2020 Plan Documents for Members

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

More 2020 documents will be posted here as they become 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 2019 plan document? View 2019 Plan Documents

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).

2020 Summary of Benefits and Coverage

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

More plans to be posted as soon as available.

• Individual HMO Bronze 7500
• Individual EPO Bronze 7500
• Small Group Gold HMO 0
• Small Group Bronze EPO 7200
• Small Group Bronze EPO 7900
• Small Group Bronze EPO 8150
• Small Group Bronze HMO 7200
• Small Group Bronze HMO 7900
• Small Group Bronze HMO 8150
• Small Group Bronze HSA EPO 6750
• Small Group Bronze HSA HMO 6750
• Small Group Bronze HSA POS 6750
• Small Group Bronze HSA PPO 6750
• Small Group Bronze POS 7200
• Small Group Bronze POS 7900
• Small Group Bronze POS 8150
• Small Group Bronze PPO 7200
• Small Group Bronze PPO 7900
• Small Group Bronze PPO 8150
• Small Group Gold EPO 1700
• Small Group Gold EPO 2100
• Small Group Gold EPO 3500
• Small Group Gold HMO 1700
• Small Group Gold HMO 2100
• Small Group Gold HMO 3500
• Small Group Gold HSA EPO 3200
• Small Group Gold HSA HMO 3200
• Small Group Gold HSA POS 3200
• Small Group Gold HSA PPO 3200
• Small Group Gold POS 1700
• Small Group Gold POS 2100
• Small Group Gold POS 3500
• Small Group Gold PPO 1700
• Small Group Gold PPO 2100
• Small Group Gold PPO 3500
• Small Group Silver EPO 4800
• Small Group Silver EPO 5500
• Small Group Silver EPO 6900
• Small Group Silver HMO 4800
• Small Group Silver HMO 5500
• Small Group Silver HMO 6900
• Small Group Silver HSA EPO 4300
• Small Group Silver HSA HMO 4300
• Small Group Silver HSA POS 4300
• Small Group Silver HSA PPO 4300
• Small Group Silver POS 4800
• Small Group Silver POS 5500
• Small Group Silver POS 6900
• Small Group Silver PPO 4800
• Small Group Silver PPO 5500
• Small Group Silver PPO 6900

• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group CC 70 with LRX3-008
• Large Group CC 70 with LRX3-009
• Large Group CC 70 with LRX3-010
• Large Group CC 70 with LRX3-011
• Large Group CC 70 $3,000 HMO with LRX3-008
• Large Group CC 70 $3,000 HMO with LRX3-009
• Large Group CC 70 $3,000 HMO with LRX3-010
• Large Group CC 70 $3,000 HMO with LRX3-011
• Large Group CC 70 with LRX3-008
• Large Group CC 70 with LRX3-009
• Large Group CC 70 with LRX3-010
• Large Group CC70 with LRX3-011
• Large Group CC 70 $5,000 HMO with LRX3-008
• Large Group CC 70 $5,000 HMO with LRX3-009
• Large Group CC 70 $5,000 HMO with LRX3-010
• Large Group CC 70 $5,000 HMO with LRX3-011
• Large Group CC 70 Value with LRX3-008
• Large Group CC 70 Value with LRX3-009
• Large Group CC 70 Value with LRX3-010
• Large Group CC 70 Value with LRX3-011
• Large Group CC 80 $500 with LRX3-008
• Large Group CC 80 $500 with LRX3-009
• Large Group CC 80 $500 with LRX3-010
• Large Group CC 80 $500 with LRX3-011
• Large Group CC 80 $750 with LRX3-008
• Large Group CC 80 $750 with LRX3-009
• Large Group CC 80 $750 with LRX3-010
• Large Group CC 80 $750 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 $2,000 HMO with LRX3-008
• Large Group CC 80 $2,000 HMO with LRX3-009
• Large Group CC 80 $2,000 HMO with LRX3-010
• Large Group CC 80 $2,000 HMO with LRX3-011
• Large Group CC 80 $2,500 with LRX3-008
• Large Group CC 80 $2,500 with LRX3-009
• Large Group CC 80 $2,500 with LRX3-010
• Large Group CC 80 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 $4,500 with LRX3-008
• Large Group CC 80 $4,500 with LRX3-009
• Large Group CC 80 $4,500 with LRX3-010
• Large Group CC 80 $4,500 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 90 with LRX3-008
• Large Group CC 90 with LRX3-009
• Large Group CC 90 with LRX3-010
• Large Group CC 90 with LRX3-011
• Large Group CC 90 with LRX3-008
• Large Group CC 90 with LRX3-009
• Large Group CC 90 with LRX3-010
• Large Group CC 90 with LRX3-011
• Large Group EPO 100 $2,500 with LRX3-008
• Large Group EPO 100 $2,500 with LRX3-009
• Large Group EPO 100 $2,500 with LRX3-010
• Large Group EPO 100 $2,500 with LRX3-011
• Large Group EPO 100 $3,500 with LRX3-010
• Large Group EPO 100 $3,500 with LRX3-011
• Large Group EPO 100 $5,000 with LRX3-008
• Large Group EPO 100 $5,000 with LRX3-009
• Large Group EPO 100 $5,000 with LRX3-008
• Large Group EPO 100 $5,000 with LRX3-009
• Large Group EPO 100 $5,000 with LRX3-010
• Large Group EPO 100 $5,000 with LRX3-011
• Large Group EPO 100 $6,450 with LRX3-010
• Large Group EPO 100 $6,450 with LRX3-011
• Large Group EPO 100 $7,150 with LRX3-008
• Large Group EPO 100 $7,150 with LRX3-009
• Large Group EPO 100 $7,150 with LRX3-010
• Large Group EPO 100 $7,150 with LRX3-011
• Large Group EPO 70 $2,000 with LRX3-008
• Large Group EPO 70 $2,000 with LRX3-009
• Large Group EPO 70 $2,000 with LRX3-010
• Large Group EPO 70 $2,000 with LRX3-011
• Large Group EPO 70 $3,000 with LRX3-008
• Large Group EPO 70 $3,000 with LRX3-009
• Large Group EPO 70 $3,000 with LRX3-010
• Large Group EPO 70 $3,000 with LRX3-011
• Large Group EPO 70 $4,000 with LRX3-008
• Large Group EPO 70 $4,000 with LRX3-009
• Large Group EPO 70 $4,000 with LRX3-010
• Large Group EPO 70 $4,000 with LRX3-011
• Large Group EPO 70 $5,000 with LRX3-008
• Large Group EPO 70 $5,000 with LRX3-009
• Large Group EPO 70 $5,000 with LRX3-010
• Large Group EPO 70 $5,000 with LRX3-011
• Large Group EPO 70 $6,000 with LRX3-008
• Large Group EPO 70 $6,000 with LRX3-009
• Large Group EPO 70 $6,000 with LRX3-010
• Large Group EPO 70 $6,000 with LRX3-011
• Large Group EPO 80 $500 with LRX3-008
• Large Group EPO 80 $500 with LRX3-009
• Large Group EPO 80 $500 with LRX3-010
• Large Group EPO 80 $500 with LRX3-011
• Large Group EPO 80 $750 with LRX3-008
• Large Group EPO 80 $750 with LRX3-009
• Large Group EPO 80 $750 with LRX3-010
• Large Group EPO 80 $750 with LRX3-011
• Large Group EPO 80 $1,000 with LRX3-008
• Large Group EPO 80 $1,000 with LRX3-009
• Large Group EPO 80 $1,000 with LRX3-010
• Large Group EPO 80 $1,000 with LRX3-011
• Large Group EPO 80 $1,500 with LRX3-008
• Large Group EPO 80 $1,500 with LRX3-009
• Large Group EPO 80 $1,500 with LRX3-010
• Large Group EPO 80 $1,500 with LRX3-011
• Large Group EPO 80 $1,500 with LRX3-008
• Large Group EPO 80 $1,500 with LRX3-009
• Large Group EPO 80 $1,500 with LRX3-010
• Large Group EPO 80 $1,500 with LRX3-011
• Large Group EPO 80 $2,000 with LRX3-008
• Large Group EPO 80 $2,000 with LRX3-009
• Large Group EPO 80 $2,000 with LRX3-010
• Large Group EPO 80 $2,000 with LRX3-011
• Large Group EPO 80 $2,500 with LRX3-008
• Large Group EPO 80 $2,500 with LRX3-009
• Large Group EPO 80 $2,500 with LRX3-010
• Large Group EPO 80 $2,500 with LRX3-011
• Large Group EPO 80 $3,000 with LRX3-008
• Large Group EPO 80 $3,000 with LRX3-009
• Large Group EPO 80 $3,000 with LRX3-008
• Large Group EPO 80 $3,000 with LRX3-009
• Large Group EPO 80 $3,000 with LRX3-010
• Large Group EPO 80 $3,000 with LRX3-011
• Large Group EPO 80 $3,500 with LRX3-008
• Large Group EPO 80 $3,500 with LRX3-009
• Large Group EPO 80 $3,500 with LRX3-010
• Large Group EPO 80 $3,500 with LRX3-011
• Large Group EPO 80 $4,500 with LRX3-008
• Large Group EPO 80 $4,500 with LRX3-009
• Large Group EPO 80 $4,500 with LRX3-010
• Large Group EPO 80 $4,500 with LRX3-011
• Large Group EPO 80 $5,500 with LRX3-008
• Large Group EPO 80 $5,500 with LRX3-009
• Large Group EPO 80 $5,500 with LRX3-010
• Large Group EPO 80 $5,500 with LRX3-011
• Large Group EPO 90 $500 with LRX3-008
• Large Group EPO 90 $500 with LRX3-009
• Large Group EPO 90 $500 with LRX3-010
• Large Group EPO 90 $500 with LRX3-011
• Large Group EPO 90 $1,000 with LRX3-008
• Large Group EPO 90 $1,000 with LRX3-009
• Large Group EPO 90 $1,000 with LRX3-010
• Large Group EPO 90 $1,000 with LRX3-011
• Large Group HMO40 Value with LRX3-008
• Large Group HMO40 Value with LRX3-009
• Large Group HMO40 Value with LRX3-010
• Large Group HMO40 Value with LRX3-011
• Large Group HMO 15 with LRX3-008
• Large Group HMO 15 with LRX3-009
• Large Group HMO 15 with LRX3-010
• Large Group HMO 15 with LRX3-011
• Large Group HMO 30 with LRX3-008
• Large Group HMO 30 with LRX3-009
• Large Group HMO 30 with LRX3-010
• Large Group HMO 30 with LRX3-011
• Large Group PPO 100/70 $2,500 with LRX3-008
• Large Group PPO 100/70 $2,500 with LRX3-009
• Large Group PPO 100/70 $2,500 with LRX3-010
• Large Group PPO 100/70 $2,500 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group PPO 100/70 $5,000 with LRX3-008
• Large Group PPO 100/70 $5,000 with LRX3-009
• Large Group PPO 100/70 $5,000 with LRX3-010
• Large Group PPO 100/70 $5,000 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group PPO 100/70 $7,150 with LRX3-008
• Large Group PPO 100/70 $7,150 with LRX3-009
• Large Group PPO 100/70 $7,150 with LRX3-010
• Large Group PPO 100/70 $7,150 with LRX3-011
• Large Group PPO 70/50 $2,000 with LRX3-008
• Large Group PPO 70/50 $2,000 with LRX3-009
• Large Group PPO 70/50 $2,000 with LRX3-010
• Large Group PPO 70/50 $2,000 with LRX3-011
• Large Group PPO 70/50 $3,000 with LRX3-008
• Large Group PPO 70/50 $3,000 with LRX3-009
• Large Group PPO 70/50 $3,000 with LRX3-010
• Large Group PPO 70/50 $3,000 with LRX3-011
• Large Group PPO 70/50 $4,000 with LRX3-008
• Large Group PPO 70/50 $4,000 with LRX3-009
• Large Group PPO 70/50 $4,000 with LRX3-010
• Large Group PPO 70/50 $4,000 with LRX3-011
• Large Group PPO 70/50 $5,000 with LRX3-008
• Large Group PPO 70/50 $5,000 with LRX3-009
• Large Group PPO 70/50 $5,000 with LRX3-010
• Large Group PPO 70/50 $5,000 with LRX3-011
• Large Group PPO 70/50 $6,000 with LRX3-008
• Large Group PPO 70/50 $6,000 with LRX3-009
• Large Group PPO 70/50 $6,000 with LRX3-010
• Large Group PPO 70/50 $6,000 with LRX3-011
• Large Group PPO 80/50 $500 with LRX3-008
• Large Group PPO 80/50 $500 with LRX3-009
• Large Group PPO 80/50 $500 with LRX3-010
• Large Group PPO 80/50 $500 with LRX3-011
• Large Group PPO 80/50 $750 with LRX3-008
• Large Group PPO 80/50 $750 with LRX3-009
• Large Group PPO 80/50 $750 with LRX3-010
• Large Group PPO 80/50 $750 with LRX3-011
• Large Group PPO 80/50 $1,000 with LRX3-008
• Large Group PPO 80/50 $1,000 with LRX3-009
• Large Group PPO 80/50 $1,000 with LRX3-010
• Large Group PPO 80/50 $1,000 with LRX3-011
• Large Group PPO 80/50 $1,500 with LRX3-008
• Large Group PPO 80/50 $1,500 with LRX3-009
• Large Group PPO 80/50 $1,500 with LRX3-010
• Large Group PPO 80/50 $1,500 with LRX3-011
• Large Group PPO 80/50 $1,500 with LRX3-008
• Large Group PPO 80/50 $1,500 with LRX3-009
• Large Group PPO 80/50 $1,500 with LRX3-010
• Large Group PPO 80/50 $1,500 with LRX3-011
• Large Group PPO 80/50 $2,000 with LRX3-008
• Large Group PPO 80/50 $2,000 with LRX3-009
• Large Group PPO 80/50 $2,000 with LRX3-010
• Large Group PPO 80/50 $2,000 with LRX3-011
• Large Group PPO 80/50 $2,500 with LRX3-008
• Large Group PPO 80/50 $2,500 with LRX3-009
• Large Group PPO 80/50 $2,500 with LRX3-010
• Large Group PPO 80/50 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group PPO 80/50 $3,000 with LRX3-008
• Large Group PPO 80/50 $3,000 with LRX3-009
• Large Group PPO 80/50 $3,000 with LRX3-010
• Large Group PPO 80/50 $3,000 with LRX3-011
• Large Group PPO 80/50 $3,500 with LRX3-008
• Large Group PPO 80/50 $3,500 with LRX3-009
• Large Group PPO 80/50 $3,500 with LRX3-010
• Large Group PPO 80/50 $3,500 with LRX3-011
• Large Group PPO 80/50 $4,500 with LRX3-008
• Large Group PPO 80/50 $4,500 with LRX3-009
• Large Group PPO 80/50 $4,500 with LRX3-010
• Large Group PPO 80/50 $4,500 with LRX3-011
• Large Group PPO 80/50 $5,500 with LRX3-008
• Large Group PPO 80/50 $5,500 with LRX3-009
• Large Group PPO 80/50 $5,500 with LRX3-010
• Large Group PPO 80/50 $5,500 with LRX3-011
• Large Group PPO 90/70 $500 with LRX3-008
• Large Group PPO 90/70 $500 with LRX3-009
• Large Group PPO 90/70 $500 with LRX3-010
• Large Group PPO 90/70 $500 with LRX3-011
• Large Group PPO 90/70 $1,000 with LRX3-008
• Large Group PPO 90/70 $1,000 with LRX3-009
• Large Group PPO 90/70 $1,000 with LRX3-010
• Large Group PPO 90/70 $1,000 with LRX3-011
• Large Group POS 100/70 $2,500 with LRX3-008
• Large Group POS 100/70 $2,500 with LRX3-009
• Large Group POS 100/70 $2,500 with LRX3-010
• Large Group POS 100/70 $2,500 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group POS 100/70 $5,000 with LRX3-008
• Large Group POS 100/70 $5,000 with LRX3-009
• Large Group POS 100/70 $5,000 with LRX3-010
• Large Group POS 100/70 $5,000 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group POS 100/70 $7,150 with LRX3-008
• Large Group POS 100/70 $7,150 with LRX3-009
• Large Group POS 100/70 $7,150 with LRX3-010
• Large Group POS 100/70 $7,150 with LRX3-011
• Large Group POS 70/50 $2,000 with LRX3-008
• Large Group POS 70/50 $2,000 with LRX3-009
• Large Group POS 70/50 $2,000 with LRX3-010
• Large Group POS 70/50 $2,000 with LRX3-011
• Large Group POS 70/50 $3,000 with LRX3-008
• Large Group POS 70/50 $3,000 with LRX3-009
• Large Group POS 70/50 $3,000 with LRX3-010
• Large Group POS 70/50 $3,000 with LRX3-011
• Large Group POS 70/50 $4,000 with LRX3-008
• Large Group POS 70/50 $4,000 with LRX3-009
• Large Group POS 70/50 $4,000 with LRX3-010
• Large Group POS 70/50 $4,000 with LRX3-011
• Large Group POS 70/50 $5,000 with LRX3-008
• Large Group POS 70/50 $5,000 with LRX3-009
• Large Group POS 70/50 $5,000 with LRX3-010
• Large Group POS 70/50 $5,000 with LRX3-011
• Large Group POS 70/50 $6,000 with LRX3-008
• Large Group POS 70/50 $6,000 with LRX3-009
• Large Group POS 70/50 $6,000 with LRX3-010
• Large Group POS 70/50 $6,000 with LRX3-011
• Large Group POS 80/50 $500 with LRX3-008
• Large Group POS 80/50 $500 with LRX3-009
• Large Group POS 80/50 $500 with LRX3-010
• Large Group POS 80/50 $500 with LRX3-011
• Large Group POS 80/50 $750 with LRX3-008
• Large Group POS 80/50 $750 with LRX3-009
• Large Group POS 80/50 $750 with LRX3-010
• Large Group POS 80/50 $750 with LRX3-011
• Large Group POS 80/50 $1,000 with LRX3-008
• Large Group POS 80/50 $1,000 with LRX3-009
• Large Group POS 80/50 $1,000 with LRX3-010
• Large Group POS 80/50 $1,000 with LRX3-011
• Large Group POS 80/50 $1,500 with LRX3-008
• Large Group POS 80/50 $1,500 with LRX3-009
• Large Group POS 80/50 $1,500 with LRX3-010
• Large Group POS 80/50 $1,500 with LRX3-011
• Large Group POS 80/50 $1,500 with LRX3-008
• Large Group POS 80/50 $1,500 with LRX3-009
• Large Group POS 80/50 $1,500 with LRX3-010
• Large Group POS 80/50 $1,500 with LRX3-011
• Large Group POS 80/50 $2,000 with LRX3-008
• Large Group POS 80/50 $2,000 with LRX3-009
• Large Group POS 80/50 $2,000 with LRX3-010
• Large Group POS 80/50 $2,000 with LRX3-011
• Large Group POS 80/50 $2,500 with LRX3-008
• Large Group POS 80/50 $2,500 with LRX3-009
• Large Group POS 80/50 $2,500 with LRX3-010
• Large Group POS 80/50 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group POS 80/50 $3,000 with LRX3-008
• Large Group POS 80/50 $3,000 with LRX3-009
• Large Group POS 80/50 $3,000 with LRX3-010
• Large Group POS 80/50 $3,000 with LRX3-011
• Large Group POS 80/50 $3,500 with LRX3-008
• Large Group POS 80/50 $3,500 with LRX3-009
• Large Group POS 80/50 $3,500 with LRX3-010
• Large Group POS 80/50 $3,500 with LRX3-011
• Large Group POS 80/50 $4,500 with LRX3-008
• Large Group POS 80/50 $4,500 with LRX3-009
• Large Group POS 80/50 $4,500 with LRX3-010
• Large Group POS 80/50 $4,500 with LRX3-011
• Large Group POS 80/50 $5,500 with LRX3-008
• Large Group POS 80/50 $5,500 with LRX3-009
• Large Group POS 80/50 $5,500 with LRX3-010
• Large Group POS 80/50 $5,500 with LRX3-011
• Large Group POS 90/70 $500 with LRX3-008
• Large Group POS 90/70 $500 with LRX3-009
• Large Group POS 90/70 $500 with LRX3-010
• Large Group POS 90/70 $500 with LRX3-011
• Large Group POS 90/70 $1,000 with LRX3-008
• Large Group POS 90/70 $1,000 with LRX3-009
• Large Group POS 90/70 $1,000 with LRX3-010
• Large Group POS 90/70 $1,000 with LRX3-011

2020 Evidence of Coverage

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

More plans to be posted as soon as available.

• Individual HMO Bronze 7500
• Individual EPO Bronze 7500
• Small Group Gold HMO 0
• Small Group Bronze EPO 7200
• Small Group Bronze EPO 7900
• Small Group Bronze EPO 8150
• Small Group Bronze HMO 7200
• Small Group Bronze HMO 7900
• Small Group Bronze HMO 8150
• Small Group Bronze HSA EPO 6750
• Small Group Bronze HSA HMO 6750
• Small Group Bronze HSA POS 6750
• Small Group Bronze HSA PPO 6750
• Small Group Bronze POS 7200
• Small Group Bronze POS 7900
• Small Group Bronze POS 8150
• Small Group Bronze PPO 7200
• Small Group Bronze PPO 7900
• Small Group Bronze PPO 8150
• Small Group Gold EPO 1700
• Small Group Gold EPO 2100
• Small Group Gold EPO 3500
• Small Group Gold HMO 1700
• Small Group Gold HMO 2100
• Small Group Gold HMO 3500
• Small Group Gold HSA EPO 3200
• Small Group Gold HSA HMO 3200
• Small Group Gold HSA POS 3200
• Small Group Gold HSA PPO 3200
• Small Group Gold POS 1700
• Small Group Gold POS 2100
• Small Group Gold POS 3500
• Small Group Gold PPO 1700
• Small Group Gold PPO 2100
• Small Group Gold PPO 3500
• Small Group Silver EPO 4800
• Small Group Silver EPO 5500
• Small Group Silver EPO 6900
• Small Group Silver HMO 4800
• Small Group Silver HMO 5500
• Small Group Silver HMO 6900
• Small Group Silver HSA EPO 4300
• Small Group Silver HSA HMO 4300
• Small Group Silver HSA POS 4300
• Small Group Silver HSA PPO 4300
• Small Group Silver POS 4800
• Small Group Silver POS 5500
• Small Group Silver POS 6900
• Small Group Silver PPO 4800
• Small Group Silver PPO 5500
• Small Group Silver PPO 6900

• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group CC 100 with LRX3-008
• Large Group CC 100 with LRX3-009
• Large Group CC 100 with LRX3-010
• Large Group CC 100 with LRX3-011
• Large Group CC 70 with LRX3-008
• Large Group CC 70 with LRX3-009
• Large Group CC 70 with LRX3-010
• Large Group CC 70 with LRX3-011
• Large Group CC 70 $3,000 HMO with LRX3-008
• Large Group CC 70 $3,000 HMO with LRX3-009
• Large Group CC 70 $3,000 HMO with LRX3-010
• Large Group CC 70 $3,000 HMO with LRX3-011
• Large Group CC 70 with LRX3-008
• Large Group CC 70 with LRX3-009
• Large Group CC 70 with LRX3-010
• Large Group CC70 with LRX3-011
• Large Group CC 70 $5,000 HMO with LRX3-008
• Large Group CC 70 $5,000 HMO with LRX3-009
• Large Group CC 70 $5,000 HMO with LRX3-010
• Large Group CC 70 $5,000 HMO with LRX3-011
• Large Group CC 70 Value with LRX3-008
• Large Group CC 70 Value with LRX3-009
• Large Group CC 70 Value with LRX3-010
• Large Group CC 70 Value with LRX3-011
• Large Group CC 80 $500 with LRX3-008
• Large Group CC 80 $500 with LRX3-009
• Large Group CC 80 $500 with LRX3-010
• Large Group CC 80 $500 with LRX3-011
• Large Group CC 80 $750 with LRX3-008
• Large Group CC 80 $750 with LRX3-009
• Large Group CC 80 $750 with LRX3-010
• Large Group CC 80 $750 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 $2,000 HMO with LRX3-008
• Large Group CC 80 $2,000 HMO with LRX3-009
• Large Group CC 80 $2,000 HMO with LRX3-010
• Large Group CC 80 $2,000 HMO with LRX3-011
• Large Group CC 80 $2,500 with LRX3-008
• Large Group CC 80 $2,500 with LRX3-009
• Large Group CC 80 $2,500 with LRX3-010
• Large Group CC 80 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 80 $4,500 with LRX3-008
• Large Group CC 80 $4,500 with LRX3-009
• Large Group CC 80 $4,500 with LRX3-010
• Large Group CC 80 $4,500 with LRX3-011
• Large Group CC 80 with LRX3-008
• Large Group CC 80 with LRX3-009
• Large Group CC 80 with LRX3-010
• Large Group CC 80 with LRX3-011
• Large Group CC 90 with LRX3-008
• Large Group CC 90 with LRX3-009
• Large Group CC 90 with LRX3-010
• Large Group CC 90 with LRX3-011
• Large Group CC 90 with LRX3-008
• Large Group CC 90 with LRX3-009
• Large Group CC 90 with LRX3-010
• Large Group CC 90 with LRX3-011
• Large Group EPO 100 $2,500 with LRX3-008
• Large Group EPO 100 $2,500 with LRX3-009
• Large Group EPO 100 $2,500 with LRX3-010
• Large Group EPO 100 $2,500 with LRX3-011
• Large Group EPO 100 $3,500 with LRX3-010
• Large Group EPO 100 $3,500 with LRX3-011
• Large Group EPO 100 $5,000 with LRX3-008
• Large Group EPO 100 $5,000 with LRX3-009
• Large Group EPO 100 $5,000 with LRX3-008
• Large Group EPO 100 $5,000 with LRX3-009
• Large Group EPO 100 $5,000 with LRX3-010
• Large Group EPO 100 $5,000 with LRX3-011
• Large Group EPO 100 $6,450 with LRX3-010
• Large Group EPO 100 $6,450 with LRX3-011
• Large Group EPO 100 $7,150 with LRX3-008
• Large Group EPO 100 $7,150 with LRX3-009
• Large Group EPO 100 $7,150 with LRX3-010
• Large Group EPO 100 $7,150 with LRX3-011
• Large Group EPO 70 $2,000 with LRX3-008
• Large Group EPO 70 $2,000 with LRX3-009
• Large Group EPO 70 $2,000 with LRX3-010
• Large Group EPO 70 $2,000 with LRX3-011
• Large Group EPO 70 $3,000 with LRX3-008
• Large Group EPO 70 $3,000 with LRX3-009
• Large Group EPO 70 $3,000 with LRX3-010
• Large Group EPO 70 $3,000 with LRX3-011
• Large Group EPO 70 $4,000 with LRX3-008
• Large Group EPO 70 $4,000 with LRX3-009
• Large Group EPO 70 $4,000 with LRX3-010
• Large Group EPO 70 $4,000 with LRX3-011
• Large Group EPO 70 $5,000 with LRX3-008
• Large Group EPO 70 $5,000 with LRX3-009
• Large Group EPO 70 $5,000 with LRX3-010
• Large Group EPO 70 $5,000 with LRX3-011
• Large Group EPO 70 $6,000 with LRX3-008
• Large Group EPO 70 $6,000 with LRX3-009
• Large Group EPO 70 $6,000 with LRX3-010
• Large Group EPO 70 $6,000 with LRX3-011
• Large Group EPO 80 $500 with LRX3-008
• Large Group EPO 80 $500 with LRX3-009
• Large Group EPO 80 $500 with LRX3-010
• Large Group EPO 80 $500 with LRX3-011
• Large Group EPO 80 $750 with LRX3-008
• Large Group EPO 80 $750 with LRX3-009
• Large Group EPO 80 $750 with LRX3-010
• Large Group EPO 80 $750 with LRX3-011
• Large Group EPO 80 $1,000 with LRX3-008
• Large Group EPO 80 $1,000 with LRX3-009
• Large Group EPO 80 $1,000 with LRX3-010
• Large Group EPO 80 $1,000 with LRX3-011
• Large Group EPO 80 $1,500 with LRX3-008
• Large Group EPO 80 $1,500 with LRX3-009
• Large Group EPO 80 $1,500 with LRX3-010
• Large Group EPO 80 $1,500 with LRX3-011
• Large Group EPO 80 $1,500 with LRX3-008
• Large Group EPO 80 $1,500 with LRX3-009
• Large Group EPO 80 $1,500 with LRX3-010
• Large Group EPO 80 $1,500 with LRX3-011
• Large Group EPO 80 $2,000 with LRX3-008
• Large Group EPO 80 $2,000 with LRX3-009
• Large Group EPO 80 $2,000 with LRX3-010
• Large Group EPO 80 $2,000 with LRX3-011
• Large Group EPO 80 $2,500 with LRX3-008
• Large Group EPO 80 $2,500 with LRX3-009
• Large Group EPO 80 $2,500 with LRX3-010
• Large Group EPO 80 $2,500 with LRX3-011
• Large Group EPO 80 $3,000 with LRX3-008
• Large Group EPO 80 $3,000 with LRX3-009
• Large Group EPO 80 $3,000 with LRX3-008
• Large Group EPO 80 $3,000 with LRX3-009
• Large Group EPO 80 $3,000 with LRX3-010
• Large Group EPO 80 $3,000 with LRX3-011
• Large Group EPO 80 $3,500 with LRX3-008
• Large Group EPO 80 $3,500 with LRX3-009
• Large Group EPO 80 $3,500 with LRX3-010
• Large Group EPO 80 $3,500 with LRX3-011
• Large Group EPO 80 $4,500 with LRX3-008
• Large Group EPO 80 $4,500 with LRX3-009
• Large Group EPO 80 $4,500 with LRX3-010
• Large Group EPO 80 $4,500 with LRX3-011
• Large Group EPO 80 $5,500 with LRX3-008
• Large Group EPO 80 $5,500 with LRX3-009
• Large Group EPO 80 $5,500 with LRX3-010
• Large Group EPO 80 $5,500 with LRX3-011
• Large Group EPO 90 $500 with LRX3-008
• Large Group EPO 90 $500 with LRX3-009
• Large Group EPO 90 $500 with LRX3-010
• Large Group EPO 90 $500 with LRX3-011
• Large Group EPO 90 $1,000 with LRX3-008
• Large Group EPO 90 $1,000 with LRX3-009
• Large Group EPO 90 $1,000 with LRX3-010
• Large Group EPO 90 $1,000 with LRX3-011
• Large Group HMO40 Value with LRX3-008
• Large Group HMO40 Value with LRX3-009
• Large Group HMO40 Value with LRX3-010
• Large Group HMO40 Value with LRX3-011
• Large Group HMO 15 with LRX3-008
• Large Group HMO 15 with LRX3-009
• Large Group HMO 15 with LRX3-010
• Large Group HMO 15 with LRX3-011
• Large Group HMO 30 with LRX3-008
• Large Group HMO 30 with LRX3-009
• Large Group HMO 30 with LRX3-010
• Large Group HMO 30 with LRX3-011
• Large Group PPO 100/70 $2,500 with LRX3-008
• Large Group PPO 100/70 $2,500 with LRX3-009
• Large Group PPO 100/70 $2,500 with LRX3-010
• Large Group PPO 100/70 $2,500 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group PPO 100/70 $5,000 with LRX3-008
• Large Group PPO 100/70 $5,000 with LRX3-009
• Large Group PPO 100/70 $5,000 with LRX3-010
• Large Group PPO 100/70 $5,000 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group PPO 100/70 $7,150 with LRX3-008
• Large Group PPO 100/70 $7,150 with LRX3-009
• Large Group PPO 100/70 $7,150 with LRX3-010
• Large Group PPO 100/70 $7,150 with LRX3-011
• Large Group PPO 70/50 $2,000 with LRX3-008
• Large Group PPO 70/50 $2,000 with LRX3-009
• Large Group PPO 70/50 $2,000 with LRX3-010
• Large Group PPO 70/50 $2,000 with LRX3-011
• Large Group PPO 70/50 $3,000 with LRX3-008
• Large Group PPO 70/50 $3,000 with LRX3-009
• Large Group PPO 70/50 $3,000 with LRX3-010
• Large Group PPO 70/50 $3,000 with LRX3-011
• Large Group PPO 70/50 $4,000 with LRX3-008
• Large Group PPO 70/50 $4,000 with LRX3-009
• Large Group PPO 70/50 $4,000 with LRX3-010
• Large Group PPO 70/50 $4,000 with LRX3-011
• Large Group PPO 70/50 $5,000 with LRX3-008
• Large Group PPO 70/50 $5,000 with LRX3-009
• Large Group PPO 70/50 $5,000 with LRX3-010
• Large Group PPO 70/50 $5,000 with LRX3-011
• Large Group PPO 70/50 $6,000 with LRX3-008
• Large Group PPO 70/50 $6,000 with LRX3-009
• Large Group PPO 70/50 $6,000 with LRX3-010
• Large Group PPO 70/50 $6,000 with LRX3-011
• Large Group PPO 80/50 $500 with LRX3-008
• Large Group PPO 80/50 $500 with LRX3-009
• Large Group PPO 80/50 $500 with LRX3-010
• Large Group PPO 80/50 $500 with LRX3-011
• Large Group PPO 80/50 $750 with LRX3-008
• Large Group PPO 80/50 $750 with LRX3-009
• Large Group PPO 80/50 $750 with LRX3-010
• Large Group PPO 80/50 $750 with LRX3-011
• Large Group PPO 80/50 $1,000 with LRX3-008
• Large Group PPO 80/50 $1,000 with LRX3-009
• Large Group PPO 80/50 $1,000 with LRX3-010
• Large Group PPO 80/50 $1,000 with LRX3-011
• Large Group PPO 80/50 $1,500 with LRX3-008
• Large Group PPO 80/50 $1,500 with LRX3-009
• Large Group PPO 80/50 $1,500 with LRX3-010
• Large Group PPO 80/50 $1,500 with LRX3-011
• Large Group PPO 80/50 $1,500 with LRX3-008
• Large Group PPO 80/50 $1,500 with LRX3-009
• Large Group PPO 80/50 $1,500 with LRX3-010
• Large Group PPO 80/50 $1,500 with LRX3-011
• Large Group PPO 80/50 $2,000 with LRX3-008
• Large Group PPO 80/50 $2,000 with LRX3-009
• Large Group PPO 80/50 $2,000 with LRX3-010
• Large Group PPO 80/50 $2,000 with LRX3-011
• Large Group PPO 80/50 $2,500 with LRX3-008
• Large Group PPO 80/50 $2,500 with LRX3-009
• Large Group PPO 80/50 $2,500 with LRX3-010
• Large Group PPO 80/50 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group PPO 80/50 $3,000 with LRX3-008
• Large Group PPO 80/50 $3,000 with LRX3-009
• Large Group PPO 80/50 $3,000 with LRX3-010
• Large Group PPO 80/50 $3,000 with LRX3-011
• Large Group PPO 80/50 $3,500 with LRX3-008
• Large Group PPO 80/50 $3,500 with LRX3-009
• Large Group PPO 80/50 $3,500 with LRX3-010
• Large Group PPO 80/50 $3,500 with LRX3-011
• Large Group PPO 80/50 $4,500 with LRX3-008
• Large Group PPO 80/50 $4,500 with LRX3-009
• Large Group PPO 80/50 $4,500 with LRX3-010
• Large Group PPO 80/50 $4,500 with LRX3-011
• Large Group PPO 80/50 $5,500 with LRX3-008
• Large Group PPO 80/50 $5,500 with LRX3-009
• Large Group PPO 80/50 $5,500 with LRX3-010
• Large Group PPO 80/50 $5,500 with LRX3-011
• Large Group PPO 90/70 $500 with LRX3-008
• Large Group PPO 90/70 $500 with LRX3-009
• Large Group PPO 90/70 $500 with LRX3-010
• Large Group PPO 90/70 $500 with LRX3-011
• Large Group PPO 90/70 $1,000 with LRX3-008
• Large Group PPO 90/70 $1,000 with LRX3-009
• Large Group PPO 90/70 $1,000 with LRX3-010
• Large Group PPO 90/70 $1,000 with LRX3-011
• Large Group POS 100/70 $2,500 with LRX3-008
• Large Group POS 100/70 $2,500 with LRX3-009
• Large Group POS 100/70 $2,500 with LRX3-010
• Large Group POS 100/70 $2,500 with LRX3-011
• Large Group HDHP100 $3,500 HDHP003
• Large Group HDHP100 $3,500 HDHP004
• Large Group HDHP100 $5,000 HDHP003
• Large Group HDHP100 $5,000 HDHP004
• Large Group POS 100/70 $5,000 with LRX3-008
• Large Group POS 100/70 $5,000 with LRX3-009
• Large Group POS 100/70 $5,000 with LRX3-010
• Large Group POS 100/70 $5,000 with LRX3-011
• Large Group HDHP100 $6,450 HDHP003
• Large Group HDHP100 $6,450 HDHP004
• Large Group POS 100/70 $7,150 with LRX3-008
• Large Group POS 100/70 $7,150 with LRX3-009
• Large Group POS 100/70 $7,150 with LRX3-010
• Large Group POS 100/70 $7,150 with LRX3-011
• Large Group POS 70/50 $2,000 with LRX3-008
• Large Group POS 70/50 $2,000 with LRX3-009
• Large Group POS 70/50 $2,000 with LRX3-010
• Large Group POS 70/50 $2,000 with LRX3-011
• Large Group POS 70/50 $3,000 with LRX3-008
• Large Group POS 70/50 $3,000 with LRX3-009
• Large Group POS 70/50 $3,000 with LRX3-010
• Large Group POS 70/50 $3,000 with LRX3-011
• Large Group POS 70/50 $4,000 with LRX3-008
• Large Group POS 70/50 $4,000 with LRX3-009
• Large Group POS 70/50 $4,000 with LRX3-010
• Large Group POS 70/50 $4,000 with LRX3-011
• Large Group POS 70/50 $5,000 with LRX3-008
• Large Group POS 70/50 $5,000 with LRX3-009
• Large Group POS 70/50 $5,000 with LRX3-010
• Large Group POS 70/50 $5,000 with LRX3-011
• Large Group POS 70/50 $6,000 with LRX3-008
• Large Group POS 70/50 $6,000 with LRX3-009
• Large Group POS 70/50 $6,000 with LRX3-010
• Large Group POS 70/50 $6,000 with LRX3-011
• Large Group POS 80/50 $500 with LRX3-008
• Large Group POS 80/50 $500 with LRX3-009
• Large Group POS 80/50 $500 with LRX3-010
• Large Group POS 80/50 $500 with LRX3-011
• Large Group POS 80/50 $750 with LRX3-008
• Large Group POS 80/50 $750 with LRX3-009
• Large Group POS 80/50 $750 with LRX3-010
• Large Group POS 80/50 $750 with LRX3-011
• Large Group POS 80/50 $1,000 with LRX3-008
• Large Group POS 80/50 $1,000 with LRX3-009
• Large Group POS 80/50 $1,000 with LRX3-010
• Large Group POS 80/50 $1,000 with LRX3-011
• Large Group POS 80/50 $1,500 with LRX3-008
• Large Group POS 80/50 $1,500 with LRX3-009
• Large Group POS 80/50 $1,500 with LRX3-010
• Large Group POS 80/50 $1,500 with LRX3-011
• Large Group POS 80/50 $1,500 with LRX3-008
• Large Group POS 80/50 $1,500 with LRX3-009
• Large Group POS 80/50 $1,500 with LRX3-010
• Large Group POS 80/50 $1,500 with LRX3-011
• Large Group POS 80/50 $2,000 with LRX3-008
• Large Group POS 80/50 $2,000 with LRX3-009
• Large Group POS 80/50 $2,000 with LRX3-010
• Large Group POS 80/50 $2,000 with LRX3-011
• Large Group POS 80/50 $2,500 with LRX3-008
• Large Group POS 80/50 $2,500 with LRX3-009
• Large Group POS 80/50 $2,500 with LRX3-010
• Large Group POS 80/50 $2,500 with LRX3-011
• Large Group HDHP80 $3,000 HDHP003
• Large Group HDHP80 $3,000 HDHP004
• Large Group POS 80/50 $3,000 with LRX3-008
• Large Group POS 80/50 $3,000 with LRX3-009
• Large Group POS 80/50 $3,000 with LRX3-010
• Large Group POS 80/50 $3,000 with LRX3-011
• Large Group POS 80/50 $3,500 with LRX3-008
• Large Group POS 80/50 $3,500 with LRX3-009
• Large Group POS 80/50 $3,500 with LRX3-010
• Large Group POS 80/50 $3,500 with LRX3-011
• Large Group POS 80/50 $4,500 with LRX3-008
• Large Group POS 80/50 $4,500 with LRX3-009
• Large Group POS 80/50 $4,500 with LRX3-010
• Large Group POS 80/50 $4,500 with LRX3-011
• Large Group POS 80/50 $5,500 with LRX3-008
• Large Group POS 80/50 $5,500 with LRX3-009
• Large Group POS 80/50 $5,500 with LRX3-010
• Large Group POS 80/50 $5,500 with LRX3-011
• Large Group POS 90/70 $500 with LRX3-008
• Large Group POS 90/70 $500 with LRX3-009
• Large Group POS 90/70 $500 with LRX3-010
• Large Group POS 90/70 $500 with LRX3-011
• Large Group POS 90/70 $1,000 with LRX3-008
• Large Group POS 90/70 $1,000 with LRX3-009
• Large Group POS 90/70 $1,000 with LRX3-010
• Large Group POS 90/70 $1,000 with LRX3-011

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.