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PACIFICARE

PacifiCare is no longer offering a PPO Plan. 
For a PPO Plan please view the Health Net Options

Rates

PacifiCare HMO Plan  Summary 

2010 Amendment to Combined EOC

Review Pharmacy Benefits   HMO

 

Print PacifiCare Application and complete form

• In order to enroll you need to select a doctor within the network and fill in the PCP section in the application.

Click here to find a PacifiCare Doctor

 

Print Health Net application and complete form

• In order to enroll you need to select a doctor within the network and fill in the PCP section in the application.

Click here to find Health Net Doctor

Click here to print forms and sign

You must be a member of the CAFCC
(California Association for Family Child Care) for $20 a year.

If you are a member already proceed to next step.

If you are not a member, print out theCAFCC application English, CAFCC application Spanish complete and attach a $20 check made out to CAFCC.

There are two options for payment:          

• Auto deduction directly from your checking account.
• Receive a monthly bill and mail in payment.

If you would like auto deduction, please print out the AUTO PAY FORM and complete and prepare a VOID check.

For bill pay please complete a check for the first month's premium, made out to BA&IS (NOT VANTAGE!).

Put the following into an envelope to mail to Vantage:

1. Completed application
2. Both Joiner Forms
3. 1st month's pay OR auto pay form and VOID check
4. Copy of childcare license and driver's license
5. Copy of CAFCC card OR application with a $20 check

Mail to:

Vantage Business Support & Insurance Services
Attn: Childcare Program
2363 mariner Square Dr., Ste. 240
Alameda, CA 94501