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Page numbers referenced within this brochure apply only to the printed brochure

Calvo's SelectCare

www.calvos.net
Customer service: 671-477-9808

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
Health Maintenance Organization High and Standard Options

This plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page 7 for details. This plan is accredited. See page 12.

Serving: The Island of Guam, the Commonwealth of the Northern Mariana Islands, and the Republic of Palau

Enrollment in this plan is limited. You must live or work in our geographic service area to enroll. See page 15 for requirements.

Enrollment codes for this Plan:
    B41 High Option - Self Only
    B43 High Option - Self Plus One
    B42 High Option - Self and Family
    B44 Standard Option - Self Only
    B46 Standard Option - Self Plus One
    B45 Standard Option - Self and Family
Federal Employees Health Benefits Program seal
OPM Logo