2017 & 2018 Summary of Benefits Documents

American Indian

2018 Summary of Benefits American Indian Zero (PDF)
2018 Summary of Benefits American Indian Gold - Limited Cost Sharing (PDF)
2018 Summary of Benefits American Indian Silver - HD Limited (PDF)
2018 Summary of Benefits American Indian Silver - LD Limited (PDF)
2017 Summary of Benefits American Indian Zero (PDF)
2017 Summary of Benefits American Indian Zero - Limited Cost Sharing (PDF)

Catastrophic

2018 Summary of Benefits Catastrophic (PDF)
2018 Summary of Benefits Catastrophic - State (PDF)
2017 Summary of Benefits Catastrophic (PDF)
2017 Summary of Benefits Catastrophic - State (PDF)

Gold

2018 Summary of Benefits Gold (PDF)
2018 Summary of Benefits Gold - State (PDF)
2017 Summary of Benefits Gold (PDF)
2017 Summary of Benefits Gold - Limited Cost Sharing (PDF)
2017 Summary of Benefits Gold - State (PDF)
2017 Summary of Benefits Gold - State Limited Cost Sharing (PDF)

Silver

2018 Summary of Benefits Silver - High Deductible (PDF)
2018 Summary of Benefits Silver - High Deductible 73% (PDF)
2018 Summary of Benefits Silver - High Deductible 87% (PDF)
2018 Summary of Benefits Silver - High Deductible 94% (PDF)
2018 Summary of Benefits Silver - Low Deductible 73% (PDF)
2018 Summary of Benefits Silver - Low Deductible (PDF)
2018 Summary of Benefits Silver - Low Deductible 87% (PDF)
2018 Summary of Benefits Silver - Low Deductible 94% (PDF)
2018 Summary of Benefits Silver - State Low Deductible (PDF)
2018 Summary of Benefits Silver - State Low Deductible 73% (PDF)
2018 Summary of Benefits Silver - State Low Deductible 87% (PDF)
2018 Summary of Benefits Silver - State Low Deductible 94% (PDF)
2017 Summary of Benefits Silver - High Deductible (PDF)
2017 Summary of Benefits Silver - High Deductible 73% (PDF)
2017 Summary of Benefits Silver - High Deductible 87% (PDF)
2017 Summary of Benefits Silver - High Deductible 94% (PDF)
2017 Summary of Benefits Silver - High Deductible Limited Cost Sharing (PDF)
2017 Summary of Benefits Silver - Low Deductible 73% (PDF)
2017 Summary of Benefits Silver - Low Deductible (PDF)
2017 Summary of Benefits Silver - Low Deductible 87% (PDF)
2017 Summary of Benefits Silver - Low Deductible 94% (PDF)
2017 Summary of Benefits Silver - Low Deductible Limited Cost Sharing (PDF)
2017 Summary of Benefits Silver - State Low Deductible (PDF)
2017 Summary of Benefits Silver - State Low Deductible 73% (PDF)
2017 Summary of Benefits Silver - State Low Deductible 87% (PDF)
2017 Summary of Benefits Silver - State Low Deductible 94% (PDF)
2017 Summary of Benefits Silver - State Limited Cost Sharing (PDF)

Bronze

2017 Summary of Benefits Bronze (PDF)
2017 Summary of Benefits Bronze - Limited Cost Sharing (PDF)
2017 Summary of Benefits Bronze - State (PDF)
2017 Summary of Benefits Bronze - State Limited Cost Sharing (PDF)

Pediatric Dental

Summary of Benefits Pediatric Dental Gold (PDF)
Summary of Benefits Pediatric Dental Silver - HD (PDF)
Summary of Benefits Pediatric Dental Silver - LD (PDF)
Summary of Benefits Pediatric Dental Bronze (PDF)


MM162
Last Updated: 2/23/17