Employer group health plans

Your plan documents

Certificate of Coverage

The Certificate of Coverage is your official policy. It outlines the covered and non-covered benefits, information on how to access benefits and details any exclusions/limitations associated with benefits. The Certificate of Coverage also includes term definitions, enrollment and disenrollment issues, coordination of benefit information, member rights/responsibilities and complaints/appeals procedures. If you can’t find the information you need in your certificate or if you need a copy of your certificate, please contact your human resources department or call Health Tradition at 1-877-832-1823.

Summary of Benefits and Coverage (SBC)

The Summary provides information on some covered and non-covered services, including some exclusions. It indicates your out-of-pocket maximums for annual deductible and coinsurance per member and per family, defines office copays, confinement fees and emergency room co-payments.

The summary provides a quick reference for many benefit questions but does not include everything and does not replace your Certificate of Coverage. Health Tradition sends a copy of your Summary of Benefits annually to your employer. To clarify which plan you have, or if you need additional information, please call us at 1-888-459-3020.

See the Summary of Benefits for your plan below:

 

HMO plans with coverage beginning after January 1, 2019

Platinum Level

Gold Level

Silver Level

Bronze Level

POS plans with coverage beginning after January 1, 2019

Platinum Level

Gold Level

Silver Level

Bronze Level

HMO plans with coverage beginning after January 1, 2018

Platinum Level

Gold Level

Silver Level

Bronze Level

POS plans with coverage beginning after January 1, 2018

Platinum Level

Gold Level

Silver Level

Bronze Level