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January 2014 Benefit Summaries
Individual and Family Plans

The following Individual and Family Plan medical benefit summaries are effective January 1, 2014, and must be accompanied by the Important Legal Information Booklet (PDF, 1.3MB) when presented to your clients.
In addition to the benefit summaries, the Summary of Benefits and Coverage (SBC) forms provide your clients with an easy-to-understand overview of what our IFP plans cover. Visit our SBC page to download the forms. For more information on SBCs, please refer to your SBC Guide (PDF, 1.3MB)
Benefit Summary Guides
Download the full benefit summary guide for all of our IFP medical, vision and dental plans.
2014 Benefit Summary Guides
PPO Benefit Summary Guide English (PDF, 2.4MB) 
Updated November 22, 2013 
Spanish (PDF, 5.2MB)
Updated November 22, 2013 
 
EPO Benefit Summary Guide English (PDF, 2.4MB) 
Updated March 26, 2014
Spanish (PDF, 5.1MB) 
Updated March 26, 2014
Native American PPO/EPO Benefit Summary Guide English (PDF, 5.1MB) 
Updated April 3, 2014
Spanish (PDF, 4.5MB) 
Updated April 3, 2014
Benefit summaries by plan type

PPO plans   |   EPO plans   |   Native American plans 
PPO Plans
PPO Plans Benefit Summaries
Ultimate PPO English (PDF, 498KB) 
Spanish (PDF, 498KB) 
Preferred PPO English (PDF, 498KB) 
Spanish (PDF, 498KB) 
Enhanced PPO English (PDF, 498KB)
Spanish (PDF, 498KB) 
Enhanced PPO 150 Subsidy English (PDF, 498KB)
Spanish (PDF, 498KB)
Enhanced PPO 200 Subsidy English (PDF, 498KB)
Spanish (PDF, 498KB)
Enhanced PPO 250 Subsidy English (PDF, 498KB)
Spanish (PDF, 498KB)
Basic PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Basic PPO for HSA English (PDF, 498KB)
Spanish (PDF, 498KB)
Get Covered PPO English (PDF, 498KB) 
Spanish (PDF, 498KB) 
Learn more about our PPO plans»
EPO Plans
EPO Plans Benefit Summaries
Ultimate EPO English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB) 
Updated April 2, 2014
Preferred EPO English (PDF, 498KB) 
Updated March 26, 2014
Spanish (PDF, 498KB) 
Updated April 2, 2014
Enhanced EPO English (PDF, 448KB) 
Updated March 26, 2014
Spanish (PDF, 448KB) 
Updated April 2, 2014
Enhanced EPO 150 Subsidy English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB)
Updated April 2, 2014

Enhanced EPO 200 Subsidy English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB)
Updated April 2, 2014

Enhanced EPO 250 Subsidy English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB)
Updated April 2, 2014

Basic EPO English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB)
Updated April 2, 2014

Basic EPO for HSA English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB)
Updated April 2, 2014

Get Covered EPO English (PDF, 498KB) 
Updated March 26, 2014
Spanish (PDF, 498KB) 
Updated April 2, 2014
Learn more about our EPO plans»
Native American PPO / EPO Plans
Native American Plans Benefit Summaries
Ultimate PPO English (PDF, 506KB) 
Spanish (PDF, 506KB) 
Ultimate EPO English (PDF, 494KB) 
Updated March 26, 2014
Spanish (PDF, 494KB) 
Updated April 2, 2014
Preferred PPO English (PDF, 516KB) 
Spanish (PDF, 516KB) 
Preferred EPO English (PDF, 487KB) 
Updated March 26, 2014
Spanish (PDF, 487KB) 
Updated April 2, 2014
Enhanced PPO English (PDF, 519KB) 
Spanish (PDF, 519KB) 
Enhanced EPO English (PDF, 498KB)
Updated March 26, 2014
Spanish (PDF, 498KB) 
Updated April 2, 2014
Basic PPO English (PDF, 509KB)
Spanish (PDF, 509KB)
Basic EPO English (PDF, 510KB)
Updated March 26, 2014
Spanish (PDF, 510KB)
Updated April 2, 2014

Basic PPO for HSA English (PDF, 502KB)
Spanish (PDF, 502KB)
Basic EPO for HSA English (PDF, 508KB)
Updated March 26, 2014
Spanish (PDF, 508KB)
Updated April 2, 2014

Native American PPO 300 Subsidy English (PDF, 420KB)
Spanish (PDF, 420KB)
Native American EPO 300 Subsidy English (PDF, 473KB)
Updated March 26, 2014
Spanish (PDF, 473KB)
Updated April 2, 2014

Learn more about our Native American PPO / EPO plans»
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