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Know the Details 2026

Know the Details 2026

Forms and Notices

Understanding the details of your health plan is important. Get better acquainted with your benefits here. If you still have any questions, we are just a phone call away.

ÌýDefinition of Terms

  • Evidence of Coverage (EOC):ÌýThe EOC documents in detail the health care benefits covered by a plan. It also provides information on plan requirements and cost-sharing for certain benefits.
  • Summary of Benefit and Coverage (SBC): The SBC is an easy-to-read summary document that allows comparison between health plans. This document lists important information about the plan such as cost-sharing, coverage limitations, exceptions and benefits scenarios.
  • Formulary: A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.

Questions?

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8 a.m. – 5 p.m.

Call Us:
Local: 713.295.6704
Toll-Free 1.855.315.5386

Important Plan Documents​

³Ô¹ÏºÚÁÏÍø Bronze Plans
Evidence of Coverage Deductible

³Ô¹ÏºÚÁÏÍø Silver Plans
Evidence of Coverage Deductible

³Ô¹ÏºÚÁÏÍø Gold Plans Evidence of Coverage Deductible

Formulary and Other Documents

Ultra Select Plans

Family making emergency hurricane plan.

Important Plan Documents

³Ô¹ÏºÚÁÏÍø Ultra Select Bronze Plans
Evidence of Coverage Deductible

³Ô¹ÏºÚÁÏÍø Ultra SelectÌýSilver Plans
Evidence of Coverage Deductible

³Ô¹ÏºÚÁÏÍø Ultra Select Gold Plans
Evidence of Coverage Deductible

Formulary and Other Documents

Why Choose ³Ô¹ÏºÚÁÏÍø?

As a local nonprofit health plan, ³Ô¹ÏºÚÁÏÍø gives you plenty of reasons to join our ³Ô¹ÏºÚÁÏÍø. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, ³Ô¹ÏºÚÁÏÍø is always working life forward for you and your family.

“³Ô¹ÏºÚÁÏÍø is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.â€

– Cecily
Member of ³Ô¹ÏºÚÁÏÍø

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