Welcome to Valley Health Plan

Member Services Assistance

For information on how to obtain medical care, interpret your covered health benefits, change your Primary Care Physician, add dependents, request a new VHP ID card, submit claims, file a Grievance, or to assist you with any other service issues, refer to this section.

Termination of Benefits

You may choose to end your membership in the Benefit Plan through voluntary Disenrollment; or your Coverage may be terminated through loss of employment, cancellation or termination of the Agreement, or for reasons of cause as explained in this section.

Individual Continuation of Coverage

Should you become disabled, lose your job, or retire, optional coverage may be available for you or your Eligible Dependent(s). Refer to this section for information on the various options available for you and your family.

Retiree Continuation of Coverage

This section is dedicated to retiree continuation of coverage. Here you will learn how to become a VHP Retiree Member, who is eligible, what retiree covered services are available and about retiree termination.

General Information

This section provides additional information on VHP’s responsibilities to you, your medical records, and your rights and responsibilities as a VHP Member.

Definitions

To help you better understand defined terms, we have provided an explanation of the major words and terms. Defined terms are identified by their initial capitalization. Example: Covered Services; Plan Provider.

Table of Contents

Refer to the Table of Contents to locate the sections included in this Combined Evidence of Coverage and Disclosure Form (EOC). As you read this booklet, you may have questions. For information, call a Valley Health Plan Member Services Representative at 1.888.421.8444 (toll-free). For the hearing and speech impaired, call the California Relay Service (CRS) by simply dialing 711 or the 800 CRS number from your modality. Visit our website at www.valleyhealthplan.org for additional information.