2019 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. They require full payment of their deductible before most services are covered. They are typically paired with a Health Savings Account that can be used by the member to pay for health related expenses and deductibles.

Core HMO

Core plans feature lower monthly premiums with higher out-of-pocket costs for covered services. These plans generally include higher copayments and annual deductibles, and sometimes feature coinsurance that applies 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. They require full payment of their deductible before most services are covered. They are typically paired with a Health Savings Account that can be used by the member to pay for health related expenses and deductibles.

Core PPO

Core plans feature lower monthly premiums with higher out-of-pocket costs for covered services. These plans generally include higher copayments and annual deductibles, and sometimes feature coinsurance that applies to covered services.

Essential PPO

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