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 the Health Tradition Customer Service Team.
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 maximum limits for annual deductible and coinsurance per member and per family, defines office copays, confinement fees and emergency room copayments.
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 the Health Tradition Customer Service Team.
Please login to your Employer Maddy Portal account to see your SBC and your Certificate of Coverage.