Health plan documents
July 1, 2024 - June 30, 2025
EPO (with Virtual Blue)
EPO plan (with Virtual Blue)
Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Resumen de Beneficios
Summary of Benefits and Coverage
Resumen de Beneficios y Cobertura
Evidence of Coverage – Medical, pharmacy, acupuncture, and chiropractic services
Evidence of Coverage Amendment
PPO (with Virtual Blue)
PPO plan (with Virtual Blue)
Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Resumen de Beneficios
Summary of Benefits and Coverage
Resumen de Beneficios y Cobertura
Evidence of Coverage – Medical, pharmacy, acupuncture, and chiropractic services
Evidence of Coverage Amendment
HDHP PPO (with Virtual Blue)
HDHP PPO plan (with Virtual Blue)
Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
Resumen de Beneficios
Summary of Benefits and Coverage
Resumen de Beneficios y Cobertura
Evidence of Coverage – Medical, pharmacy, acupuncture, and chiropractic services
Evidence of Coverage Amendment
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