Off Exchange Plan Documents 2024
Formulary
| DOCUMENTS | DOWNLOAD/ACCESS |
|---|---|
AdvanceHealth, Cultivate, EverydayHealth, Individual PPO, and TrueHealth Plans | |
StandardHealth Plans | |
Portfolio and PPO HSA Plans |
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 GoldEverydayHealth SilverEverydayHealth BronzePlans Download AdvanceHealth GoldAdvanceHealth SilverAdvanceHealth BronzePlans Download Portfolio BronzePlans Download PPO PremierHealth GoldPPO PremierHealth SilverPlans Download PPO Portfolio HSA GoldPlans Download StandardHealth GoldStandardHealth SilverStandardHealth BronzePlans Download PPO StandardHealth GoldPPO StandardHealth SilverPlans Download ACA StandardHealth Silver with Health Choice
Benefit Books
| HMO Base Off Exchange Benefit Book | |
| PPO Base Off Exchange Benefit Book | |
| HMO ACA StandardHealth with Health Choice Base Off Exchange Benefit Book |
DOCUMENTS DOWNLOAD/ACCESS HMO AdvanceHealth Bronze 9000 HMO AdvanceHealth Gold 4375 HMO AdvanceHealth Silver 6900 DOCUMENTS DOWNLOAD/ACCESS HMO EverydayHealth Gold 1700 HMO EverydayHealth Silver 5000 HMO EverydayHealth Bronze 8000 DOCUMENTS DOWNLOAD/ACCESS HMO Portfolio HSA Bronze 7050 DOCUMENTS DOWNLOAD/ACCESS HMO StandardHealth Bronze 7500 HMO StandardHealth Gold 1500 HMO StandardHealth Silver 5900 DOCUMENTS DOWNLOAD/ACCESS HMO StandardHealth with Health Choice Silver 5900 DOCUMENTS DOWNLOAD/ACCESS PPO Portfolio HSA Gold 2500 DOCUMENTS DOWNLOAD/ACCESS PPO StandardHealth Gold 1500 PPO StandardHealth Silver 5900 DOCUMENTS DOWNLOAD/ACCESS PPO PremierHealth Gold 1250 PPO PremierHealth Silver 4100