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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
Partnership HealthPlan of California is authorized by the State of California to provide health care services for Medi-Cal managed care beneficiaries in 24 Northern California counties.
The enacted 2024‑25 budget provides $161 billion for Medi-Cal, roughly half of which is funded by the federal government and the remaining covered by state and local sources. Of this amount, $35 billion comes from the General Fund—roughly 17 percent of total General Fund spending.
Medi-Cal is a state-sponsored health insurance program administered to you through the Alliance. Medi-Cal provides comprehensive health care coverage for those who meet income guidelines.
For provider enrollment information visit our website at .alamedasocialservices and follow the directions for the Provider Enrollment Process, or call (510) 577-1877.
Central California Alliance for Health (the Alliance) is a managed care health plan for people who have Medi-Cal. The Alliance works with the State of California to provide health care to people who live in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.
You should contact the Compliance Department promptly by one of the following methods: Send an email via AHS global address “Compliance AHS” • Call the Compliance Department at 510-535-7788; or • Call the Compliance Hotline 844-310-0005, including reporting concerns anonymously.
For any questions or information regarding Medi-Cal health plans, visit or call a Health Care Options (HCO) representative at 1-800-430-4263.