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 N/A PDF
HMO Core 2000 PDF PDF N/A 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 N/A PDF
HMO Essential 1000 PDF PDF N/A PDF
HMO Essential 1500 PDF PDF N/A PDF
HMO Essential 2000 PDF PDF N/A PDF
HMO Essential 3000 PDF PDF N/A PDF
HMO Essential 4000 PDF PDF N/A PDF
HMO Essential 5000 PDF PDF N/A PDF
HMO Essential Care PDF PDF N/A PDF
HMO Essential Max PDF PDF N/A PDF
HMO Essential Plus 2000 PDF PDF N/A 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 N/A PDF
HMO Focus PDF PDF N/A 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 N/A PDF
HMO Thrive First $500 N/A PDF N/A 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 N/A PDF
HMO Wise 3000/10% HDHP PDF PDF N/A PDF
HMO Wise Max 2000 HDHP PDF PDF N/A PDF
HMO Wise Max 3000 HDHP PDF PDF N/A PDF
HMO Wise Plus 3000 HDHP PDF PDF N/A PDF
HMO Wise Plus HDHP PDF PDF N/A PDF
HMO Wise Saver 3450 HDHP PDF PDF N/A 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 N/A PDF
PPO Core 2000 National PDF PDF N/A 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 N/A PDF
PPO Essential 1000 National PDF PDF N/A PDF
PPO Essential 1500 National PDF PDF N/A PDF
PPO Essential 2000 National PDF PDF N/A PDF
PPO Essential 3000 National PDF PDF N/A PDF
PPO Essential 4000 National PDF PDF N/A PDF
PPO Essential 5000 National PDF PDF N/A PDF
PPO Essential Care National PDF PDF N/A 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 N/A PDF
PPO Thrive First $500 National PDF PDF N/A 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 N/A PDF
PPO Wise 3000/10% National HDHP PDF PDF N/A PDF
PPO Wise Max 2000 National HDHP PDF PDF N/A PDF
PPO Wise Max 3000 National HDHP PDF PDF N/A PDF
PPO Wise Plus 3000 National HDHP PDF PDF N/A PDF
PPO Wise Saver 3450 National HDHP PDF PDF N/A 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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