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Your Health Plan Documents

Samples of your new health plan documents can be found below.  See your human resources team for specifics.

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Summary Benefits and Coverage (SBC)

The Summary of Benefits and Coverage is a standard document that helps you determine which plan will work for you, before you select a plan.  Click the compass to learn more!
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Benefit Description Document (BDD) for Gold and Silver CDHP

The Benefit Description Document (BDD) is one of the documents that comprise your official plan documents.  In an effort to remain “green” the BDD is available to you when you are logged into the Member Resource Center.  Click the compass to view the Gold CDHP and Silver CDHP BDD.

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Benefit Description Document (BDD) for Platinum and Gold EPO 

The Benefit Description Document (BDD) is one of the documents that comprise your official plan documents.  In an effort to remain “green” the BDD is available to you when you are logged into the Member Resource Center.  Click the compass to view the Platinum and Gold EPO BDD.

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Benefit Description Document (BDD) Wrap Template

The BDD Wrap is the second document that makes up your official plan documents.  This is a sample only. Your personalized BDD Wrap is available to you from your human resources team, with specifics for you and your colleagues.  Click the compass to open the template.

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Sample Outline of Coverage for Gold CDHP

The Outline of Coverage is the final piece of your official plan documents.  An Outline of Coverage is mailed to your home and explains the specifics on your cost-sharing responsibilities.  This is a sample of the Gold CDHP outline of coverage.  See your personalized Outline of Coverage for details on your plan.  Click the compass to view the sample.

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Sample ID Card

The ID card is the third piece of your plan documents.  An ID card is sent to your home when you change your benefits or plan type.  This is a sample of your ID card.  You should present your ID card to your provider or pharmacy when you seek care.  Click the compass to view the sample.