Downloadable Plan Documents

Your one-stop resource for important documents and forms.

For your convenience, we’ve provided the following helpful documents, which are viewable with Adobe Reader:

Benefits at a Glance

Effective January 1, 2021, the health plan formerly known as the Be Well @ Shell Kelsey-Seybold Health Plan has a new name. The Kelsey-Seybold Greater Houston Plan offers the same great doctors and benefits, including 100% coverage for cancer prevention, diagnosis, and treatment. Read the 2021 Benefits at a Glance.

After-Hours Services, Emergencies, and Urgent Care

Kelsey-Seybold is available 24/7 if you have questions about urgent care matters or need to speak to an after-hours nurse. If a situation seems life-threatening, take immediate action and call 911. You also have access to 100+ urgent care facilities through Cigna Healthcare. Call the Cigna Customer Service Line at 1-855-279-1509 to find an urgent care facility near you. Read more about round-the-clock care at Kelsey-Seybold.

Guest Privileges Program

With the Cigna Guest Privileges program offered by the Kelsey-Seybold Greater Houston Plan, you have the peace of mind of knowing that when you’re temporarily away from home for an extended period of time, you have health coverage. Read about the program

Virtual Care (Video Visits)

Virtual Care visits with Kelsey-Seybold primary and specialty care providers are a covered benefit for Kelsey-Seybold Greater Houston Plan members. Have a real-time conversation from your smartphone, iPad, or computer.

Read about Video Visits.

Transition of Care

If you’re currently under treatment for a serious medical condition or you’re in your second or third trimester of pregnancy with a non-Kelsey-Seybold physician, you should complete the Kelsey-Seybold Greater Houston Plan Transition of Care Request Form no later than 30 days after the effective date of your coverage to continue seeing your non-Kelsey-Seybold provider.

View the Transition of Care Request Form.