Small Business ACA Plan Documents 2022
Formulary
| Documents | Download/Access |
|---|---|
Formulary EverydayHealth | |
Formulary Portfolio |
Benefit Books
| Documents | Download |
|---|---|
| Group PPO Base Benefit Book Off Exchange | |
| Group HMO Base Benefit Book Off Exchange | |
| PPO January Rider | |
| HMO January Rider | |
| PPO Emergency Services Rider | |
| EverydayHealth PPO Platinum 500 | |
| EverydayHealth PPO Platinum 750 | |
| EverydayHealth PPO Platinum 1000 | |
| EverydayHealth PPO Gold 1000 | |
| EverydayHealth PPO Gold 1500 | |
| EverydayHealth PPO Gold 2000 | |
| EverydayHealth PPO Gold 2500 | |
| EverydayHealth PPO Gold 3000 | |
| EverydayHealth PPO Gold 3500 | |
| EverydayHealth PPO Silver 2500 | |
| EverydayHealth PPO Silver 3000 | |
| EverydayHealth PPO Silver 3000/70 | |
| EverydayHealth PPO Silver 3500 | |
| EverydayHealth PPO Silver 4000 | |
| EverydayHealth PPO Silver 5000 | |
| EverydayHealth PPO Silver 5500/100 | |
| EverydayHealth PPO Silver 6000 | |
| EverydayHealth PPO Silver 6500 | |
| EverydayHealth PPO Bronze 7000 | |
| EverydayHealth PPO Bronze 8500/100 | |
| EverydayHealth HMO Gold 1500 | |
| EverydayHealth HMO Silver 2500 | |
| EverydayHealth HMO Silver 3500 | |
| EverydayHealth HMO Silver 4500 | |
| EverydayHealth HMO Silver 5500 | |
| EverydayHealth HMO Bronze 7000 | |
| EverydayHealth HMO Bronze 8500/100 | |
| Portfolio HSA PPO Gold 1500 | |
| Portfolio HSA PPO Silver 2900 | |
| Portfolio HSA PPO Silver 3250 | |
| Portfolio HSA PPO Silver 4000 | |
| Portfolio HSA PPO Bronze 5900 | |
| Portfolio HSA PPO Bronze 7050/100 | |
| Portfolio HSA HMO Silver 3750 | |
| Portfolio HSA HMO Silver 4250 | |
| Portfolio HSA HMO Bronze 7050/100 |
Employer Health Plan Product Guide
| GUIDE | DOWNLOAD |
|---|---|
| Small Business 2022 |
Summary of Benefits and Coverage (SBC)
The Summary of Benefits and Coverage (SBC) provides a concise description of what services your plan covers along with what you will pay for covered benefits.
Plans Download EverydayHealth PPO Platinum 500EverydayHealth PPO Platinum 500 - Alliance NetworkEverydayHealth PPO Platinum 500 - PimaConnect NetworkEverydayHealth PPO Platinum 750EverydayHealth PPO Platinum 750 - Alliance NetworkEverydayHealth PPO Platinum 750 - PimaConnect NetworkEverydayHealth PPO Platinum 1000EverydayHealth PPO Platinum 1000 - Alliance NetworkEverydayHealth PPO Platinum 1000 - PimaConnect NetworkEverydayHealth PPO Gold 1000EverydayHealth PPO Gold 1000 - Alliance NetworkEverydayHealth PPO Gold 1000 - PimaConnect NetworkEverydayHealth PPO Gold 1500EverydayHealth PPO Gold 1500 - Alliance NetworkEverydayHealth PPO Gold 1500 - PimaConnect NetworkEverydayHealth PPO Gold 2000EverydayHealth PPO Gold 2000 - Alliance NetworkEverydayHealth PPO Gold 2000 - PimaConnect NetworkEverydayHealth PPO Gold 2500EverydayHealth PPO Gold 2500 - Alliance NetworkEverydayHealth PPO Gold 2500 - PimaConnect NetworkEverydayHealth PPO Gold 3000EverydayHealth PPO Gold 3000 - Alliance NetworkEverydayHealth PPO Gold 3000 - PimaConnect NetworkEverydayHealth PPO Gold 3500EverydayHealth PPO Gold 3500 - Alliance NetworkEverydayHealth PPO Gold 3500 - PimaConnect NetworkEverydayHealth PPO Silver 2500EverydayHealth PPO Silver 2500 - Alliance NetworkEverydayHealth PPO Silver 2500 - PimaConnect NetworkEverydayHealth PPO Silver 3000EverydayHealth PPO Silver 3000 - Alliance NetworkEverydayHealth PPO Silver 3000 - PimaConnect NetworkEverydayHealth PPO Silver 3000/70EverydayHealth PPO Silver 3000/70 - Alliance NetworkEverydayHealth PPO Silver 3000/70 - PimaConnect NetworkEverydayHealth PPO Silver 3500EverydayHealth PPO Silver 3500 - Alliance NetworkEverydayHealth PPO Silver 3500 - PimaConnect NetworkEverydayHealth PPO Silver 4000EverydayHealth PPO Silver 4000 - Alliance NetworkEverydayHealth PPO Silver 4000 - PimaConnect NetworkEverydayHealth PPO Silver 5000EverydayHealth PPO Silver 5000 - Alliance NetworkEverydayHealth PPO Silver 5000 - PimaConnect NetworkEverydayHealth PPO Silver 5500/100EverydayHealth PPO Silver 5500/100 - Alliance NetworkEverydayHealth PPO Silver 5500/100 - PimaConnect NetworkEverydayHealth PPO Silver 6000EverydayHealth PPO Silver 6000 - Alliance NetworkEverydayHealth PPO Silver 6000 - PimaConnect NetworkEverydayHealth PPO Silver 6500EverydayHealth PPO Silver 6500 - Alliance NetworkEverydayHealth PPO Silver 6500 - PimaConnect NetworkEverydayHealth PPO Bronze 7000EverydayHealth PPO Bronze 7000 - Alliance NetworkEverydayHealth PPO Bronze 7000 - PimaConnect NetworkEverydayHealth PPO Bronze 8500EverydayHealth PPO Bronze 8500 - Alliance NetworkEverydayHealth PPO Bronze 8500 - PimaConnect NetworkPlans Download EverydayHealth HMO Gold 1500EverydayHealth HMO Gold 1500 - Alliance NetworkEverydayHealth HMO Gold 1500 - PimaConnect NetworkEverydayHealth HMO Silver 2500EverydayHealth HMO Silver 2500 - Alliance NetworkEverydayHealth HMO Silver 2500 - PimaConnect NetworkEverydayHealth HMO Silver 3500EverydayHealth HMO Silver 3500 - Alliance NetworkEverydayHealth HMO Silver 3500 - PimaConnect NetworkEverydayHealth HMO Silver 4500EverydayHealth HMO Silver 4500 - Alliance NetworkEverydayHealth HMO Silver 4500 - PimaConnect NetworkEverydayHealth HMO Silver 5500EverydayHealth HMO Silver 5500 - Alliance NetworkEverydayHealth HMO Silver 5500 - PimaConnect NetworkEverydayHealth HMO Bronze 7000EverydayHealth HMO Bronze 7000 - Alliance NetworkEverydayHealth HMO Bronze 7000 - PimaConnect NetworkEverydayHealth HMO Bronze 8500EverydayHealth HMO Bronze 8500 - Alliance NetworkEverydayHealth HMO Bronze 8500 - PimaConnect NetworkPlans Download Portfolio HSA PPO Gold 1500Portfolio HSA PPO Gold 1500 - Alliance NetworkPortfolio HSA PPO Gold 1500 - PimaConnect NetworkPortfolio HSA PPO Silver 2900Portfolio HSA PPO Silver 2900 - Alliance NetworkPortfolio HSA PPO Silver 2900 - PimaConnect NetworkPortfolio HSA PPO Silver 3250Portfolio HSA PPO Silver 3250 - Alliance NetworkPortfolio HSA PPO Silver 3250 - PimaConnect NetworkPortfolio HSA PPO Silver 4000Portfolio HSA PPO Silver 4000 - Alliance NetworkPortfolio HSA PPO Silver 4000 - PimaConnect NetworkPortfolio HSA PPO Bronze 5900Portfolio HSA PPO Bronze 5900 - Alliance NetworkPortfolio HSA PPO Bronze 5900 - PimaConnect NetworkPortfolio HSA PPO Bronze 7050Portfolio HSA PPO Bronze 7050 - Alliance NetworkPortfolio HSA PPO Bronze 7050 - PimaConnect NetworkPlans Download Portfolio HSA HMO Silver 3750Portfolio HSA HMO Silver 3750 - Alliance NetworkPortfolio HSA HMO Silver 3750 - PimaConnect NetworkPortfolio HSA HMO Silver 4250Portfolio HSA HMO Silver 4250 - Alliance NetworkPortfolio HSA HMO Silver 4250 - PimaConnect NetworkPortfolio HSA HMO Bronze 7050Portfolio HSA HMO Bronze 7050 - Alliance NetworkPortfolio HSA HMO Bronze 7050 - PimaConnect Network