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The Document Center provides easy access to public documents. Click on one of the categories below to see related documents or use the search function.
Categories always sorted by seq (sub-categories sorted within each category)
Documents sorted by DATE in Ascending Order within category
Clark County Self-Funded PPO
Clark County EPO
Documents sorted by DATE in Ascending Order within category
Health Benefit Forms7 documents
- HEALTH BENEFITS ENROLLMENT FORM
- HEALTH BENEFIT CHANGE FORM
- CCSF PPO WELLNESS BENEFIT DESIGNATION FORM 2022 to be submitted to UMR
- CCSF PPO SPOUSAL COORDINATION OF BENEFITS FORM
- CCSF PPO WELLNESS BENEFIT DESIGNATION FORM 2021 to be submitted to UMR
- CC EPO COORDINATION OF BENEFITS FORM
- CCSF PPO & EPO GUARANTOR AFFIDAVIT FORM
Clark County Self-Funded PPO
***ATTENTION***The Clark County Self-Funded Plan does not guarantee that all services of providers or facilities will be covered under your health care plan. Benefits should be confirmed by contacting UMR at (800) 395-7069 or by email at clarkcounty@healthscopebenefits.com. Failure to check this may result in your claims not being reimbursed for certain incurred expenses.12 documents
- UMR
- Navitus Health Solutions
- EyeMed Vision Care
- Commercial Formulary (Clark County Employees & Non-Medicare Retirees Only) *Subject to Change*
- CCSF PPO Dental Providers
- CCSF Out-of-Area Dependents and Retirees - Medical Providers
- CCSF PPO Provider Directory
- 2023 CCSF PPO Plan Document
- 2022 CCSF PPO Plan Document
- CCSF Out-of-Area Dependents and Retirees - Mental Health Providers
- Machine-Readable Files For any questions regarding the link or pricing, please contact UMR Customer Care at 800.395.7069; the number is also listed at the back of your ID card.