Health Plan Resources

Resources to help you better understand and use your health plan.

Your Benefits:

2026 Plan Year Documents - PERS Platinum

2026 Plan Year Documents - PERS Gold

Included Health is not your insurance. We are not responsible for processing, approving, and denying claims.

Please note this format does not conform to the WCAG 2.0 Level AA standards, we are in the final stages of making this version available.

2025 Forms

PERS Platinum

PERS Gold

Open Enrollment

Find a Form:

Continuity of Care

*Please note the Continuity of Care Request Form and Continuity of Care Program Brochure apply to members who are enrolled in the PERS Gold/Platinum plans. These materials do not apply to individuals switching from other carriers into the BSC PPO plans.

Included Health is not your insurance. We are not responsible for processing, approving, and denying claims.

Grievance and Appeals

Grievance: An expression of dissatisfaction with service by the plan that does not involve a request to reconsider a denial of a medical service, medical treatment, or benefit.

Appeal: A request for a medical service, medical treatment, or benefit that has been denied by the Plan, where the Plan will render a decision on the request.

By calling Included Health, you can get support with filing a grievance or appeal. By logging into Included Health, you can get help via the chat feature.

You can submit an appeal or grievance online here. You can also submit an appeal or grievance in writing by mail: Blue Shield of California Appeals and Grievance Department P.O. Box 5588 El Dorado Hills, CA 95762

When you’re submitting your grievance or appeal, try to include as many details as you can—things like who was involved, what happened, when it occurred, and why it’s an issue. The more specific you are, the easier it will be to address your concern. A grievance with Included Health would be about any issues or concerns you have with their services. If your concerns are about how Blue Shield of California is handling claims, benefits, or anything administrative, we can support you in submitting a grievance or appeal. Both Included Health and Blue Shield of California are independently responsible for addressing the issues in their area. Appeals, however, are explicitly handled by Blue Shield of California. Included Health can help you initiate this process.

Blue Shield of California Grievance Form

Blue Shield of California or Included Health may need to collect personal health information (PHI) during their review of your grievance or appeal. To avoid delays, we’ll need you to complete and sign the authorization form.

If you’re representing someone else, the form will also need to be signed by the member whose information is being shared. Additionally, if the member is 12 years or older and the issue involves sensitive services—like reproductive health, behavioral health, substance use, or certain lab tests—the Authorized Representative section must be filled out as well.

Blue Shield of California Authorization Form

ID Card

Login to the Included Health app to access your ID Card. It’s always available on your mobile device through the Included Health app. It’s convenient, and you can be confident that your health plan information and details are always up to date.