2021 Large Group Plan Documents

HMO Core

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.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

HMO Essential

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

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

HMO Premium

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.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

HMO Thrive

Thrive Plans feature modest premiums with low out-of-pocket expenses for routine and maintenance care paired with significant cost-share for non-routine services.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

HMO Wise

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.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

PPO Core

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.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

PPO Essential

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

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

PPO Thrive

Thrive Plans feature modest premiums with low out-of-pocket expenses for routine and maintenance care paired with significant cost-share for non-routine services.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage

PPO Wise

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.

SBC = Summary of Benefits and Coverage
EOC = Explanation of Coverage