Health plan documents - current year
Alta Loma
Barstow
Bassett
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Bear Valley
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Beaumont
Central
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Centralia
Bronze Plan Options
Gold Plan Options
Platinum Plan Options
Silver Plan Options
CharterSafe (including River Springs)
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Chino Valley
View previous year plan documents
- Access+ HMO 3A plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Access+ HMO 9A plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Cucamonga
View previous year plan documents
- Access+ HMO 1C plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Etiwanda
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Hemet
View previous year plan documents
- Access+ HMO 9A plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Access+ HMO 12 plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Hesperia
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Hesperia - Certificated
Mountain View
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Ramona
Bronze Plan Options
Gold Plan Options
Platinum Plan Options
Silver Plan Options
Rim of the World
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
San Bernardino County Superintendent
San Gabriel Valley ROP
Bronze Plan Options
Gold Plan Options
Platinum Plan Options
Silver Plan Options
Santee
Bronze Plan Options
Gold Plan Options
Platinum Plan Options
Silver Plan Options
Savanna
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Summit Leadership Academy
View previous year plan documents
Bronze Plan Options
- Bronze Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Bronze Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Gold Plan Options
- Gold Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Gold Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Platinum Plan Options
- Platinum Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Platinum Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Silver Plan Options
- Silver Access+ HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Trio HMO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
- Silver Tandem PPO plan with HSA
- Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Victor Valley
- Glossary
Summary of Benefits (SOB): This document outlines what the plan covers and how much it costs, helping you make an informed decision. This document has fewer details than the EOC but more details that the SBC.
Evidence of coverage (EOC): This is your plan document that explains in full all the terms of your plan coverage, the benefits, copays or coinsurance, exclusions, limitations and how to access coverage.
Summary of Benefits and Coverage (SBC): This is an easy-to-read summary of the plan’s benefits and coverage that is in a standardized format that allows you to easily compare the Blue Shield health plans to other carriers’ health plans.