22 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	835	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5820	836	0		29	10	S5820_836_0	1			1		05/23/2017	2018.03	05/23/2017 02:39:26 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	836	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5857	802	0		29	10	S5857_802_0	2			1		05/22/2017	2018.03	05/22/2017 02:17:40 PM Eastern Daylight Time					06/05/2017 11:38:27 AM Eastern Daylight Time	PRIORITY HEALTH INSURANCE COMPANY	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Rx EG Non-Calendar Year (PDP)	10	29					S5857	802	0	2018	United States		1					2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com									(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850										(711)-		(711)-		(711)-		(711)-																
S5857	803	0		29	10	S5857_803_0	2			1		05/05/2017	2018.03	05/05/2017 10:16:29 AM Eastern Daylight Time					06/05/2017 11:38:27 AM Eastern Daylight Time	PRIORITY HEALTH INSURANCE COMPANY	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Rx EG Calendar Year (PDP)	10	29					S5857	803	0	2018	United States		1					2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com									(888)389-6648		(616)464-8820		(888)389-6676		(616)464-8850										(711)-		(711)-		(711)-		(711)-																
S5877	004	0		29	10	S5877_004_0	1			1		05/31/2017	2018.03	05/31/2017 06:08:17 PM Mountain Daylight Time		06/05/2017 08:55:42 AM Mountain Daylight Time			06/05/2017 08:58:31 AM Mountain Daylight Time	EDUCATORS MUTUAL INSURANCE ASSOCIATION	EMI Health	http://medicare.emihealth.com/	Educators Rx Basic (PDP)	10	29					S5877	004	0	2018	State of Utah and State of Idaho		2					2						http://www.express-scripts.com	https://medicare.emihealth.com/Formulary.aspx										(800)572-8734		(801)262-7475		(888)236-4823		(801)262-7475										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5877	007	0		29	10	S5877_007_0	1			1		05/31/2017	2018.03	05/31/2017 05:14:54 PM Mountain Daylight Time		06/05/2017 08:55:42 AM Mountain Daylight Time			06/05/2017 08:58:31 AM Mountain Daylight Time	EDUCATORS MUTUAL INSURANCE ASSOCIATION	EMI Health	http://medicare.emihealth.com/	Educators Rx Advantage (PDP)	10	29					S5877	007	0	2018	State of Utah and State of Idaho		2					2						http://www.express-scripts.com	https://medicare.emihealth.com/Formulary.aspx										(800)572-8734		(801)262-7475		(888)236-4823		(801)262-7475										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5877	801	0		29	10	S5877_801_0	1			1		05/31/2017	2018.03	05/31/2017 04:36:43 PM Mountain Daylight Time					06/05/2017 08:58:31 AM Mountain Daylight Time	EDUCATORS MUTUAL INSURANCE ASSOCIATION	EMI Health	http://medicare.emihealth.com/	Alpine School District Retiree Plan (PDP)	10	29					S5877	801	0	2018	State of Utah and State of Idaho		1					2						http://www.express-scripts.com	https://medicare.emihealth.com/Formulary.aspx										(800)572-8734		(801)262-7475		(888)236-4823		(801)262-7475										(800)716-3231		(800)716-3231		(711)-		(711)-																
S5884	001	0		29	10	S5884_001_0	4			1		07/17/2017	2018.03	07/17/2017 02:52:55 PM Eastern Daylight Time		05/23/2017 04:28:56 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	001	0	2018	States of Alabama and Tennessee		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	002	0		29	10	S5884_002_0	3			1		07/17/2017	2018.03	07/17/2017 02:54:24 PM Eastern Daylight Time		05/23/2017 04:29:40 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	002	0	2018	States of CT, MA, RI, VT		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	004	0		29	10	S5884_004_0	4			1		07/17/2017	2018.03	07/17/2017 02:55:56 PM Eastern Daylight Time		05/23/2017 04:30:24 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	004	0	2018	States of DC, DE, MD		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	005	0		29	10	S5884_005_0	4			1		07/17/2017	2018.03	07/17/2017 02:57:29 PM Eastern Daylight Time		05/23/2017 04:31:08 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	005	0	2018	States of Pennsylvania and West Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	008	0		29	10	S5884_008_0	4			1		07/17/2017	2018.03	07/17/2017 02:59:12 PM Eastern Daylight Time		05/23/2017 04:31:54 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	008	0	2018	State of South Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	009	0		29	10	S5884_009_0	4			1		07/17/2017	2018.03	07/17/2017 03:00:47 PM Eastern Daylight Time		05/23/2017 04:32:38 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	009	0	2018	State of Georgia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	010	0		29	10	S5884_010_0	4			1		07/17/2017	2018.03	07/17/2017 03:02:21 PM Eastern Daylight Time		05/23/2017 04:33:24 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	010	0	2018	State of Florida		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	015	0		29	10	S5884_015_0	4			1		07/17/2017	2018.03	07/17/2017 03:04:03 PM Eastern Daylight Time		05/23/2017 04:34:08 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	015	0	2018	State of Illinois		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	019	0		29	10	S5884_019_0	2			1		07/17/2017	2018.03	07/17/2017 03:05:40 PM Eastern Daylight Time		05/23/2017 04:34:52 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	019	0	2018	State of Louisiana		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	020	0		29	10	S5884_020_0	2			1		07/17/2017	2018.03	07/17/2017 03:07:23 PM Eastern Daylight Time		05/23/2017 04:35:36 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	020	0	2018	State of Texas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	021	0		29	10	S5884_021_0	2			1		07/17/2017	2018.03	07/17/2017 03:08:56 PM Eastern Daylight Time		05/23/2017 04:36:22 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	021	0	2018	State of Oklahoma		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	022	0		29	10	S5884_022_0	2			1		07/17/2017	2018.03	07/17/2017 03:10:01 PM Eastern Daylight Time		05/23/2017 04:37:06 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	022	0	2018	State of Kansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	024	0		29	10	S5884_024_0	2			1		07/17/2017	2018.03	07/17/2017 03:11:04 PM Eastern Daylight Time		05/23/2017 04:37:52 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	024	0	2018	State of New Mexico		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	028	0		29	10	S5884_028_0	2			1		07/17/2017	2018.03	07/17/2017 03:12:13 PM Eastern Daylight Time		05/23/2017 04:38:38 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	028	0	2018	States of Oregon and Washington		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	030	0		29	10	S5884_030_0	2			1		07/17/2017	2018.03	07/17/2017 03:13:17 PM Eastern Daylight Time		05/23/2017 04:39:26 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	030	0	2018	State of California		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	062	0		29	10	S5884_062_0	4			1		07/17/2017	2018.03	07/17/2017 03:14:19 PM Eastern Daylight Time		05/23/2017 04:40:12 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	062	0	2018	State of New Jersey		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	065	0		29	10	S5884_065_0	4			1		07/17/2017	2018.03	07/17/2017 03:15:27 PM Eastern Daylight Time		05/23/2017 04:40:58 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	065	0	2018	State of Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	066	0		29	10	S5884_066_0	4			1		07/17/2017	2018.03	07/17/2017 03:16:38 PM Eastern Daylight Time		05/23/2017 04:41:42 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	066	0	2018	State of North Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	071	0		29	10	S5884_071_0	4			1		07/17/2017	2018.03	07/17/2017 03:17:41 PM Eastern Daylight Time		05/23/2017 04:42:28 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	071	0	2018	State of Michigan		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	072	0		29	10	S5884_072_0	4			1		07/17/2017	2018.03	07/17/2017 03:18:44 PM Eastern Daylight Time		05/23/2017 04:43:14 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	072	0	2018	State of Ohio		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	073	0		29	10	S5884_073_0	4			1		07/17/2017	2018.03	07/17/2017 03:19:52 PM Eastern Daylight Time		05/23/2017 04:43:58 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	073	0	2018	States of Indiana and Kentucky		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	074	0		29	10	S5884_074_0	4			1		07/17/2017	2018.03	07/17/2017 03:20:53 PM Eastern Daylight Time		05/23/2017 04:44:46 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	074	0	2018	State of Wisconsin		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	076	0		29	10	S5884_076_0	4			1		07/17/2017	2018.03	07/17/2017 03:21:54 PM Eastern Daylight Time		05/23/2017 04:45:32 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	076	0	2018	State of Missouri		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	077	0		29	10	S5884_077_0	2			1		07/17/2017	2018.03	07/17/2017 03:22:56 PM Eastern Daylight Time		05/23/2017 04:46:18 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	077	0	2018	State of Arkansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	078	0		29	10	S5884_078_0	2			1		07/17/2017	2018.03	07/17/2017 03:24:07 PM Eastern Daylight Time		05/23/2017 04:47:04 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	078	0	2018	State of Mississippi		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	083	0		29	10	S5884_083_0	2			1		07/17/2017	2018.03	07/17/2017 03:25:15 PM Eastern Daylight Time		05/23/2017 04:47:52 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	083	0	2018	States of IA, MN, MT, ND, NE, SD, WY		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	085	0		29	10	S5884_085_0	2			1		07/17/2017	2018.03	07/17/2017 03:26:13 PM Eastern Daylight Time		05/23/2017 04:48:38 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	085	0	2018	State of Colorado		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	086	0		29	10	S5884_086_0	2			1		07/17/2017	2018.03	07/17/2017 03:27:12 PM Eastern Daylight Time		05/23/2017 04:49:24 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	086	0	2018	State of Arizona		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	087	0		29	10	S5884_087_0	2			1		07/17/2017	2018.03	07/17/2017 03:28:16 PM Eastern Daylight Time		05/23/2017 04:50:10 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	087	0	2018	State of Nevada		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	089	0		29	10	S5884_089_0	2			1		07/17/2017	2018.03	07/17/2017 03:29:20 PM Eastern Daylight Time		05/23/2017 04:50:56 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	089	0	2018	States of Idaho and Utah		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	092	0		29	10	S5884_092_0	3			1		07/17/2017	2018.03	07/17/2017 03:30:20 PM Eastern Daylight Time		05/23/2017 04:51:44 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	092	0	2018	States of Maine and New Hampshire		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	093	0		29	10	S5884_093_0	2			1		07/17/2017	2018.03	07/17/2017 03:31:22 PM Eastern Daylight Time		05/23/2017 04:52:30 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	093	0	2018	State of Hawaii		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	094	0		29	10	S5884_094_0	2			1		07/17/2017	2018.03	07/17/2017 03:32:22 PM Eastern Daylight Time		05/23/2017 04:53:16 PM Eastern Daylight Time			07/17/2017 05:08:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	094	0	2018	State of Alaska		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	101	0		29	10	S5884_101_0	1			1		05/19/2017	2018.03	05/19/2017 08:12:24 PM Eastern Daylight Time		05/23/2017 04:54:04 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	101	0	2018	States of Maine and New Hampshire		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	102	0		29	10	S5884_102_0	2			1		05/19/2017	2018.03	05/19/2017 10:35:10 PM Eastern Daylight Time		05/23/2017 04:54:50 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	102	0	2018	States of CT, MA, RI, VT		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	103	0		29	10	S5884_103_0	1			1		05/19/2017	2018.03	05/19/2017 08:20:21 PM Eastern Daylight Time		05/23/2017 04:55:34 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	103	0	2018	States of DC, DE, MD		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	104	0		29	10	S5884_104_0	1			1		05/19/2017	2018.03	05/19/2017 08:23:58 PM Eastern Daylight Time		05/23/2017 04:56:20 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	104	0	2018	States of Pennsylvania and West Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	105	0		29	10	S5884_105_0	1			1		05/19/2017	2018.03	05/19/2017 08:32:19 PM Eastern Daylight Time		05/23/2017 04:57:04 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	105	0	2018	State of Florida		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	106	0		29	10	S5884_106_0	1			1		05/19/2017	2018.03	05/19/2017 08:38:45 PM Eastern Daylight Time		05/23/2017 04:57:50 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	106	0	2018	States of Alabama and Tennessee		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	107	0		29	10	S5884_107_0	1			1		05/19/2017	2018.03	05/19/2017 08:47:43 PM Eastern Daylight Time		05/23/2017 04:58:36 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	107	0	2018	State of Illinois		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	108	0		29	10	S5884_108_0	1			1		05/19/2017	2018.03	05/19/2017 08:51:13 PM Eastern Daylight Time		05/23/2017 04:59:22 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	108	0	2018	State of Louisiana		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	109	0		29	10	S5884_109_0	1			1		05/19/2017	2018.03	05/19/2017 08:54:08 PM Eastern Daylight Time		05/23/2017 05:00:08 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	109	0	2018	State of Kansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	110	0		29	10	S5884_110_0	1			1		05/19/2017	2018.03	05/19/2017 08:59:51 PM Eastern Daylight Time		05/23/2017 05:00:54 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	110	0	2018	State of New Mexico		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	111	0		29	10	S5884_111_0	1			1		05/19/2017	2018.03	05/19/2017 09:03:09 PM Eastern Daylight Time		05/23/2017 05:01:40 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	111	0	2018	State of Colorado		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	112	0		29	10	S5884_112_0	1			1		05/19/2017	2018.03	05/19/2017 09:06:33 PM Eastern Daylight Time		05/23/2017 05:02:24 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	112	0	2018	State of Nevada		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	113	0		29	10	S5884_113_0	1			1		05/19/2017	2018.03	05/19/2017 09:10:30 PM Eastern Daylight Time		05/23/2017 05:03:12 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	113	0	2018	States of Oregon and Washington		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	114	0		29	10	S5884_114_0	1			1		05/19/2017	2018.03	05/19/2017 10:37:15 PM Eastern Daylight Time		05/23/2017 05:03:56 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	114	0	2018	State of California		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	115	0		29	10	S5884_115_0	1			1		05/19/2017	2018.03	05/19/2017 09:17:17 PM Eastern Daylight Time		05/23/2017 05:04:42 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	115	0	2018	State of Hawaii		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	116	0		29	10	S5884_116_0	1			1		05/19/2017	2018.03	05/19/2017 09:21:46 PM Eastern Daylight Time		05/23/2017 05:05:26 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	116	0	2018	State of Alaska		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	131	0		29	10	S5884_131_0	2			1		05/19/2017	2018.03	05/19/2017 09:24:35 PM Eastern Daylight Time		05/23/2017 05:06:12 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	131	0	2018	State of New Jersey		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	132	0		29	10	S5884_132_0	1			1		05/19/2017	2018.03	05/19/2017 09:27:55 PM Eastern Daylight Time		05/23/2017 05:06:58 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	132	0	2018	State of Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	133	0		29	10	S5884_133_0	1			1		05/19/2017	2018.03	05/19/2017 09:31:06 PM Eastern Daylight Time		05/23/2017 05:07:44 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	133	0	2018	State of North Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	134	0		29	10	S5884_134_0	1			1		05/19/2017	2018.03	05/19/2017 09:35:14 PM Eastern Daylight Time		05/23/2017 05:08:30 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	134	0	2018	State of South Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	135	0		29	10	S5884_135_0	1			1		05/19/2017	2018.03	05/19/2017 09:38:59 PM Eastern Daylight Time		05/23/2017 05:09:14 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	135	0	2018	State of Georgia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	136	0		29	10	S5884_136_0	1			1		05/19/2017	2018.03	05/19/2017 09:42:32 PM Eastern Daylight Time		05/23/2017 05:10:00 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	136	0	2018	State of Michigan		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	137	0		29	10	S5884_137_0	1			1		05/19/2017	2018.03	05/19/2017 09:46:31 PM Eastern Daylight Time		05/23/2017 05:10:44 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	137	0	2018	State of Ohio		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	138	0		29	10	S5884_138_0	1			1		05/19/2017	2018.03	05/19/2017 09:49:00 PM Eastern Daylight Time		05/23/2017 05:11:30 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	138	0	2018	States of Indiana and Kentucky		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	139	0		29	10	S5884_139_0	1			1		05/19/2017	2018.03	05/19/2017 09:51:34 PM Eastern Daylight Time		05/23/2017 05:12:16 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	139	0	2018	State of Wisconsin		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	140	0		29	10	S5884_140_0	1			1		05/19/2017	2018.03	05/19/2017 09:54:33 PM Eastern Daylight Time		05/23/2017 05:13:00 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	140	0	2018	State of Missouri		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	141	0		29	10	S5884_141_0	1			1		05/19/2017	2018.03	05/19/2017 09:59:27 PM Eastern Daylight Time		05/23/2017 05:13:46 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	141	0	2018	State of Arkansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	142	0		29	10	S5884_142_0	1			1		05/19/2017	2018.03	05/19/2017 10:03:29 PM Eastern Daylight Time		05/23/2017 05:14:32 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	142	0	2018	State of Mississippi		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	143	0		29	10	S5884_143_0	1			1		05/19/2017	2018.03	05/19/2017 10:06:04 PM Eastern Daylight Time		05/23/2017 05:15:18 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	143	0	2018	State of Texas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	144	0		29	10	S5884_144_0	1			1		05/19/2017	2018.03	05/19/2017 10:39:21 PM Eastern Daylight Time		05/23/2017 05:16:04 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	144	0	2018	State of Oklahoma		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	145	0		29	10	S5884_145_0	1			1		05/19/2017	2018.03	05/19/2017 10:12:46 PM Eastern Daylight Time		05/23/2017 05:16:50 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	145	0	2018	States of IA, MN, MT, ND, NE, SD, WY		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	146	0		29	10	S5884_146_0	1			1		05/19/2017	2018.03	05/19/2017 10:17:50 PM Eastern Daylight Time		05/23/2017 05:17:34 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	146	0	2018	State of Arizona		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	147	0		29	10	S5884_147_0	2			1		05/19/2017	2018.03	05/19/2017 10:20:04 PM Eastern Daylight Time		05/23/2017 05:18:20 PM Eastern Daylight Time			05/31/2017 11:08:19 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Preferred Rx Plan (PDP)	10	29					S5884	147	0	2018	States of Idaho and Utah		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	148	0		29	10	S5884_148_0	1			1		05/23/2017	2018.03	05/23/2017 08:53:20 AM Eastern Daylight Time		05/23/2017 05:19:04 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	148	0	2018	States of Maine and New Hampshire		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	149	0		29	10	S5884_149_0	2			1		05/20/2017	2018.03	05/20/2017 12:03:07 AM Eastern Daylight Time		05/23/2017 05:19:48 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	149	0	2018	States of CT, MA, RI, VT		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	150	0		29	10	S5884_150_0	2			1		05/20/2017	2018.03	05/20/2017 12:05:49 AM Eastern Daylight Time		05/23/2017 05:20:34 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	150	0	2018	State of New Jersey		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	151	0		29	10	S5884_151_0	2			1		05/20/2017	2018.03	05/20/2017 12:07:56 AM Eastern Daylight Time		05/23/2017 05:21:18 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	151	0	2018	States of DC, DE, MD		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	152	0		29	10	S5884_152_0	2			1		05/20/2017	2018.03	05/20/2017 12:10:18 AM Eastern Daylight Time		05/23/2017 05:22:02 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	152	0	2018	States of Pennsylvania and West Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	153	0		29	10	S5884_153_0	2			1		05/20/2017	2018.03	05/20/2017 12:12:38 AM Eastern Daylight Time		05/23/2017 05:22:46 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	153	0	2018	State of Virginia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	154	0		29	10	S5884_154_0	2			1		05/20/2017	2018.03	05/20/2017 12:14:50 AM Eastern Daylight Time		05/23/2017 05:23:36 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	154	0	2018	State of North Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	155	0		29	10	S5884_155_0	2			1		05/20/2017	2018.03	05/20/2017 12:17:29 AM Eastern Daylight Time		05/23/2017 05:24:28 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	155	0	2018	State of South Carolina		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	156	0		29	10	S5884_156_0	2			1		05/20/2017	2018.03	05/20/2017 12:19:54 AM Eastern Daylight Time		05/23/2017 05:25:14 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	156	0	2018	State of Georgia		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	157	0		29	10	S5884_157_0	2			1		05/20/2017	2018.03	05/20/2017 12:22:39 AM Eastern Daylight Time		05/23/2017 05:25:58 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	157	0	2018	State of Florida		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	158	0		29	10	S5884_158_0	2			1		05/20/2017	2018.03	05/20/2017 12:25:43 AM Eastern Daylight Time		05/23/2017 05:26:44 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	158	0	2018	States of Alabama and Tennessee		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	159	0		29	10	S5884_159_0	2			1		05/20/2017	2018.03	05/20/2017 12:28:33 AM Eastern Daylight Time		05/23/2017 05:27:30 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	159	0	2018	State of Michigan		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	160	0		29	10	S5884_160_0	2			1		05/20/2017	2018.03	05/20/2017 12:31:17 AM Eastern Daylight Time		05/23/2017 05:28:14 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	160	0	2018	State of Ohio		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	161	0		29	10	S5884_161_0	2			1		05/20/2017	2018.03	05/20/2017 12:33:44 AM Eastern Daylight Time		05/23/2017 05:29:00 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	161	0	2018	States of Indiana and Kentucky		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	162	0		29	10	S5884_162_0	2			1		05/20/2017	2018.03	05/20/2017 12:35:48 AM Eastern Daylight Time		05/23/2017 05:29:46 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	162	0	2018	State of Wisconsin		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	163	0		29	10	S5884_163_0	2			1		05/20/2017	2018.03	05/20/2017 12:39:05 AM Eastern Daylight Time		05/23/2017 05:30:30 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	163	0	2018	State of Illinois		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	164	0		29	10	S5884_164_0	2			1		05/20/2017	2018.03	05/20/2017 12:42:10 AM Eastern Daylight Time		05/23/2017 05:31:16 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	164	0	2018	State of Missouri		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	165	0		29	10	S5884_165_0	1			1		05/20/2017	2018.03	05/20/2017 12:45:00 AM Eastern Daylight Time		05/23/2017 05:32:00 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	165	0	2018	State of Arkansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	166	0		29	10	S5884_166_0	1			1		05/20/2017	2018.03	05/20/2017 12:48:24 AM Eastern Daylight Time		05/23/2017 05:32:44 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	166	0	2018	State of Mississippi		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	167	0		29	10	S5884_167_0	1			1		05/20/2017	2018.03	05/20/2017 12:50:41 AM Eastern Daylight Time		05/23/2017 05:33:28 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	167	0	2018	State of Louisiana		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	168	0		29	10	S5884_168_0	1			1		05/20/2017	2018.03	05/20/2017 12:53:08 AM Eastern Daylight Time		05/23/2017 05:34:14 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	168	0	2018	State of Texas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	169	0		29	10	S5884_169_0	1			1		05/20/2017	2018.03	05/20/2017 12:55:17 AM Eastern Daylight Time		05/23/2017 05:35:00 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	169	0	2018	State of Oklahoma		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	170	0		29	10	S5884_170_0	1			1		05/20/2017	2018.03	05/20/2017 12:57:29 AM Eastern Daylight Time		05/23/2017 05:35:44 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	170	0	2018	State of Kansas		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	171	0		29	10	S5884_171_0	1			1		05/20/2017	2018.03	05/20/2017 12:59:43 AM Eastern Daylight Time		05/23/2017 05:36:30 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	171	0	2018	States of IA, MN, MT, ND, NE, SD, WY		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	172	0		29	10	S5884_172_0	1			1		05/20/2017	2018.03	05/20/2017 01:02:12 AM Eastern Daylight Time		05/23/2017 05:37:16 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	172	0	2018	State of New Mexico		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	173	0		29	10	S5884_173_0	1			1		05/20/2017	2018.03	05/20/2017 01:04:34 AM Eastern Daylight Time		05/23/2017 05:38:00 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	173	0	2018	State of Colorado		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	174	0		29	10	S5884_174_0	1			1		05/20/2017	2018.03	05/20/2017 01:06:32 AM Eastern Daylight Time		05/23/2017 05:38:46 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	174	0	2018	State of Arizona		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	175	0		29	10	S5884_175_0	1			1		05/20/2017	2018.03	05/20/2017 01:08:55 AM Eastern Daylight Time		05/23/2017 05:39:32 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	175	0	2018	State of Nevada		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	176	0		29	10	S5884_176_0	1			1		05/20/2017	2018.03	05/20/2017 01:11:20 AM Eastern Daylight Time		05/23/2017 05:40:18 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	176	0	2018	States of Oregon and Washington		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	177	0		29	10	S5884_177_0	1			1		05/20/2017	2018.03	05/20/2017 01:13:35 AM Eastern Daylight Time		05/23/2017 05:41:04 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	177	0	2018	States of Idaho and Utah		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	178	0		29	10	S5884_178_0	1			1		05/20/2017	2018.03	05/20/2017 01:15:37 AM Eastern Daylight Time		05/23/2017 05:41:50 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	178	0	2018	State of California		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	179	0		29	10	S5884_179_0	1			1		05/20/2017	2018.03	05/20/2017 01:18:55 AM Eastern Daylight Time		05/23/2017 05:42:36 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	179	0	2018	State of Hawaii		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	180	0		29	10	S5884_180_0	2			1		05/20/2017	2018.03	05/20/2017 01:21:09 AM Eastern Daylight Time		05/23/2017 05:43:22 PM Eastern Daylight Time			05/31/2017 11:07:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart Rx Plan (PDP)	10	29					S5884	180	0	2018	State of Alaska		2					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(800)281-6918		(800)281-6918		(800)706-0872		(800)706-0872										(711)-		(711)-		(711)-		(711)-																
S5884	834	0		29	10	S5884_834_0	4			1		05/31/2017	2018.03	05/31/2017 09:49:08 AM Eastern Daylight Time					06/05/2017 01:35:42 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana.com/medicare	Humana Medicare Employer (PDP)	10	29					S5884	834	0	2018	All Regions		1					2						http://www.humana.com/Medicare/medicare_prescription_drugs/	http://www.humana.com/medicare/medicare_prescription_drugs/medicare_drug_tools/medicare_drug_list/										(888)396-8810		(888)396-8810		(800)824-8242		(800)824-8242										(711)-		(711)-		(711)-		(711)-																
S5904	001	0		29	10	S5904_001_0	10			1		07/05/2017	2018.03	07/05/2017 01:33:43 PM Eastern Daylight Time		07/18/2017 02:32:00 PM Eastern Daylight Time			07/18/2017 10:13:55 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Premier Rx (PDP)	10	29					S5904	001	0	2018	State of Florida		2					2						www.BlueMedicareFL.com	MyPrime.com										(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465										(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770																
S5904	002	0		29	10	S5904_002_0	7			1		06/01/2017	2018.03	06/01/2017 02:58:40 PM Eastern Daylight Time		06/05/2017 05:34:12 PM Eastern Daylight Time			06/05/2017 05:40:55 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Complete Rx (PDP)	10	29					S5904	002	0	2018	State of Florida		2					2						www.BlueMedicareFL.com	MyPrime.com										(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465										(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770																
S5904	801	0		29	10	S5904_801_0	1			1		06/04/2017	2018.03	06/04/2017 05:48:53 PM Eastern Daylight Time					06/04/2017 05:55:18 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Group Rx (PDP)	10	29					S5904	801	0	2018	State of Florida with National Coverage		1					2						www.BlueMedicareFL.com	MyPrime.com										(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465										(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770																
S5904	802	0		29	10	S5904_802_0	1			1		06/04/2017	2018.03	06/04/2017 05:49:19 PM Eastern Daylight Time					06/04/2017 05:55:18 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Florida Blue	BlueMedicareFL.com	BlueMedicare Group Rx (PDP)	10	29					S5904	802	0	2018	State of Florida with National Coverage		1					2						www.BlueMedicareFL.com	MyPrime.com										(800)926-6565		(800)926-6565		(855)601-9465		(855)601-9465										(800)955-8770		(800)955-8770		(800)955-8770		(800)955-8770																
S5916	001	0		29	10	S5916_001_0	7			1		05/19/2017	2018.03	05/19/2017 04:49:21 PM Mountain Daylight Time		06/04/2017 02:26:57 PM Mountain Daylight Time			06/04/2017 10:43:30 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	Regence BlueShield of Idaho and Regence BC BS Utah	www.regence.com/medicare	Regence Medicare Script Basic (PDP)	10	29					S5916	001	0	2018	Region of Idaho and Utah		2					2						www.regence.com/medicare	www.regence.com/medicare										(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-																
S5916	002	0		29	10	S5916_002_0	7			1		05/11/2017	2018.03	05/11/2017 02:24:59 PM Mountain Daylight Time		06/04/2017 02:27:54 PM Mountain Daylight Time			06/04/2017 10:43:30 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	Regence BlueShield of Idaho and Regence BC BS Utah	www.regence.com/medicare	Regence Medicare Script Enhanced (PDP)	10	29					S5916	002	0	2018	Region of Idaho and Utah		2					2						www.regence.com/medicare	www.regence.com/medicare	www.regence.com/medicare									(800)541-8981		(800)541-8981		(888)369-3171		(888)369-3171										(711)-		(711)-		(711)-		(711)-																
S5916	802	0		29	10	S5916_802_0	3			1		05/12/2017	2018.03	05/12/2017 10:14:46 PM Mountain Daylight Time					06/02/2017 10:15:18 PM Mountain Daylight Time	REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH	Regence BlueShield of Idaho and Regence BC BS Utah	www.regence.com/medicare	Regence Medicare Script (PDP)	10	29					S5916	802	0	2018	Nationwide except territories		1					2						www.regence.com/medicare	www.regence.com/medicare										(888)319-8904		(888)319-8904		(888)319-8904		(888)319-8904										(711)-		(711)-		(711)-		(711)-																
S5921	348	0		29	10	S5921_348_0	1			1		05/27/2017	2018.03	05/27/2017 02:03:33 PM Central Daylight Time		05/31/2017 11:42:54 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	348	0	2018	Connecticut, Massachusetts, Rhode Island, Vermont		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	349	0		29	10	S5921_349_0	1			1		05/26/2017	2018.03	05/26/2017 01:42:33 PM Central Daylight Time		05/31/2017 11:43:20 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	349	0	2018	New Jersey		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	350	0		29	10	S5921_350_0	1			1		05/27/2017	2018.03	05/27/2017 02:24:09 PM Central Daylight Time		05/31/2017 11:43:46 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	350	0	2018	Delaware, Maryland and Washington D.C.		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	351	0		29	10	S5921_351_0	1			1		05/27/2017	2018.03	05/27/2017 02:28:22 PM Central Daylight Time		05/31/2017 11:44:14 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	351	0	2018	Pennsylvania and West Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	352	0		29	10	S5921_352_0	2			1		05/27/2017	2018.03	05/27/2017 02:31:45 PM Central Daylight Time		05/31/2017 11:44:44 PM Central Daylight Time			06/02/2017 03:53:28 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	352	0	2018	Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	353	0		29	10	S5921_353_0	1			1		05/27/2017	2018.03	05/27/2017 02:48:50 PM Central Daylight Time		05/31/2017 11:45:08 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	353	0	2018	North Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	354	0		29	10	S5921_354_0	1			1		05/27/2017	2018.03	05/27/2017 02:52:36 PM Central Daylight Time		06/02/2017 04:44:35 PM Central Daylight Time			06/04/2017 01:36:10 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	354	0	2018	South Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	355	0		29	10	S5921_355_0	1			1		05/27/2017	2018.03	05/27/2017 02:55:41 PM Central Daylight Time		05/31/2017 11:46:00 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	355	0	2018	Georgia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	356	0		29	10	S5921_356_0	2			1		05/27/2017	2018.03	05/27/2017 03:13:47 PM Central Daylight Time		05/31/2017 11:46:30 PM Central Daylight Time			06/02/2017 03:53:28 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	356	0	2018	Florida		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	357	0		29	10	S5921_357_0	1			1		05/27/2017	2018.03	05/27/2017 03:15:53 PM Central Daylight Time		05/31/2017 11:46:56 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	357	0	2018	Alabama and Tennessee		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	358	0		29	10	S5921_358_0	1			1		05/27/2017	2018.03	05/27/2017 03:17:57 PM Central Daylight Time		05/31/2017 11:47:22 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	358	0	2018	Michigan		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	359	0		29	10	S5921_359_0	1			1		05/27/2017	2018.03	05/27/2017 03:27:40 PM Central Daylight Time		05/31/2017 11:47:48 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	359	0	2018	Ohio		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	360	0		29	10	S5921_360_0	1			1		05/27/2017	2018.03	05/27/2017 03:30:41 PM Central Daylight Time		05/31/2017 11:48:14 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	360	0	2018	Indiana and Kentucky		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	361	0		29	10	S5921_361_0	1			1		05/27/2017	2018.03	05/27/2017 03:32:32 PM Central Daylight Time		05/31/2017 11:48:44 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	361	0	2018	Wisconsin		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	362	0		29	10	S5921_362_0	1			1		05/27/2017	2018.03	05/27/2017 03:39:14 PM Central Daylight Time		05/31/2017 11:49:14 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	362	0	2018	Illinois		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	363	0		29	10	S5921_363_0	1			1		05/27/2017	2018.03	05/27/2017 03:40:57 PM Central Daylight Time		05/31/2017 11:49:40 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	363	0	2018	Missouri		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	364	0		29	10	S5921_364_0	1			1		05/27/2017	2018.03	05/27/2017 03:44:40 PM Central Daylight Time		05/31/2017 11:50:08 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	364	0	2018	Arkansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	365	0		29	10	S5921_365_0	1			1		05/30/2017	2018.03	05/30/2017 01:44:30 PM Central Daylight Time		05/31/2017 11:50:36 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	365	0	2018	Mississippi		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	366	0		29	10	S5921_366_0	3			1		05/27/2017	2018.03	05/27/2017 04:06:35 PM Central Daylight Time		06/05/2017 02:23:34 PM Central Daylight Time			06/05/2017 02:46:51 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	366	0	2018	Louisiana		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	367	0		29	10	S5921_367_0	1			1		05/27/2017	2018.03	05/27/2017 04:08:11 PM Central Daylight Time		05/31/2017 11:51:26 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	367	0	2018	Texas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	368	0		29	10	S5921_368_0	1			1		05/27/2017	2018.03	05/27/2017 04:10:03 PM Central Daylight Time		05/31/2017 11:51:52 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	368	0	2018	Oklahoma		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	369	0		29	10	S5921_369_0	1			1		05/27/2017	2018.03	05/27/2017 04:12:03 PM Central Daylight Time		05/31/2017 11:52:18 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	369	0	2018	Kansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	370	0		29	10	S5921_370_0	2			1		05/27/2017	2018.03	05/27/2017 04:19:36 PM Central Daylight Time		05/31/2017 11:52:48 PM Central Daylight Time			06/02/2017 03:53:28 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	370	0	2018	IA, MN, MT, ND, NE, SD, WY		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	371	0		29	10	S5921_371_0	1			1		05/27/2017	2018.03	05/27/2017 04:20:59 PM Central Daylight Time		05/31/2017 11:53:16 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	371	0	2018	New Mexico		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	372	0		29	10	S5921_372_0	1			1		05/27/2017	2018.03	05/27/2017 04:22:44 PM Central Daylight Time		05/31/2017 11:53:44 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	372	0	2018	Colorado		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	373	0		29	10	S5921_373_0	1			1		05/27/2017	2018.03	05/27/2017 04:36:04 PM Central Daylight Time		05/31/2017 11:54:10 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	373	0	2018	Nevada		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	374	0		29	10	S5921_374_0	1			1		05/27/2017	2018.03	05/27/2017 04:41:32 PM Central Daylight Time		05/31/2017 11:54:36 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	374	0	2018	Oregon and Washington		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	375	0		29	10	S5921_375_0	1			1		05/27/2017	2018.03	05/27/2017 04:43:29 PM Central Daylight Time		05/31/2017 11:55:00 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	375	0	2018	Idaho and Utah		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	376	0		29	10	S5921_376_0	1			1		05/26/2017	2018.03	05/26/2017 01:58:41 PM Central Daylight Time		05/31/2017 11:55:30 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	376	0	2018	California		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	377	0		29	10	S5921_377_0	1			1		05/26/2017	2018.03	05/26/2017 02:00:36 PM Central Daylight Time		05/31/2017 11:55:58 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	377	0	2018	Alaska		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	378	0		29	10	S5921_378_0	1			1		05/27/2017	2018.03	05/27/2017 04:46:17 PM Central Daylight Time		05/31/2017 11:56:26 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	378	0	2018	Maine and New Hampshire		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	379	0		29	10	S5921_379_0	1			1		05/27/2017	2018.03	05/27/2017 04:48:39 PM Central Daylight Time		05/31/2017 11:56:52 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	379	0	2018	New York		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	380	0		29	10	S5921_380_0	2			1		05/27/2017	2018.03	05/27/2017 04:50:50 PM Central Daylight Time		05/31/2017 11:57:18 PM Central Daylight Time			06/02/2017 03:53:28 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	380	0	2018	Arizona		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	381	0		29	10	S5921_381_0	1			1		05/27/2017	2018.03	05/27/2017 04:52:10 PM Central Daylight Time		05/31/2017 11:57:42 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Saver Plus (PDP)	10	29					S5921	381	0	2018	Hawaii		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)460-8854		(866)460-8854		(888)867-5564		(888)867-5564										(711)-		(711)-		(711)-		(711)-																
S5921	382	0		29	10	S5921_382_0	1			1		06/01/2017	2018.03	06/01/2017 08:51:36 AM Central Daylight Time		06/01/2017 10:27:54 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	382	0	2018	New York		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	383	0		29	10	S5921_383_0	1			1		06/01/2017	2018.03	06/01/2017 08:52:18 AM Central Daylight Time		06/01/2017 10:28:42 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	383	0	2018	Florida		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com	www.AARPMedicarePlans.com									(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	384	0		29	10	S5921_384_0	1			1		06/01/2017	2018.03	06/01/2017 08:53:32 AM Central Daylight Time		05/31/2017 11:59:02 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	384	0	2018	Northern New England		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	385	0		29	10	S5921_385_0	1			1		05/20/2017	2018.03	05/20/2017 11:15:12 AM Central Daylight Time		05/31/2017 11:59:28 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	385	0	2018	Central New England		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	386	0		29	10	S5921_386_0	1			1		05/20/2017	2018.03	05/20/2017 11:25:53 AM Central Daylight Time		05/31/2017 11:59:54 PM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	386	0	2018	New Jersey		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	387	0		29	10	S5921_387_0	1			1		05/20/2017	2018.03	05/20/2017 11:26:28 AM Central Daylight Time		06/01/2017 12:00:20 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	387	0	2018	Mid-Atlantic		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	388	0		29	10	S5921_388_0	1			1		05/20/2017	2018.03	05/20/2017 11:31:30 AM Central Daylight Time		06/01/2017 12:00:44 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	388	0	2018	Pennsylvania and West Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	389	0		29	10	S5921_389_0	1			1		05/20/2017	2018.03	05/20/2017 11:32:04 AM Central Daylight Time		06/01/2017 12:01:10 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	389	0	2018	Virginia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	390	0		29	10	S5921_390_0	1			1		05/20/2017	2018.03	05/20/2017 11:32:39 AM Central Daylight Time		06/01/2017 12:01:34 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	390	0	2018	North Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	391	0		29	10	S5921_391_0	1			1		05/20/2017	2018.03	05/20/2017 11:33:16 AM Central Daylight Time		06/01/2017 12:02:00 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	391	0	2018	South Carolina		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	392	0		29	10	S5921_392_0	1			1		05/20/2017	2018.03	05/20/2017 11:33:48 AM Central Daylight Time		06/01/2017 12:02:24 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	392	0	2018	Georgia		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	393	0		29	10	S5921_393_0	1			1		05/20/2017	2018.03	05/20/2017 11:35:00 AM Central Daylight Time		06/01/2017 12:02:50 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	393	0	2018	Alabama and Tennessee		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	394	0		29	10	S5921_394_0	1			1		05/20/2017	2018.03	05/20/2017 11:35:34 AM Central Daylight Time		06/01/2017 12:03:14 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	394	0	2018	Michigan		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	395	0		29	10	S5921_395_0	1			1		05/20/2017	2018.03	05/20/2017 11:36:03 AM Central Daylight Time		06/01/2017 12:03:40 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	395	0	2018	Ohio		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	396	0		29	10	S5921_396_0	1			1		05/20/2017	2018.03	05/20/2017 11:38:04 AM Central Daylight Time		06/01/2017 12:04:04 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	396	0	2018	Indiana and Kentucky		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	397	0		29	10	S5921_397_0	1			1		05/20/2017	2018.03	05/20/2017 11:38:43 AM Central Daylight Time		06/01/2017 12:04:30 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	397	0	2018	Wisconsin		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	398	0		29	10	S5921_398_0	1			1		05/20/2017	2018.03	05/20/2017 11:39:21 AM Central Daylight Time		06/01/2017 12:04:54 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	398	0	2018	Illinois		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	399	0		29	10	S5921_399_0	1			1		05/20/2017	2018.03	05/20/2017 11:39:51 AM Central Daylight Time		06/01/2017 12:05:20 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	399	0	2018	Missouri		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	400	0		29	10	S5921_400_0	1			1		05/20/2017	2018.03	05/20/2017 11:40:30 AM Central Daylight Time		06/01/2017 12:05:44 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	400	0	2018	Arkansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	401	0		29	10	S5921_401_0	1			1		05/20/2017	2018.03	05/20/2017 11:41:13 AM Central Daylight Time		06/01/2017 12:06:08 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	401	0	2018	Mississippi		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	402	0		29	10	S5921_402_0	1			1		05/20/2017	2018.03	05/20/2017 11:41:40 AM Central Daylight Time		06/01/2017 12:06:34 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	402	0	2018	Louisiana		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	403	0		29	10	S5921_403_0	1			1		05/20/2017	2018.03	05/20/2017 11:42:08 AM Central Daylight Time		06/01/2017 12:06:58 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	403	0	2018	Texas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	404	0		29	10	S5921_404_0	1			1		05/20/2017	2018.03	05/20/2017 11:42:38 AM Central Daylight Time		06/01/2017 12:07:24 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	404	0	2018	Oklahoma		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	405	0		29	10	S5921_405_0	1			1		05/20/2017	2018.03	05/20/2017 11:43:23 AM Central Daylight Time		06/01/2017 12:07:48 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	405	0	2018	Kansas		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	406	0		29	10	S5921_406_0	1			1		05/20/2017	2018.03	05/20/2017 11:54:07 AM Central Daylight Time		06/01/2017 12:08:14 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	406	0	2018	Upper Midwest and Northern Plains		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	407	0		29	10	S5921_407_0	1			1		05/20/2017	2018.03	05/20/2017 11:54:39 AM Central Daylight Time		06/01/2017 12:08:38 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	407	0	2018	New Mexico		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	408	0		29	10	S5921_408_0	1			1		05/20/2017	2018.03	05/20/2017 11:55:06 AM Central Daylight Time		06/01/2017 12:09:04 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	408	0	2018	Colorado		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	409	0		29	10	S5921_409_0	1			1		05/20/2017	2018.03	05/20/2017 11:55:33 AM Central Daylight Time		06/01/2017 12:09:28 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	409	0	2018	Arizona		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	410	0		29	10	S5921_410_0	1			1		05/20/2017	2018.03	05/20/2017 11:56:04 AM Central Daylight Time		06/01/2017 12:09:54 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	410	0	2018	Nevada		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	411	0		29	10	S5921_411_0	1			1		05/20/2017	2018.03	05/20/2017 11:56:30 AM Central Daylight Time		06/01/2017 12:10:18 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	411	0	2018	Oregon and Washington		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	412	0		29	10	S5921_412_0	1			1		05/20/2017	2018.03	05/20/2017 11:57:03 AM Central Daylight Time		06/01/2017 12:10:44 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	412	0	2018	Idaho and Utah		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	413	0		29	10	S5921_413_0	1			1		05/20/2017	2018.03	05/20/2017 11:57:36 AM Central Daylight Time		06/01/2017 12:11:08 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	413	0	2018	California		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	414	0		29	10	S5921_414_0	1			1		05/25/2017	2018.03	05/25/2017 12:51:08 PM Central Daylight Time		06/01/2017 12:11:34 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	414	0	2018	Hawaii		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	415	0		29	10	S5921_415_0	1			1		05/20/2017	2018.03	05/20/2017 11:58:38 AM Central Daylight Time		06/01/2017 12:11:58 AM Central Daylight Time			06/02/2017 11:23:48 AM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Walgreens (PDP)	10	29					S5921	415	0	2018	Alaska		2					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(866)870-3470		(866)870-3470		(800)753-8004		(800)753-8004										(711)-		(711)-		(711)-		(711)-																
S5921	802	0		29	10	S5921_802_0	1			1		05/23/2017	2018.03	05/23/2017 02:58:11 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5921	802	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5921	837	0		29	10	S5921_837_0	1			1		05/23/2017	2018.03	05/23/2017 02:58:17 PM Central Daylight Time					06/01/2017 04:32:58 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.UHCRetiree.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5921	837	0	2018	National		1					2						www.AARPMedicarePlans.com	www.AARPMedicarePlans.com										(888)556-6648		(888)556-6648		(877)558-4749		(877)558-4749										(711)-		(711)-		(711)-		(711)-																
S5953	001	0		29	10	S5953_001_0	1			1		06/01/2017	2018.03	06/01/2017 11:47:16 AM Eastern Daylight Time		06/02/2017 08:36:12 PM Eastern Daylight Time			06/03/2017 10:33:19 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Rx Value (PDP)	10	29					S5953	001	0	2018	South Carolina		2					2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18										(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-																
S5953	002	0		29	10	S5953_002_0	1			1		05/23/2017	2018.03	05/23/2017 04:11:56 PM Eastern Daylight Time		06/02/2017 08:36:44 PM Eastern Daylight Time			06/03/2017 10:33:19 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	BlueCross Rx Plus (PDP)	10	29					S5953	002	0	2018	South Carolina		2					2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18										(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-																
S5953	801	0		29	10	S5953_801_0	1			1		05/24/2017	2018.03	05/24/2017 09:39:59 AM Eastern Daylight Time					06/03/2017 10:47:09 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	Group Blue Rx Plus (PDP)	10	29					S5953	801	0	2018	South Carolina		1					2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18										(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-																
S5953	802	0		29	10	S5953_802_0	1			1		05/24/2017	2018.03	05/24/2017 09:41:24 AM Eastern Daylight Time					06/03/2017 10:47:09 AM Eastern Daylight Time	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx18	Group Blue Rx Plus (PDP)	10	29					S5953	802	0	2018	South Carolina		1					2						www.scbluesmedadvantage.com/marx18	www.scbluesmedadvantage.com/marx18										(888)645-6025		(888)645-6025		(800)930-2836		(800)930-2836										(711)-		(711)-		(711)-		(711)-																
S5960	801	0		29	10	S5960_801_0	2			1		05/24/2017	2018.03	05/24/2017 10:11:51 AM Eastern Daylight Time					06/05/2017 07:55:34 PM Eastern Daylight Time	UNICARE LIFE & HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards (PDP)	10	29					S5960	801	0	2018	All States (Nationwide)		1					2						www.unicare.com/medicare	www.unicare.com/medicare										(866)470-6265		(866)470-6265		(866)646-2436		(866)646-2436										(711)-		(711)-		(711)-		(711)-																
S5960	803	0		29	10	S5960_803_0	2			1		05/24/2017	2018.03	05/24/2017 10:12:03 AM Eastern Daylight Time					06/05/2017 07:55:34 PM Eastern Daylight Time	UNICARE LIFE & HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards (PDP)	10	29					S5960	803	0	2018	All States (Nationwide)		1					2						www.unicare.com/medicare	www.unicare.com/medicare										(866)470-6265		(866)470-6265		(866)646-2436		(866)646-2436										(711)-		(711)-		(711)-		(711)-																
S5966	803	0		29	10	S5966_803_0	1			1		05/23/2017	2018.03	05/23/2017 11:18:44 AM Eastern Daylight Time					06/01/2017 01:16:24 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PDP	www.emblemhealth.com	EmblemHealth National Drug Plan (PDP)	10	29					S5966	803	0	2018	United States		1					2						www.emblemhealth.com	www.emblemhealth.com										(800)585-5786		(800)585-5786		(800)447-9169		(800)447-9169										(711)-		(711)-		(711)-		(711)-																
S5966	804	0		29	10	S5966_804_0	1			1		05/23/2017	2018.03	05/23/2017 11:18:57 AM Eastern Daylight Time					06/01/2017 01:40:49 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PDP	www.emblemhealth.com	EmblemHealth National Drug Plan (PDP)	10	29					S5966	804	0	2018	United States		1					2						www.emblemhealth.com	www.emblemhealth.com										(800)585-5786		(800)585-5786		(800)447-9169		(800)447-9169										(711)-		(711)-		(711)-		(711)-																
S5975	801	0		29	10	S5975_801_0	2			1		06/02/2017	2018.03	06/02/2017 08:29:38 AM Pacific Daylight Time					06/02/2017 08:30:01 AM Pacific Daylight Time	MODA HEALTH PLAN, INC.	Moda Health Plan, Inc.	www.modahealth.com/medicare	Moda Health Rx Employer Option (PDP)	10	29					S5975	801	0	2018	National		1					2						www.modahealth.com/medicare	www.modahealth.com/medicare										(888)786-7509		(503)265-4709		(888)786-7509		(503)265-4709										(711)-		(711)-		(711)-		(711)-																
S5983	004	0		29	10	S5983_004_0	1			1		05/26/2017	2018.03	05/26/2017 11:27:38 PM Eastern Daylight Time		05/31/2017 05:08:32 PM Eastern Daylight Time			06/03/2017 07:13:19 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Value (PDP)	10	29					S5983	004	0	2018	State of New York		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5983	006	0		29	10	S5983_006_0	2			1		05/28/2017	2018.03	05/28/2017 05:56:21 PM Eastern Daylight Time		05/31/2017 05:45:00 PM Eastern Daylight Time			06/03/2017 07:34:43 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Choice (PDP)	10	29					S5983	006	0	2018	State of New York		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5983	007	0		29	10	S5983_007_0	1			1		05/31/2017	2018.03	05/31/2017 12:27:32 PM Eastern Daylight Time		06/01/2017 04:19:02 PM Eastern Daylight Time			06/03/2017 07:50:12 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare - Saver (PDP)	10	29					S5983	007	0	2018	State of New York		2					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5983	805	0		29	10	S5983_805_0	1			1		05/29/2017	2018.03	05/29/2017 02:33:39 PM Eastern Daylight Time					06/03/2017 07:59:08 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Express Scripts Medicare	www.Express-ScriptsMedicare.com	Express Scripts Medicare (PDP)	10	29					S5983	805	0	2018	Premier Performance Closed 5 Tier - Calendar		1					2						www.Express-ScriptsMedicare.com	www.Express-ScriptsMedicare.com										(800)758-4574		(800)758-4574		(866)477-5704		(866)477-5704										(800)716-3231		(800)716-3231		(800)716-3231		(800)716-3231																
S5993	001	0		29	10	S5993_001_0	4			1		06/28/2017	2018.03	06/28/2017 10:44:37 AM Eastern Daylight Time		06/30/2017 09:45:30 AM Eastern Daylight Time			06/30/2017 09:53:41 AM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.horizonblue.com/medicare	Horizon Medicare Blue Rx Standard (PDP)	10	29					S5993	001	0	2018	New Jersey		2					2						http://www.horizonblue.com/pdp-pharmacy-search	http://www.horizonblue.com/pdp-drug-search										(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-																
S5993	003	0		29	10	S5993_003_0	4			1		06/28/2017	2018.03	06/28/2017 11:00:05 AM Eastern Daylight Time		06/30/2017 09:44:29 AM Eastern Daylight Time			06/30/2017 09:53:41 AM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.horizonblue.com/medicare	Horizon Medicare Blue Rx Enhanced (PDP)	10	29					S5993	003	0	2018	New Jersey		2					2						http://www.horizonblue.com/pdp-pharmacy-search	http://www.horizonblue.com/pdp-drug-search										(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-																
S5993	801	0		29	10	S5993_801_0	2			1		05/19/2017	2018.03	05/19/2017 10:57:22 AM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.horizonblue.com	Horizon Medicare Blue Group Rx (PDP)	10	29					S5993	801	0	2018	National		1					2						https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPDPG/en.html	https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPDPG/en/find-medicine.html										(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-																
S5993	804	0		29	10	S5993_804_0	1			1		05/26/2017	2018.03	05/26/2017 02:09:47 PM Eastern Daylight Time					05/30/2017 06:46:57 PM Eastern Daylight Time	HORIZON INSURANCE COMPANY	Horizon Blue Cross Blue Shield of New Jersey	www.horizonblue.com	Horizon Medicare Blue Group RX Plus (PDP)	10	29					S5993	804	0	2018	National		1					2						https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPDPG/en.html	https://www.myprime.com/v/HBCBSNJ/MEDICARE_D/NJPDPG/en/find-medicine.html										(800)391-1906		(800)391-1906		(888)765-7134		(888)765-7134										(711)-		(711)-		(711)-		(711)-																
S6506	001	0		29	10	S6506_001_0	1			1		05/31/2017	2018.03	05/31/2017 04:53:21 PM Central Daylight Time		06/02/2017 08:44:52 AM Central Daylight Time			06/02/2017 11:37:43 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Blue Cross and Blue Shield of Arizona	www.YourAZMedicareSolutions.com	Blue MedicareRx Value (PDP)	10	29					S6506	001	0	2018	Arizona		2					2						www.YourAZMedicareSolutions.com	www.YourAZMedicareSolutions.com										(877)853-7693		(877)853-7693		(888)264-1568		(888)264-1568										(711)-		(711)-		(711)-		(711)-																
S6506	002	0		29	10	S6506_002_0	1			1		05/31/2017	2018.03	05/31/2017 04:53:38 PM Central Daylight Time		06/02/2017 08:44:52 AM Central Daylight Time			06/02/2017 11:37:43 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Blue Cross and Blue Shield of Arizona	www.YourAZMedicareSolutions.com	Blue MedicareRx Enhanced (PDP)	10	29					S6506	002	0	2018	Arizona		2					2						www.YourAZMedicareSolutions.com	www.YourAZMedicareSolutions.com										(877)853-7693		(877)853-7693		(888)264-1568		(888)264-1568										(711)-		(711)-		(711)-		(711)-																
S6506	801	0		29	10	S6506_801_0	1			1		05/26/2017	2018.03	05/26/2017 09:25:11 AM Central Daylight Time					06/02/2017 11:37:43 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Blue Cross and Blue Shield of Arizona	www.YourAZMedicareSolutions.com	Blue MedicareRx for Groups (PDP)	10	29					S6506	801	0	2018	Nationwide		1					2						www.YourAZMedicareSolutions.com	www.YourAZMedicareSolutions.com										(877)560-8058		(877)560-8058		(888)264-1568		(888)264-1568										(711)-		(711)-		(711)-		(711)-																
S6875	801	0		29	10	S6875_801_0	1			1		05/30/2017	2018.03	05/30/2017 12:28:59 PM Eastern Daylight Time					05/30/2017 02:34:52 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Select Option	http://www.ibxmedicare.com	Select Option Rx Group Option I CY (PDP)	10	29					S6875	801	0	2018	National		1					2						http://www.ibxmedicare.com	http://www.ibxmedicare.com	http://www.ibxmedicare.com									(888)678-7009		(888)678-7009		(888)678-7009		(888)678-7009										(711)-		(711)-		(711)-		(711)-																
S6875	802	0		29	10	S6875_802_0	1			1		05/03/2017	2018.03	05/03/2017 04:39:44 PM Eastern Daylight Time					05/30/2017 02:36:27 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Select Option	http://www.ibxmedicare.com	Select Option Rx Group Option I Non-CY (PDP)	10	29					S6875	802	0	2018	National		1					2						http://www.ibxmedicare.com	http://www.ibxmedicare.com	http://www.ibxmedicare.com									(888)678-7009		(888)678-7009		(888)678-7009		(888)678-7009										(711)-		(711)-		(711)-		(711)-																
S6986	001	0		29	10	S6986_001_0	1			1		06/02/2017	2018.03	06/02/2017 08:56:38 AM Central Daylight Time		06/02/2017 08:44:53 AM Central Daylight Time			06/02/2017 11:45:45 AM Central Daylight Time	MII LIFE, INC.	MII Life, Inc.	www.basicbluerx.com	Basic Blue Rx (PDP)	10	29					S6986	001	0	2018	Michigan		2					2						www.basicbluerx.com	www.basicbluerx.com										(877)376-2185		(877)376-2185		(888)575-7519		(888)575-7519										(711)-		(711)-		(711)-		(711)-																
S6986	002	0		29	10	S6986_002_0	1			1		06/02/2017	2018.03	06/02/2017 08:59:07 AM Central Daylight Time		06/02/2017 08:44:53 AM Central Daylight Time			06/02/2017 11:45:45 AM Central Daylight Time	MII LIFE, INC.	MII Life, Inc.	www.basicbluerx.com	Basic Blue Rx (PDP)	10	29					S6986	002	0	2018	North Carolina		2					2						www.basicbluerx.com	www.basicbluerx.com										(877)376-2185		(877)376-2185		(888)575-7519		(888)575-7519										(711)-		(711)-		(711)-		(711)-																
S6986	003	0		29	10	S6986_003_0	1			1		06/02/2017	2018.03	06/02/2017 09:01:36 AM Central Daylight Time		06/02/2017 08:44:53 AM Central Daylight Time			06/02/2017 11:45:45 AM Central Daylight Time	MII LIFE, INC.	MII Life, Inc.	www.basicbluerx.com	Basic Blue Rx (PDP)	10	29					S6986	003	0	2018	Pennsylvania and West Virginia		2					2						www.basicbluerx.com	www.basicbluerx.com										(877)376-2185		(877)376-2185		(888)575-7519		(888)575-7519										(711)-		(711)-		(711)-		(711)-																
S7694	001	0		29	10	S7694_001_0	4			1		06/02/2017	2018.03	06/02/2017 10:47:14 AM Eastern Daylight Time		06/01/2017 09:46:11 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	001	0	2018	Northern New England Region 01 - ME, NH		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	002	0		29	10	S7694_002_0	2			1		06/02/2017	2018.03	06/02/2017 10:49:41 AM Eastern Daylight Time		06/01/2017 09:47:35 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	002	0	2018	Central N England Region 02 - CT/MA/RI/VT		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	003	0		29	10	S7694_003_0	3			1		06/02/2017	2018.03	06/02/2017 03:20:11 PM Eastern Daylight Time		06/01/2017 09:48:21 PM Eastern Daylight Time			06/02/2017 03:20:33 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	003	0	2018	New York EnvisionRxPlus Region 03		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	004	0		29	10	S7694_004_0	2			1		06/02/2017	2018.03	06/02/2017 01:50:58 PM Eastern Daylight Time		05/31/2017 09:08:15 PM Eastern Daylight Time			06/02/2017 01:51:26 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	004	0	2018	New Jersey EnvisionRxPlus Region 04		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	005	0		29	10	S7694_005_0	2			1		06/02/2017	2018.03	06/02/2017 11:02:49 AM Eastern Daylight Time		06/01/2017 09:49:53 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	005	0	2018	Mid-Atlantic EnvisionRxPlus Region 05 - DE/DC/MD		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	006	0		29	10	S7694_006_0	2			1		06/02/2017	2018.03	06/02/2017 11:21:50 AM Eastern Daylight Time		06/01/2017 09:48:56 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	006	0	2018	Pennsylvania, WV EnvisionRxPlus Region 06		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	007	0		29	10	S7694_007_0	1			1		06/01/2017	2018.03	06/01/2017 02:38:04 PM Eastern Daylight Time		05/31/2017 09:10:23 PM Eastern Daylight Time			06/02/2017 09:21:38 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	007	0	2018	Virginia EnvisionRxPlus Region 07		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	008	0		29	10	S7694_008_0	1			1		06/02/2017	2018.03	06/02/2017 09:10:44 AM Eastern Daylight Time		06/01/2017 09:50:35 PM Eastern Daylight Time			06/02/2017 09:21:38 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	008	0	2018	North Carolina EnvisionRxPlus Region 08		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	009	0		29	10	S7694_009_0	2			1		06/02/2017	2018.03	06/02/2017 11:25:48 AM Eastern Daylight Time		06/01/2017 09:51:16 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	009	0	2018	South Carolina EnvisionRxPlus Region 09		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	010	0		29	10	S7694_010_0	2			1		06/02/2017	2018.03	06/02/2017 11:29:04 AM Eastern Daylight Time		06/01/2017 09:51:54 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	010	0	2018	Georgia EnvisionRxPlus Region 10		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	011	0		29	10	S7694_011_0	1			1		06/01/2017	2018.03	06/01/2017 03:30:10 PM Eastern Daylight Time		05/31/2017 09:13:39 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	011	0	2018	Florida EnvisionRxPlus Region 11		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	012	0		29	10	S7694_012_0	1			1		06/01/2017	2018.03	06/01/2017 03:35:04 PM Eastern Daylight Time		05/31/2017 09:14:20 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	012	0	2018	Alabama,Tennessee EnvisionRxPlus Region 12		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	014	0		29	10	S7694_014_0	2			1		06/02/2017	2018.03	06/02/2017 11:33:44 AM Eastern Daylight Time		06/01/2017 09:52:33 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	014	0	2018	Ohio EnvisionRxPlus Region 14		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	015	0		29	10	S7694_015_0	2			1		06/02/2017	2018.03	06/02/2017 11:39:25 AM Eastern Daylight Time		05/31/2017 09:15:44 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	015	0	2018	Indiana, Kentucky EnvisionRxPlus Region 15		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	016	0		29	10	S7694_016_0	1			1		06/01/2017	2018.03	06/01/2017 12:22:51 PM Eastern Daylight Time		05/31/2017 09:16:16 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	016	0	2018	Wisconsin EnvisionRxPlus Region 16		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	017	0		29	10	S7694_017_0	1			1		06/01/2017	2018.03	06/01/2017 12:24:56 PM Eastern Daylight Time		05/31/2017 09:17:00 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	017	0	2018	Illinois EnvisionRxPlus Region 17		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	018	0		29	10	S7694_018_0	1			1		06/01/2017	2018.03	06/01/2017 12:27:12 PM Eastern Daylight Time		05/31/2017 09:17:50 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	018	0	2018	Missouri EnvisionRxPlus Region 18		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	019	0		29	10	S7694_019_0	1			1		06/01/2017	2018.03	06/01/2017 12:29:13 PM Eastern Daylight Time		05/31/2017 09:18:39 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	019	0	2018	Arkansas EnvisionRxPlus Region 19		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	020	0		29	10	S7694_020_0	2			1		06/02/2017	2018.03	06/02/2017 11:49:00 AM Eastern Daylight Time		06/01/2017 09:53:09 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	020	0	2018	Mississippi EnvisionRxPlus Region 20		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	021	0		29	10	S7694_021_0	1			1		06/01/2017	2018.03	06/01/2017 12:36:47 PM Eastern Daylight Time		05/31/2017 09:19:58 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	021	0	2018	Louisiana EnvisionRxPlus Region 21		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	022	0		29	10	S7694_022_0	1			1		06/01/2017	2018.03	06/01/2017 12:38:25 PM Eastern Daylight Time		05/31/2017 09:20:43 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	022	0	2018	Texas EnvisionRxPlus Region 22		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	023	0		29	10	S7694_023_0	1			1		06/01/2017	2018.03	06/01/2017 12:40:34 PM Eastern Daylight Time		05/31/2017 09:21:26 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	023	0	2018	Oklahoma EnvisionRxPlus Region 23		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	024	0		29	10	S7694_024_0	1			1		06/01/2017	2018.03	06/01/2017 12:43:21 PM Eastern Daylight Time		05/31/2017 09:22:08 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	024	0	2018	Kansas EnvisionRxPlus Region 24		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	025	0		29	10	S7694_025_0	1			1		06/01/2017	2018.03	06/01/2017 12:45:09 PM Eastern Daylight Time		05/31/2017 09:23:14 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	025	0	2018	Midwest/Plains EnvisionRxPlus IA/MN/MT/NE/ND/SD/WY		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	026	0		29	10	S7694_026_0	1			1		06/01/2017	2018.03	06/01/2017 12:47:15 PM Eastern Daylight Time		05/31/2017 09:23:54 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	026	0	2018	New Mexico EnvisionRxPlus Region 26		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	027	0		29	10	S7694_027_0	1			1		06/01/2017	2018.03	06/01/2017 12:49:05 PM Eastern Daylight Time		05/31/2017 09:24:32 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	027	0	2018	Colorado EnvisionRxPlus Region 27		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	028	0		29	10	S7694_028_0	1			1		06/01/2017	2018.03	06/01/2017 12:51:04 PM Eastern Daylight Time		05/31/2017 09:25:06 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	028	0	2018	Arizona EnvisionRxPlus Region 28		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	029	0		29	10	S7694_029_0	1			1		06/01/2017	2018.03	06/01/2017 12:52:46 PM Eastern Daylight Time		05/31/2017 09:25:40 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	029	0	2018	Nevada EnvisionRxPlus Region 29		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	030	0		29	10	S7694_030_0	2			1		06/02/2017	2018.03	06/02/2017 12:02:38 PM Eastern Daylight Time		06/01/2017 09:53:56 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	030	0	2018	Oregon, Washington EnvisionRxPlus Region 30		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	031	0		29	10	S7694_031_0	1			1		06/01/2017	2018.03	06/01/2017 12:54:39 PM Eastern Daylight Time		05/31/2017 09:27:02 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	031	0	2018	Idaho, Utah EnvisionRxPlus Region 31		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	032	0		29	10	S7694_032_0	1			1		06/01/2017	2018.03	06/01/2017 12:56:14 PM Eastern Daylight Time		05/31/2017 09:27:49 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	032	0	2018	California EnvisionRxPlus Region 32		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	033	0		29	10	S7694_033_0	1			1		06/01/2017	2018.03	06/01/2017 12:57:57 PM Eastern Daylight Time		05/31/2017 09:28:34 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	033	0	2018	Hawaii EnvisionRxPlus Region 33		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	034	0		29	10	S7694_034_0	1			1		06/01/2017	2018.03	06/01/2017 12:59:40 PM Eastern Daylight Time		05/31/2017 09:29:19 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	034	0	2018	Alaska EnvisionRxPlus Region 34		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	070	0		29	10	S7694_070_0	2			1		06/02/2017	2018.03	06/02/2017 12:06:23 PM Eastern Daylight Time		06/01/2017 09:56:55 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus (PDP)	10	29					S7694	070	0	2018	Michigan EnvisionRxPlus Region 13		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	105	0		29	10	S7694_105_0	1			1		06/01/2017	2018.03	06/01/2017 01:01:24 PM Eastern Daylight Time		05/31/2017 09:30:38 PM Eastern Daylight Time			06/01/2017 04:21:14 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	www.envisionrxplus.com	EnvisionRxPlus (PDP)	10	29					S7694	105	0	2018	Puerto Rico EnvisionRxPlus Region 38		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	106	0		29	10	S7694_106_0	2			1		06/02/2017	2018.03	06/02/2017 12:09:50 PM Eastern Daylight Time		05/31/2017 09:31:26 PM Eastern Daylight Time			06/02/2017 12:17:18 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	www.envisionrxplus.com	EnvisionRxPlus (PDP)	10	29					S7694	106	0	2018	Guam EnvisionRxPlus Region 36		2					2						envisionrxplus.com/en/pharmacy.aspx	envisionrxplus.com/en/pdl.aspx#	envision.promptpa.com									(866)250-2005		(866)250-2005		(866)250-2005		(866)250-2005										(711)-		(711)-		(711)-		(711)-																
S7694	801	0		29	10	S7694_801_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:16 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Employer Plan Calendar Year (PDP)	10	29					S7694	801	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	EnvisionRxPlus.com	envision.promptpa.com									(844)293-4760		(844)293-4760		(844)293-4760		(844)293-4760										(711)-		(711)-		(711)-		(711)-																
S7694	802	0		29	10	S7694_802_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:27 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Employer Group Non-Calendar Year (PDP)	10	29					S7694	802	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	EnvisionRxPlus.com	envision.promptpa.com									(844)293-4760		(844)293-4760		(844)293-4760		(844)293-4760										(711)-		(711)-		(711)-		(711)-																
S7694	803	0		29	10	S7694_803_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:36 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	retireerxcare.amwins.com	Retiree RxCare 4TC (PDP)	10	29					S7694	803	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	retireerxcare.amwins.com/	envision.promptpa.com									(855)693-3921		(855)693-3921		(855)693-3921		(855)693-3921										(711)-		(711)-		(711)-		(711)-																
S7694	804	0		29	10	S7694_804_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:44 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	retireerxcare.amwins.com	Retiree RxCare 5TC (PDP)	10	29					S7694	804	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	retireerxcare.amwins.com	envision.promptpa.com									(855)693-3921		(855)693-3921		(855)693-3921		(855)693-3921										(711)-		(711)-		(711)-		(711)-																
S7694	805	0		29	10	S7694_805_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:49 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	retireerxcare.amwins.com	Retiree RxCare 4TO (PDP)	10	29					S7694	805	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	retireerxcare.amwins.com	envision.promptpa.com									(855)693-3921		(855)693-3921		(855)693-3921		(855)693-3921										(711)-		(711)-		(711)-		(711)-																
S7694	806	0		29	10	S7694_806_0	1			1		06/06/2017	2018.03	06/06/2017 12:25:56 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	retireerxcare.amwins.com	Retiree RxCare 5TO (PDP)	10	29					S7694	806	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	retireerxcare.amwins.com	envision.promptpa.com									(855)693-3921		(855)693-3921		(855)693-3921		(855)693-3921										(711)-		(711)-		(711)-		(711)-																
S7694	807	0		29	10	S7694_807_0	1			1		06/06/2017	2018.03	06/06/2017 12:26:01 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	retireerxcare.amwins.com	Retiree RxCare Platinum (PDP)	10	29					S7694	807	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	retireerxcare.amwins.com	envision.promptpa.com									(855)693-3921		(855)693-3921		(855)693-3921		(855)693-3921										(711)-		(711)-		(711)-		(711)-																
S7694	808	0		29	10	S7694_808_0	1			1		06/06/2017	2018.03	06/06/2017 12:26:07 PM Eastern Daylight Time					06/06/2017 12:26:32 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Employer Group Broad (PDP)	10	29					S7694	808	0	2018	National EGWP		1					2						envisionrxplus.com/en/pharmacy.aspx	EnvisionRxPlus.com	envision.promptpa.com									(844)293-4760		(844)293-4760		(844)293-4760		(844)293-4760										(711)-		(711)-		(711)-		(711)-																
S8067	001	0		29	10	S8067_001_0	6			1		06/29/2017	2018.03	06/29/2017 06:34:16 PM Eastern Daylight Time		07/20/2017 01:05:56 PM Eastern Daylight Time			07/20/2017 05:47:43 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.avalonsecurerxpdp.com	SecureRx - Option 3 (PDP)	10	29					S8067	001	0	2018	Region 6 - Pennsylvania, West Virginia		2					2						www.avalonsecurerxpdp.com	www.avalonsecurerxpdp.com										(877)234-3853		(877)234-3853		(888)839-7330		(888)839-7330										(711)-		(711)-		(711)-		(711)-																
S8067	003	0		29	10	S8067_003_0	5			1		06/04/2017	2018.03	06/04/2017 11:07:15 PM Eastern Daylight Time		07/20/2017 12:57:20 PM Eastern Daylight Time			07/20/2017 05:47:43 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.avalonsecurerxpdp.com	SecureRx - Option 1 (PDP)	10	29					S8067	003	0	2018	Region 06 - Pennsylvania and West Virginia		2					2						www.avalonsecurerxpdp.com	www.avalonsecurerxpdp.com										(877)234-3853		(877)234-3853		(888)839-7330		(888)839-7330										(711)-		(711)-		(711)-		(711)-																
S8067	801	0		29	10	S8067_801_0	3			1		06/04/2017	2018.03	06/04/2017 11:07:52 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.avalonsecurerxpdp.com	SecureRx - ER (PDP)	10	29					S8067	801	0	2018	National		1					2						www.avalonsecurerxpdp.com	www.avalonsecurerxpdp.com										(877)234-3853		(877)234-3853		(888)839-7330		(888)839-7330										(711)-		(711)-		(711)-		(711)-																
S8067	802	0		29	10	S8067_802_0	3			1		06/04/2017	2018.03	06/04/2017 11:08:14 PM Eastern Daylight Time					06/04/2017 11:30:52 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.avalonsecurerxpdp.com	SecureRx - ER - Non-Calendar PY (PDP)	10	29					S8067	802	0	2018	National		1					2						www.avalonsecurerxpdp.com	www.avalonsecurerxpdp.com										(877)234-3853		(877)234-3853		(888)839-7330		(888)839-7330										(711)-		(711)-		(711)-		(711)-																
S8841	803	0		29	10	S8841_803_0	1			1		05/30/2017	2018.03	05/30/2017 10:23:41 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 4-Tier Silver Plan - CY (PDP)	10	29					S8841	803	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8841	804	0		29	10	S8841_804_0	1			1		05/30/2017	2018.03	05/30/2017 10:24:02 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 4-Tier Silver Plan - NCY (PDP)	10	29					S8841	804	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8841	807	0		29	10	S8841_807_0	1			1		05/30/2017	2018.03	05/30/2017 10:24:18 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 5-Tier Bronze Plan - CY (PDP)	10	29					S8841	807	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8841	808	0		29	10	S8841_808_0	1			1		05/30/2017	2018.03	05/30/2017 10:24:39 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 5-Tier Bronze Plan - NCY (PDP)	10	29					S8841	808	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8841	810	0		29	10	S8841_810_0	1			1		05/30/2017	2018.03	05/30/2017 10:24:57 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 MPSERS EGWP Plan (PDP)	10	29					S8841	810	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(855)577-6517		(855)577-6517		(855)577-6517		(855)577-6517										(711)-		(711)-		(711)-		(711)-																
S8841	812	0		29	10	S8841_812_0	1			1		05/30/2017	2018.03	05/30/2017 10:25:11 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 5-Tier Gold Plan - CY (PDP)	10	29					S8841	812	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8841	813	0		29	10	S8841_813_0	1			1		05/30/2017	2018.03	05/30/2017 10:25:26 AM Eastern Daylight Time					05/30/2017 02:01:32 PM Eastern Daylight Time	OPTUM INSURANCE OF OHIO, INC.	Optum Insurance of Ohio, Inc.	www.optum.com	2018 EGWP 5-Tier Gold Plan - NCY (PDP)	10	29					S8841	813	0	2018	National		1					2						www.optumrx.com/myCatamaranRx	www.optumrx.com/myCatamaranRx										(866)443-1095		(866)443-1095		(866)443-1095		(866)443-1095										(711)-		(711)-		(711)-		(711)-																
S8899	001	0		29	10	S8899_001_0	12			1		08/11/2017	2018.03	08/11/2017 07:49:34 AM West Pacific Standard Time		08/11/2017 08:24:50 AM West Pacific Standard Time			08/11/2017 08:25:31 AM West Pacific Standard Time	TAKECARE INSURANCE COMPANY, INC.	TakeCare Insurance Company, Inc.	takecareasia.com	TakeCare GUAM  (PDP)	10	29					S8899	001	0	2018	TAKECARE GUAM PDP		2					2						envisionrx.com	envisionrx.com	takecareasia.com									(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526										(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526																
S8899	002	0		29	10	S8899_002_0	12			1		06/15/2017	2018.03	06/15/2017 08:31:15 PM West Pacific Standard Time		08/11/2017 08:24:52 AM West Pacific Standard Time			08/11/2017 08:25:31 AM West Pacific Standard Time	TAKECARE INSURANCE COMPANY, INC.	TakeCare Insurance Company, Inc.	takecareasia.com	TakeCare CNMI  (PDP)	10	29					S8899	002	0	2018	TAKECARE CNMI PDP		2					2						envisionrx.com	envisionrx.com	takecareasia.com									(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526										(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526																
S8899	801	0		29	10	S8899_801_0	2			1		06/04/2017	2018.03	06/04/2017 09:15:46 AM West Pacific Standard Time					06/05/2017 08:59:58 AM West Pacific Standard Time	TAKECARE INSURANCE COMPANY, INC.	TakeCare Insurance Company, Inc.	takecareasia.com	TakeCare Employer Group Waiver Plan Guam (PDP)	10	29					S8899	801	0	2018	TakeCare Guam		1					2						envisionrx.com	envisionrx.com	takecareasia.com									(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526										(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526																
S8899	802	0		29	10	S8899_802_0	1			1		06/04/2017	2018.03	06/04/2017 09:15:12 AM West Pacific Standard Time					06/05/2017 08:59:58 AM West Pacific Standard Time	TAKECARE INSURANCE COMPANY, INC.	TakeCare Insurance Company, Inc.	takecareasia.com	TakeCare Employer Group Waiver Plan CNMI (PDP)	10	29					S8899	802	0	2018	TakeCare CNMI		1					2						envisionrx.com	envisionrx.com	takecareasia.com									(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526										(877)484-2411		(671)647-3526		(877)484-2411		(671)647-3526																
S9579	803	0		29	10	S9579_803_0	1			1		05/30/2017	2018.03	05/30/2017 05:22:30 PM Eastern Daylight Time					05/30/2017 05:23:15 PM Eastern Daylight Time	TRANSAMERICA LIFE INSURANCE COMPANY	Transamerica Life Insurance Company	www.medicaregenerationrx.com	Medicare GenerationRx (PDP)	10	29					S9579	803	0	2018	Medicare GenerationRx		1					2						www.medicaregenerationrx.com	www.medicaregenerationrx.com										(877)633-7943		(877)633-7943		(877)633-7943		(877)633-7943										(711)-		(711)-		(711)-		(711)-																
S9579	804	0		29	10	S9579_804_0	1			1		05/30/2017	2018.03	05/30/2017 05:23:00 PM Eastern Daylight Time					05/30/2017 05:23:15 PM Eastern Daylight Time	TRANSAMERICA LIFE INSURANCE COMPANY	Transamerica Life Insurance Company	www.medicaregenerationrx.com	Medicare GenerationRx (PDP)	10	29					S9579	804	0	2018	Medicare GenerationRx		1					2						www.medicaregenerationrx.com	www.medicaregenerationrx.com										(877)633-7943		(877)633-7943		(877)633-7943		(877)633-7943										(711)-		(711)-		(711)-		(711)-																
S9701	801	0		29	10	S9701_801_0	2			1		05/26/2017	2018.03	05/26/2017 10:54:04 AM Central Daylight Time					05/30/2017 11:50:23 AM Central Daylight Time	DEAN HEALTH INSURANCE, INC.	Navitus MedicareRx	https://medicarerx.navitus.com/	Navitus MedicareRx (PDP)	10	29					S9701	801	0	2018	Navitus MedicareRx		1					2						https://medicarerx.navitus.com/	https://medicarerx.navitus.com/										(866)270-3877		(866)270-3877		(866)270-3877		(866)270-3877										(711)-		(711)-		(711)-		(711)-																
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