Documents and Forms
The following documents provide detailed information on Peoples Health Group Medicare benefits and plan information. Use the links below to view Group Medicare documents directly from your computer.
If you would like any of these documents mailed to you, please call us toll-free at 1-800-978-9765, Monday through Friday, 8 a.m. to 6 p.m. You should receive the documents within two weeks of your request.
2008 Evidence of Coverage (PDF file - 4.3 MB) - provides information about your benefits, membership, covered and non-covered services, member rights and responsibilities and other important plan details
2008 Abridged Formulary (PDF file - 3.6 MB) - a partial list of the open formulary for prescription drugs covered by OGB Group Medicare
2008 Summary of Benefits (PDF file - 764 KB) - charts your benefits, associated costs and the benefits and costs for original Medicare.
2008 Provider Directory (PDF file - 4.3 MB)
Notice of Privacy Practices (PDF file - 588 KB) - describes how your medical information may be used and disclosed and how you can get access to this information
Viewing these documents requires the Adobe Acrobat Reader, which can be downloaded for free.
If you would like any of these documents mailed to you, please call us toll-free at 1-800-978-9765, Monday through Friday 8 a.m. to 6 p.m. You should receive the documents within two weeks of your request.
 Page content last updated: 07-24-08
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