2025 Connector Group Plan Documents

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HMO Bronze

Plan Name Benefit Summary SBC EOC Rx Rider
Bronze 2 HDHP PDF PDF PDF N/A
Thrive Bronze PDF PDF PDF N/A

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

HMO Silver

Plan Name Benefit Summary SBC EOC Rx Rider
Silver 2000 HDHP PDF PDF PDF N/A
Silver A PDF PDF PDF N/A
Silver A II PDF PDF PDF N/A

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

HMO Gold

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Gold A PDF PDF PDF N/A
Thrive Gold 2000 PDF PDF PDF N/A

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

HMO Platinum

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Platinum A PDF PDF PDF N/A

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

HMO ConnectorCare

Plan Name Benefit Summary SBC EOC Rx Rider
ConnectorCare 1 PDF PDF PDF N/A
ConnectorCare 2 PDF PDF PDF N/A
ConnectorCare 3 PDF PDF PDF N/A
ConnectorCare AIAN PDF PDF PDF N/A

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

PPO Silver Connector

Our only PPO plan offered on the Connector is a Silver plan featuring an extended National Network. The plan has two levels of cost sharing for services received in-network or out-of-network.

Plan Name Benefit Summary SBC EOC Rx Rider
PPO Silver A National PDF PDF PDF N/A

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