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January 2016 Benefit Summaries
Individual and Family Plans

The following Individual and Family Plan medical benefit summaries are effective January 1, 2016, and must be accompanied by the Important Legal Information Booklet (PDF, 2.8MB) 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.
Benefit summaries by plan type

PPO plans   |  Alaska Native & American Indian PPO plans 
PPO Plans
PPO Plans Benefit Summaries
Platinum 90 PPO English (PDF, 498KB) 
 
Gold 80 PPO English (PDF, 498KB) 
 
Silver 70 PPO English (PDF, 498KB)
 
New Silver 1850 PPO English (PDF, 498KB)
 
New Silver Seven 3750 PPO English (PDF, 498KB)
 
New Bronze 5550 PPO English (PDF, 498KB)
 
Bronze 60 PPO English (PDF, 498KB)
 
Bronze 60 HSA English (PDF, 498KB)
 
Minimum Coverage PPO English (PDF, 498KB)
 
Cost savings reduction plans
We offer three PPO Silver cost-sharing reduction plans through Covered California for consumers whose income is between 138% to 250% of the federal poverty level (FPL). These plans are available only through Covered California.
Plan Benefit Summaries
Silver 73 PPO English (PDF, 498KB) 
 
Silver 87 PPO English (PDF, 498KB) 
 
Silver 94 PPO English (PDF, 498KB)
 
Alaskan Native & American Indian PPO plans
Alaskan Native & American Indian PPO Plans Benefit Summaries
Platinum 90 PPO AI-AN English (PDF, 498KB) 
 
Gold 80 PPO AI-AN English (PDF, 498KB)
 
Silver 70 PPO AI-AN English (PDF, 498KB)
 
Bronze 60 PPO AI-AN English (PDF, 498KB)
 
Bronze 60 HSA PPO AI-AN English (PDF, 498KB)
 
$0 Cost Share PPO AI-AN  English (PDF, 498KB)
 
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