Your Health Plan Documents



Thank you for choosing Blue Shield of California.

We want to make it easier for you to understand how your health plan works and what to expect. If you have any questions about any of the plans administered by Blue Shield, please contact your dedicated Blue Shield Member Services team.

In the table are plans available through your employer from Blue Shield of California. You may download an Evidence of Coverage (EOC), Certificate of Insurance (COI), or Summary of Benefits and Coverage (SBC) document by selecting the name of a health plan. If you do not see your policy documents below, they will be published as soon as they are available. You may view representative documents at http://blueshieldca.com/policies.

We look forward to serving you and those who depend on you.
Plan NameDocument TypeEffective Date
Custom Access+ HMO Facility Coinsurance 40-40% SBC 07/2024
Custom Full PPO Split Deductible 25-750 80/60 SBC 07/2024
Custom Access+ HMO Facility Coinsurance 40-40% EOC 07/2023
Custom Access+ HMO Facility Coinsurance 40-40% SBC 07/2023
Custom Full PPO Split Deductible 25-750 80/60 EOC 07/2023
Custom Full PPO Split Deductible 25-750 80/60 SBC 07/2023

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Northern CA Plasterers Health & Welfare Trust


Help and Resources


For questions about commonly used healthcare terms, please visit the uniform glossary.

For questions about a plan in which you are enrolled, please call (800) 660-3007.