Benefits Summary (PDF) July 1, 2023
A detailed list of the level of coverage for covered services (e.g. copay, coinsurance)

Benefits Summary (PDF) July 1, 2022
A detailed list of the level of coverage for covered services (e.g. copay, coinsurance)

Summary of Benefits & Coverage ("SBC") (PDF) July 1, 2023 
A summary of the level of coverage for some services (e.g. copay, coinsurance)

Summary of Benefits & Coverage ("SBC") (PDF) July 1, 2022
A summary of the level of coverage for some services (e.g. copay, coinsurance)

Plan Booklet - Health (PDF) July 1, 2023 
A detailed description of what medical services the plan covers

Plan Booklet - Health (PDF) July 1, 2022 
A detailed description of what medical services the plan covers 

Plan Booklet - Prescription (PDF) July 1, 2021 - June 30, 2024
A detailed description of what prescription services the plan covers

Rx Copays - Prescription (PDF) July 1, 2022