Documents for Prior Period Health Coverage

Plan Booklet Schedule of Benefits Summary of Benefits and Coverage
7/01/2025-7/01/2026 (PDF) 7/01/2025-7/01/2026 (PDF) 7/01/2025-7/01/2026 (PDF)
7/01/2024-07/01/2025 (PDF) 7/01/2024-07/01/2025 (PDF) 7/01/2024-07/01/2025 (PDF)
7/01/2023-6/30/2024 (PDF) 7/01/2023-6/30/2024 (PDF) 7/01/2023-6/30/2024 (PDF)
7/01/2022-6/30/2023 (PDF) 7/01/2022-6/30/2023 (PDF) 7/01/2022-6/30/2023 (PDF)
7/01/2021-6/30/2022 (PDF) 7/01/2021-6/30/2022 (PDF) 7/01/2021-6/30/2022 (PDF)
7/1/2020 - 6/30/21 (PDF) 7/1/2020 - 6/30/21 (PDF) 7/1/2020 - 6/30/21 (PDF)
7/1/2019 - 6/30/20 (PDF) 7/1/2019 - 6/30/20 (PDF) 7/1/2019 - 6/30/20 (MS-Word)
7/1/2017-6/30/2018 (PDF) 7/1/2017-6/30/2018 (PDF) 7/1/2017-6/30/2018 (MS-Word)
7/1/2016 - 6/30/2017 (PDF) 7/1/2016 - 6/30/2017 (PDF) 7/1/2016 - 6/30/2017 (MS-Word)
1/1/2016 - 6/30/2016 (PDF) 1/1/2016 - 6/30/2016 (PDF) 1/1/2016 - 6/30/2016 (MS-Word)
7/1/2015 - 12/31/2015 (PDF) 7/1/2015 - 12/31/2015 (PDF) 7/1/2015 - 12/31/2015 (MS-Word)
7/1/2014 - 6/30/2015 (PDF) 7/1/2014 - 6/30/2015 (PDF) 7/1/2014 - 6/30/2015 (MS-Word)

Plan Booklet: A detailed description of the services the health plan covers

Schedule of Benefits: A detailed list of the level of coverage for each service (e.g. copay, coinsurance)

Summary of Benefits and Coverage: A summary of the level of coverage for some services (e.g. copay, coinsurance)