Appeals and Grievances
Appointment of Representative Form
Other Important Forms
We’re here to support you
Have a Friend Interested in CCA? Let Us Know
Submit This Form on Your Friend’s Behalf
Or Have Your Friend Call Us833-833-0708 (TTY 711)
8:00 am to 5:00 pm, Monday – Friday
Our team can help you:
- Schedule an in-person appointment
- Understand our plans and benefits
- Check if your doctor is in our network
- Find out your prescription costs
- Enroll in a plan
To refer a friend, please fill out this form.
All fields are required.