Forms and Documents What you need to know The forms below are for the 2024–25 academic year. Prior-year forms and documents are available upon request. New student resources UC SHIP Benefits Overview: UC Law SF [PDF] Care You Can Count On Brochure [PDF] Medical Benefit Booklet [PDF] Medical Summary of Benefits & Coverage (SBC) [PDF] Anthem Medical Claim Form [PDF] LiveHealth Online Flyer [PDF] Prescription drugs Optum Rx Formulary [PDF] Optum Rx Formulary Exclusions [PDF] Optum Rx Prescription Drug Claim Form [PDF] Prescription Drug Plan Booklet [PDF] Dental Delta Dental Benefit Booklet (English) [PDF] Delta Dental Benefit Booklet (Mandarin) [PDF] Delta Dental Benefit Booklet (Spanish) [PDF] Delta Dental Claim Form [PDF] Delta Dental Benefit Highlights (Keep Smiling) Flyer [PDF] Vision Blue View Vision Plan Benefit Booklet (English) [PDF] Blue View Vision Plan Benefit Booklet (Mandarin) [PDF] Blue View Vision Plan Benefit Booklet (Spanish) [PDF] Blue View Vision Claim Form [PDF] Related Pages Contacts Mobile Apps
