Member Benefit Information

Individual and Family Plan : Summary of Benefits and Coverage (SBC) Documents

What is the SBC document?

The Summary of Benefits and Coverage (SBC) form summarizes health plan information and provides estimated costs of commonly used services. This form is a standardized document that was implemented as part of the Affordable Care Act and is intended to provide a consistent format across all health plans. We hope that the SBC document, along with helpful customer care resources, will make health plans clearer to understand and easier to manage.

If you are unclear about any of the bolded terms used in the SBC, you may reference a standard glossary provided by the Federal Government. The glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. You can view the Glossary at http://www.dol.gov/ebsa/pdf/SBCUniformGlossary.pdf or request a paper copy through the Customer Care Center at (800) 279-1301.


Please complete all plan design attributes below to view a specific Individual Plan SBC

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The Summary of Benefits and Coverage (SBC) Document is only a summary. If you would like more details about the costs and coverage under the terms of your policy, please contact the Customer Care Center at (800) 279-1301 or TTY users dial 711.