Find Your Plan
Summary of Benefits and Coverage (SBC) documents and Evidence of Coverage (EOC) documents are listed separately. In general, the plan names...
- The $ value in a plan name indicates that plan's annual deductible.
- The numbers with a dash, for example 80/50, signify the in-network coverage and out-of-network percentage.
- HMO CC is the abbreviation for HMO Consumer Choice.
- HDHP is the abbreviation for High-Deductible Health Plan.
Plan names may include a prescription rider code at the end of the file name. For plans with riders, the differences are in the prescription drug co-pay amounts for in-network preferred generic, preferred brand drugs, non-preferred generic drugs and non-preferred brand drugs, and preferred specialty drugs.
- LRX20001 Medication copays: $5 preferred generic, $30 preferred brand, $50 non-preferred, and $200 on preferred specialty drugs.
- LRX20002 Medication copays: $8 preferred generic, $35 preferred brand, $70 non-preferred, and 20% on preferred specialty drugs.
- LRX20006 Medication copays: $10 preferred generic, $40 preferred brand, $80 non-preferred, and 25% on preferred specialty drugs
- LRX20007 Medication copays: $15 preferred generic, $50 preferred brand, $100 non-preferred, and 25% on preferred specialty drugs