Plan Documents

Summary of Benefits and Coverage (SBC) for Medical Plans

A Summary of Benefits and Coverage (SBC) is an easy-to-understand overview of a health plan's benefits and coverage.

The documents listed here apply to all medical plans, regardless of the provider network (carriers).

DOCUMENTS

• Triple Choice Plan Summary of Benefits and Coverage | 2024 | 2025
• High Deductible Health Plan w/HSA Summary of Benefits and Coverage | 2024 | 2025

RESOURCES

• FAQ | Frequently Asked Questions about SBCs
• Uniform Glossary of Coverage and Medical Terms

Summary Plan Descriptions for Medical, Dental and Vision Plans

These documents provide an in-depth description of what a plan provides and how it operates. 

Medical 

Applies to BCBS and UHC

• Triple Choice Plan | SPD 2024 
• High Deductible Health Plan | SPD 2025 

Dental

• UHC Solstice S800B DHMO | SPD
• Delta Dental PPO | SPD

Vision

• Avesis Vision Policy