2018 Large Groups Summary of Benefits and Coverage (SBC)

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Wise HMO

Wise plans feature lower monthly premiums with higher out-of-pocket costs for covered services. These plans generally include higher copayments and annual deductibles that apply to covered services.

Essential HMO

Essential plans feature intermediate pricing for both monthly premiums and out-of-pocket costs.

Premium HMO

Premium plans have higher monthly premiums, but lower out-of-pocket costs for covered services. These plans feature low copayments, and typically do not include deductibles.

Wise PPO

Wise plans feature lower monthly premiums with higher out-of-pocket costs for covered services. These plans generally include higher copayments and annual deductibles that apply to covered services.

Essential PPO

Essential plans feature intermediate pricing for both monthly premiums and out-of- pocket costs.

Premium PPO

Premium plans have higher monthly premiums, but lower out-of-pocket costs for covered services. The PPO National plans feature the PHCS provider network.