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Plan Documents for Members

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Member Plan Documents

As a member, you can view your specific Plan Documents in the Member Portal, quick and easy.

Simply log in and click "Plan Documents" to view your plan documents.

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2019 Plan Documents for Members

Standard Individual and Family, as well as Small Group Summary of Benefits and Coverage (SBC) and Evidence of Coverage (EOC) documents, in PDF file format, are available for download here.

* Standard Large Group SBCs and Evidence of Coverage documents will be posted as they are available.

Custom plan documents are not included in this directory as they can be accessed on the employer's SWHP sub-site and also from the Member Portal.

If you are already a member, you may more easily download the documents specific to your plan from the Member Portal. Simply log into the Member Portal and view your plan documents under the header "Plan Documents." After logging in, you will only see the plan documents that apply to you.

Looking for a 2018 plan document? View 2018 Plan Document Archive

Looking for a 2017 plan document? View 2017 Plan Document Archive.

Need any help? Contact Support at 1-800-321-7947 (TTY: 711).

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Find Your ACA Plan

Summary of Benefits and Coverage (SBC) documents and Evidence of Coverage (EOC) documents are listed separately. In general, the plan names…

  • • ACA plans are available for individual and family coverage only, and for small employer groups.
  • • The $ value in a plan name indicates that plan's annual deductible.
  • • The ACA metal levels represent covered expenses and member expenses:
    • ° Bronze: 60% of covered medical expenses paid by the policy / 40% paid by the member
    • ° Silver: 70% of covered medical expenses paid by the policy / 30% paid by the member
    • ° Gold: 80% of covered medical expenses paid by the policy / 20% paid by the member
  • • There are four types of plans to choose from: PPO, POS, HMO and EPO. Definitions for each plan type are found in the HealthCare.gov glossary.

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2019 Summary of Benefits and Coverage

Primary Care Physician (PCP) referrals are not required for any of our plans.

* 2019 Large Group Summary of Benefits and Coverage to be posted when available.

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2019 Evidence of Coverage

Primary Care Physician (PCP) referrals are not required for any of our plans.

* 2019 Large Group Evidence of Coverage to be posted when available.

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You can also find your specific documents in the Member Portal.

All files are in PDF format, which can be viewed or downloaded with your web browser. You may download and install Adobe Acrobat Reader®, for free, to view PDF files.

Contact Customer Support for assistance at 1-800-321-7947 (TTY: 7-1-1 or 1-800-735-2989).