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.

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).

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.

2019 Summary of Benefits and Coverage

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

• Individual and Family Prime HMO Bronze 7500
• Individual and Family Select EPO Bronze 7500
• Small Group Plus PPO Bronze 7300
• Small Group Plus PPO Bronze 7500
• Small Group Plus PPO Silver 4250
• Small Group Plus PPO Silver 5500
• Small Group Plus PPO Silver 7000
• Small Group Plus PPO Silver 7150
• Small Group Plus PPO Gold 1000
• Small Group Plus PPO Gold 1250
• Small Group Plus PPO Gold 1550
• Small Group Plus PPO Gold 2000
• Small Group Plus PPO Gold 2500
• Small Group Plus PPO Gold 3500
• Small Group Prime POS Bronze 7300
• Small Group Prime POS Bronze 7500
• Small Group Prime POS Silver 4250
• Small Group Prime POS Silver 5500
• Small Group Prime POS Silver 7000
• Small Group Prime POS Silver 7150
• Small Group Prime POS Gold 1000
• Small Group Prime POS Gold 1250
• Small Group Prime POS Gold 1550
• Small Group Prime POS Gold 2000
• Small Group Prime POS Gold 2500
• Small Group Prime POS Gold 3500
• Small Group Savers 100 EPO Bronze 6000
• Small Group Savers 100 EPO Silver 4000
• Small Group Savers 100 HMO Bronze 6000
• Small Group Savers 100 HMO Silver 4000
• Small Group Savers 100 PPO Bronze 6000
• Small Group Savers 100 PPO Silver 4000
• Small Group Savers POS Bronze 6000
• Small Group Savers POS Silver 4000
• Small Group Select 80 EPO Bronze 7300
• Small Group Select 80 EPO Gold 1000
• Small Group Select 80 EPO Gold 1250
• Small Group Select 80 EPO Gold 2000
• Small Group Select 80 EPO Silver 4250
• Small Group Select 80 EPO Silver 7000
• Small Group Select 100 EPO Bronze 7500
• Small Group Select 100 EPO Gold 1550
• Small Group Select 100 EPO Gold 2500
• Small Group Select 100 EPO Gold 3500
• Small Group Select 100 EPO Silver 5500
• Small Group Select 100 EPO Silver 7150
• Small Group Elite 80 HMO Bronze 7300
• Small Group Elite 100 HMO Bronze 7500
• Small Group Elite 80 HMO Silver 7000
• Small Group Elite 100 HMO Silver 7150
• Small Group Elite HMO Silver 4250
• Small Group Elite HMO Silver 5500
• Small Group Elite HMO Gold 1000
• Small Group Elite HMO Gold 1250
• Small Group Elite HMO Gold 1550
• Small Group Elite HMO Gold 2000
• Small Group Elite HMO Gold 2500
• Small Group Elite HMO Gold 3500

• 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

2019 Evidence of Coverage

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

• Individual and Family Prime HMO Bronze 7500
• Individual and Family Select EPO Bronze 7500
• Small Group Plus PPO Bronze 7300
• Small Group Plus PPO Bronze 7500
• Small Group Plus PPO Silver 4250
• Small Group Plus PPO Silver 5500
• Small Group Plus PPO Silver 7000
• Small Group Plus PPO Silver 7150
• Small Group Plus PPO Gold 1000
• Small Group Plus PPO Gold 1250
• Small Group Plus PPO Gold 1550
• Small Group Plus PPO Gold 2000
• Small Group Plus PPO Gold 2500
• Small Group Plus PPO Gold 3500
• Small Group Prime POS Bronze 7300
• Small Group Prime POS Bronze 7500
• Small Group Prime POS Silver 4250
• Small Group Prime POS Silver 5500
• Small Group Prime POS Silver 7000
• Small Group Prime POS Silver 7150
• Small Group Prime POS Gold 1000
• Small Group Prime POS Gold 1250
• Small Group Prime POS Gold 1550
• Small Group Prime POS Gold 2000
• Small Group Prime POS Gold 2500
• Small Group Prime POS Gold 3500
• Small Group Savers 100 EPO Bronze 6000
• Small Group Savers 100 EPO Silver 4000
• Small Group Savers 100 HMO Bronze 6000
• Small Group Savers 100 HMO Silver 4000
• Small Group Savers 100 PPO Bronze 6000
• Small Group Savers 100 PPO Silver 4000
• Small Group Savers POS Bronze 6000
• Small Group Savers POS Silver 4000
• Small Group Select 80 EPO Bronze 7300
• Small Group Select 80 EPO Gold 1000
• Small Group Select 80 EPO Gold 1250
• Small Group Select 80 EPO Gold 2000
• Small Group Select 80 EPO Silver 4250
• Small Group Select 80 EPO Silver 7000
• Small Group Select 100 EPO Bronze 7500
• Small Group Select 100 EPO Gold 1550
• Small Group Select 100 EPO Gold 2500
• Small Group Select 100 EPO Gold 3500
• Small Group Select 100 EPO Silver 5500
• Small Group Select 100 EPO Silver 7150
• Small Group Elite 80 HMO Bronze 7300
• Small Group Elite 100 HMO Bronze 7500
• Small Group Elite 80 HMO Silver 7000
• Small Group Elite 100 HMO Silver 7150
• Small Group Elite HMO Silver 4250
• Small Group Elite HMO Silver 5500
• Small Group Elite HMO Gold 1000
• Small Group Elite HMO Gold 1250
• Small Group Elite HMO Gold 1550
• Small Group Elite HMO Gold 2000
• Small Group Elite HMO Gold 2500
• Small Group Elite HMO Gold 3500

• 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
• Large Group tiered PPO 70/70/50 $3,500 with CLRX-1
• Large Group tiered PPO 70/70/50 $3,500 with CLRX-2
• Large Group tiered PPO 70/70/50 $3,500 with CLRX-3
• Large Group tiered PPO 70/70/50 $3,500 with CLRX-4
• Large Group tiered PPO 80/70/50 $500 with CLRX-1
• Large Group tiered PPO 80/70/50 $500 with CLRX-2
• Large Group tiered PPO 80/70/50 $500 with CLRX-3
• Large Group tiered PPO 80/70/50 $500 with CLRX-4
• Large Group tiered PPO 80/80/50 $1,500 with CLRX-1
• Large Group tiered PPO 80/80/50 $1,500 with CLRX-2
• Large Group tiered PPO 80/80/50 $1,500 with CLRX-3
• Large Group tiered PPO 80/80/50 $1,500 with CLRX-4
• Large Group tiered PPO 80/70/50 $1,500 with CLRX-1
• Large Group tiered PPO 80/70/50 $1,500 with CLRX-2
• Large Group tiered PPO 80/70/50 $1,500 with CLRX-3
• Large Group tiered PPO 80/70/50 $1,500 with CLRX-4
• Large Group tiered PPO 80/80/50 $2,500 with CLRX-1
• Large Group tiered PPO 80/80/50 $2,500 with CLRX-2
• Large Group tiered PPO 80/80/50 $2,500 with CLRX-3
• Large Group tiered PPO 80/80/50 $2,500 with CLRX-4
• Large Group tiered PPO 100/80/50 $5,000 with CHDHP-1
• Large Group tiered PPO 100/80/50 $5,000 with CHDHP-2