To view plan information or apply for 2019 2020 coverage, click here

Please download acrobat to view below PDF(s)

Deductible:The plan year dollar amount you pay before Copayments or Coinsurance are applied to covered services.

Out-of-Pocket Maximum:The plan year dollar maximum of your cost sharing including Deductibles, Copayments and Coinsurance, for covered services. After reaching this limit, the plan pays 100% of covered services for the rest of the plan year.

Coinsurance:The percentage of cost sharing you pay for specific types of covered services, after you meet your deductible.

Note: Plan eligibility depends on income level. Refer to your EOC and SBC for full benefit and coverage details. Preventive Services are provided at no cost.