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Plan Documents

Access Champion Health Plan documents by plan year, state, language and plan name where applicable. Plan Documents can be filtered by category including Summary of Benefits, Evidence of Coverage, Annual Notice of Change and more.

Plan Year

State

Language

Plan Name

On this page

  • Evidence of Coverage (EOC)
  • 2026
  • NV
  • ENG (English)

2026 Champion Plus HMO C-SNP Evidence of Coverage (EOC) – Nevada (English)

  • Document

Last Modified Date:

  • October 2, 2026
  • Evidence of Coverage (EOC)
  • 2026
  • CA
  • ESP (Español)

2026 Champion Ally (HMO) Evidence of Coverage (EOC) – California – Spanish

  • Document

Last Modified Date:

  • October 14, 2026
  • Evidence of Coverage (EOC)
  • 2026
  • CA
  • ENG (English)

2026 Champion Ally (HMO) Evidence of Coverage (EOC) – California – English

  • Document

Last Modified Date:

  • October 14, 2026
  • Evidence of Coverage (EOC), Dental Documents
  • 2026
  • CA
  • ESP (Español)

2026 Dental Evidence of Coverage (EOC) – California (Spanish)

  • Document

Last Modified Date:

  • October 2, 2026
  • Evidence of Coverage (EOC), Dental Documents
  • 2026
  • CA
  • ENG (English)

2026 Dental Evidence of Coverage (EOC) – California (English)

  • Document

Last Modified Date:

  • October 2, 2026
  • Evidence of Coverage (EOC), Dental Documents
  • 2026
  • NV
  • ESP (Español)

2026 Dental Evidence of Coverage (EOC) – Nevada (Spanish)

  • Document

Last Modified Date:

  • October 2, 2026
  • Evidence of Coverage (EOC), Dental Documents
  • 2026
  • NV
  • ENG (English)

2026 Dental Evidence of Coverage (EOC) – Nevada (English)

  • Document

Last Modified Date:

  • October 2, 2026
  • Enrollment Book
  • 2026
  • CA
  • ESP (Español)

2026 Champion Ally (HMO) Enrollment Book – California – Vietnamese

  • Document

Last Modified Date:

  • October 14, 2026
  • Enrollment Book
  • 2026
  • NV
  • CHI (中文)

2026 Champion Ally (HMO) Enrollment Book – Nevada – Chinese, Simplified

  • Document

Last Modified Date:

  • October 14, 2026
  • Enrollment Book
  • 2026
  • NV
  • VIT (Tiếng Việt)

2026 Champion Ally (HMO) Enrollment Book – Nevada – Vietnamese

  • Document

Last Modified Date:

  • October 14, 2026
  • Enrollment Book
  • 2026
  • NV
  • ESP (Español)

2026 Champion Ally (HMO) Enrollment Book – Nevada – Spanish

  • Document

Last Modified Date:

  • October 14, 2026
  • Clinical Criteria
  • 2026, 2027
  • NV
  • ENG (English)

Clinical Criteria – Nevada (English)

Clinical Criteria for Utilization Management (UM) Decision-Making – Nevada (English)
  • Document

Last Modified Date:

  • October 14, 2026
  • Clinical Criteria
  • 2026, 2027
  • CA
  • ESP (Español)

Clinical Criteria – California (Spanish)

Criterios clínicos para la toma de decisiones de gestión de la utilización (UM) – California (Spanish)
  • Document

Last Modified Date:

  • October 2, 2026
  • Clinical Criteria
  • 2026, 2027
  • CA
  • ENG (English)

Clinical Criteria – California (English)

Clinical Criteria for Utilization Management (UM) Decision-Making – California (English)
  • Document

Last Modified Date:

  • October 2, 2026
  • Catalogs
  • 2026, 2027
  • CA, NV
  • ENG (English)

Medicare Plus Grocery Catalog (Healthy Foods)

Healthy Foods Item Catalog
  • Document

Last Modified Date:

  • October 13, 2026
  • Dental Documents
  • 2026, 2027
  • CA, NV
  • ENG (English)

Dental Fee Schedule

Champion Health Plan Dental Fee Schedule – California and Nevada (English)
  • Document

Last Modified Date:

  • October 2, 2026