Summaries and Plan Booklets
Plan Benefit Summary (PDF) July 1, 2026
A detailed list of the level of coverage for covered services (e.g., copay, coinsurance)
Plan Benefit Summary (PDF) July 1, 2025
A detailed list of the level of coverage for covered services (e.g., copay, coinsurance)
Summary of Benefits & Coverage ("SBC") (PDF) July 1, 2026
A summary of the level of coverage for some services (e.g., copay, coinsurance)
Summary of Benefits & Coverage ("SBC") (PDF) July 1, 2025
A summary of the level of coverage for some services (e.g., copay, coinsurance)
Plan Booklet - Health (PDF) July 1, 2026 (Coming Soon)
A detailed description of what medical services the plan covers
Plan Booklet - Health (PDF) July 1, 2025
A detailed description of what medical services the plan covers
Plan Booklet - Prescription (PDF) July 1, 2026
A detailed description of what prescription services the plan covers
Plan Booklet - Prescription (PDF) July 1, 2025
A detailed description of what prescription services the plan covers