2025 Large Group Plan Documents

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SBCs for Medical Plans and Prescription Drug Rider combinations not listed are available upon request.

HMO Core

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Core 20% PDF PDF PDF PDF
HMO Core 2000 PDF PDF PDF PDF

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

HMO Essential

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Essential 500 PDF PDF PDF PDF
HMO Essential 1000 PDF PDF PDF PDF
HMO Essential 1500 PDF PDF PDF PDF
HMO Essential 2000 PDF PDF PDF PDF
HMO Essential 3000 PDF PDF PDF PDF
HMO Essential 4000 PDF PDF PDF PDF
HMO Essential 5000 PDF PDF PDF PDF
HMO Essential Care PDF PDF PDF PDF
HMO Essential Max PDF PDF PDF PDF
HMO Essential Plus 2000 PDF PDF PDF PDF

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

HMO Premium

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Choice Plus PDF PDF PDF PDF
HMO Focus PDF PDF PDF PDF

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

HMO Thrive

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Thrive 3000 N/A PDF PDF PDF
HMO Thrive First $500 N/A PDF PDF PDF

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

HMO Wise

Plan Name Benefit Summary SBC EOC Rx Rider
HMO Wise 2000/20% HDHP PDF PDF PDF PDF
HMO Wise 3000/10% HDHP PDF PDF PDF PDF
HMO Wise Max 2000 HDHP PDF PDF PDF PDF
HMO Wise Max 3000 HDHP PDF PDF PDF PDF
HMO Wise Plus 3000 HDHP PDF PDF PDF PDF
HMO Wise Plus HDHP PDF PDF PDF PDF
HMO Wise Saver 3450 HDHP PDF PDF PDF PDF

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

PPO Core

Plan Name Benefit Summary SBC EOC Rx Rider
PPO Core 20% National PDF PDF PDF PDF
PPO Core 2000 National PDF PDF PDF PDF

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

PPO Essential

Plan Name Benefit Summary SBC EOC Rx Rider
PPO Essential 500 National PDF PDF PDF PDF
PPO Essential 1000 National PDF PDF PDF PDF
PPO Essential 1500 National PDF PDF PDF PDF
PPO Essential 2000 National PDF PDF PDF PDF
PPO Essential 3000 National PDF PDF PDF PDF
PPO Essential 4000 National PDF PDF PDF PDF
PPO Essential 5000 National PDF PDF PDF PDF
PPO Essential Care National PDF PDF PDF PDF

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

PPO Thrive

Plan Name Benefit Summary SBC EOC Rx Rider
PPO Thrive 3000 National PDF PDF PDF PDF
PPO Thrive First $500 National PDF PDF PDF PDF

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

PPO Wise

Plan Name Benefit Summary SBC EOC Rx Rider
PPO Wise 2000/20% National HDHP PDF PDF PDF PDF
PPO Wise 3000/10% National HDHP PDF PDF PDF PDF
PPO Wise Max 2000 National HDHP PDF PDF PDF PDF
PPO Wise Max 3000 National HDHP PDF PDF PDF PDF
PPO Wise Plus 3000 National HDHP PDF PDF PDF PDF
PPO Wise Saver 3450 National HDHP PDF PDF PDF PDF

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

2025 Large Group HMO Plan Comparison

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2025 Large Group PPO Plan Comparison

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