Medical Plans

Plan 255 - PPO - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 256 - PPO - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 257 - PPO - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 320 - PPO - 100/80 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 321 - PPO - 100/80 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 325 - PPO - 100/80 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 326 - PPO - 100/80 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 330 - PPO - 100/80 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 331 - PPO - 100/80 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 335 - PPO - 100/80 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 336 - PPO - 100/80 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 337 - PPO - 100/80 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 340 - PPO - 90/70 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 341 - PPO - 90/70 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 345 - PPO - 90/70 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 346 - PPO - 90/70 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 350 - PPO - 90/70 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 351 - PPO - 90/70 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 355 - PPO - 90/70 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 356 - PPO - 90/70 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 360 - PPO - 80/60 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 361 - PPO - 80/60 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 365 - PPO - 80/60 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 366 - PPO - 80/60 - $250 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 370 - PPO - 80/60 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 371 - PPO - 80/60 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 375 - PPO - 80/60 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 376 - PPO - 80/60 - $500 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 380 - PPO - 100/80 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 381 - PPO - 100/80 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 385 - PPO - 100/80 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 386 - PPO - 100/80 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 390 - PPO - 90/70 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 391 - PPO - 90/70 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 395 - PPO - 90/70 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 396 - PPO - 90/70 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 400 - PPO - 80/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 401 - PPO - 80/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 405 - PPO - 80/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 406 - PPO - 80/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 411 - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 411L - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 415 - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 415L - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 416 - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 416L - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 417 - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 417L - DA - 100/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 421 - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 421L - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 425 - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 425L - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 426 - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 426L - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 427 - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 427L - DA - 90/60 - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 431 - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 431L - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 435 - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 435L - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 436 - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 436L - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 437 - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 437L - DA - 90/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 441 - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 441L - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 445 - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 445L - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 446 - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 446L - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 447 - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 447L - DA - 80/60 HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 451 - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 451L - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 455 - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 455L - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 456 - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 456L - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 457 - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 457L - DA - 100/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 461 - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 461L - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 465 - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 465L - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 466 - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 466L - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 467 - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 467L - DA - 80/60-R HSCP - $1000 DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 471 - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 471L - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 475 - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 475L - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 476 - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 476L - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 477 - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 477L - DA - 80/60 - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 481 - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 481L - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 485 - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 485L - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 486 - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 486L - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 487 - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 487L - DA - 80/60 - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 491 - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 491L - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 495 - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 495L - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 496 - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 496L - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 497 - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 497L - DA - 100/60-R HSCP - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 596 - DA - 50/50-R HSCP - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 811 - EPO - DA 100% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 815 - EPO - DA 100% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 816 - EPO - DA 100% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 817 - EPO - DA 100% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 821 - EPO - DA 80% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 825 - EPO - DA 80% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 826 - EPO - DA 80% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 827 - EPO - DA 80% NETWORK ONLY

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 831 - EPO - DA 80% NETWORK ONLY - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 835 - EPO - DA 80% NETWORK ONLY - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 836 - EPO - DA 80% NETWORK ONLY - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 837 - EPO - DA 80% NETWORK ONLY - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 841 - EPO - DA 80% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 845 - EPO - DA 80% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 846 - EPO - DA 80% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 847 - EPO - DA 80% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 851 - EPO - DA 100% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 855 - EPO - DA 100% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 856 - EPO - DA 100% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 857 - EPO - DA 100% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 861 - EPO - DA 50% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 865 - EPO - DA 50% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 866 - EPO - DA 50% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 867 - EPO - DA 50% NETWORK ONLY - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 873 - EPO - DA 50% NETWORK ONLY - $3500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description (Med) Summary Plan Description (Rx)

Plan 508 - PPO - 100/80/60 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 509 - PPO - 100/80/60 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 608 - DA - 100/80/60 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 608L - DA - 100/80/60 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 609 - DA - 100/80/60 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 609L - DA - 100/80/60 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 611 - DA - 50/50 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 611L - DA - 50/50 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 618 - DA - 100/70 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 618L - DA - 100/70 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 619 - DA - 100/70 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 619L - DA - 100/70 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 620 - DA - 100% HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 621 - DA - 100% HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 623 - DA - 70% HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 628 - DA - 100/70 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 628L - DA - 100/70 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 629 - DA - 100/70 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 629L - DA - 100/70 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 630 - DA - 100% HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 631 - DA - 100% HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 633 - DA - 70% HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 638 - DA - 100/80/60 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 638L - DA - 100/80/60 HSA - $1500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 639 - DA - 100/80/60 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description

Plan 639L - DA - 100/80/60 HSA - $2500 HIGH DEDUCTIBLE

Download File(s):
Benefit Description Summary of Benefits and Coverage Summary Plan Description