Small Group Health Plans
The Summary of Benefits and Coverage documents are featured below. If you need further assistance or need to obtain benefit information for a Small Group, please contact your account representative.
2025 Plan Information
APPLICATION KIT
PLAN OVERVIEWS
RATES
METAL PLAN SUMMARY OF BENEFITS AND COVERAGE (SBC)
METAL PLAN GROUP SUBSCRIBER AGREEMENT (GSA)
HMO Metal Plan GSAHDHP (HMO) Metal Plan GSAPPO Metal Plan GSAHDHP (PPO) Metal Plan GSAEngage Metal Plan GSA
Level Funded Plans
LEVEL FUNDED SUMMARY OF BENEFITS AND COVERAGE (SBC)
LEVEL FUNDED SUMMARY PLAN DESCRIPTIONS (SPD)
OPTIONAL BENEFITS
Health Savings Account (HSA) InformationVision Benefit SummaryStandard Option Dental Benefit SummaryHigh Option Dental Benefit SummaryDental Benefit Authorization Form
2024 Plan Information
APPLICATION KIT
PLAN OVERVIEWS
RATES
METAL PLAN SUMMARY OF BENEFITS AND COVERAGE (SBC)
METAL PLAN GROUP SUBSCRIBER AGREEMENT (GSA)
HMO Metal Plan GSAHDHP (HMO) Metal Plan GSATytoHome (HMO) Metal Plan GSAPPO Metal Plan GSAHDHP (PPO) Metal Plan GSATytoHome (PPO) Metal Plan GSAEngage Metal Plan GSAEngage TytoHome Metal Plan GSA
Level Funded Plans
LEVEL FUNDED SUMMARY OF BENEFITS AND COVERAGE (SBC)
LEVEL FUNDED SUMMARY PLAN DESCRIPTIONS (SPD)
HMO SPDHDHP (HMO) SPDTytoHome (HMO) SPDPPO SPDHDHP (PPO) SPDTytoHome (PPO) SPDEngage SPDEngage TytoHome SPD
OPTIONAL BENEFITS
Health Savings Account (HSA) InformationVision Benefit SummaryStandard Option Dental Benefit SummaryHigh Option Dental Benefit SummaryDental Benefit Authorization Form
TRANSPARENCY IN COVERAGE
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