HMO plan

2025 – 2026

• HMO 20
• Summary of Benefits – Medical
• Summary of Benefits – Pharmacy

• HMO 30
• Summary of Benefits – Medical
• Summary of Benefits – Pharmacy

2024 – 2025

• HMO 20
• Summary of Benefits – Medical and pharmacy
• Summary of Benefits and Coverage

• HMO 30
• Summary of Benefits – Medical and pharmacy
• Summary of Benefits and Coverage

Trio ACO/HMO plan

2025 – 2026

• Trio ACO/HMO 25
• Summary of Benefits – Medical
• Summary of Benefits – Pharmacy

• Trio ACO/HMO 40
• Summary of Benefits – Medical
• Summary of Benefits – Pharmacy

2024 – 2025

• Trio ACO/HMO 25
• Summary of Benefits – Medical and pharmacy
• Summary of Benefits and Coverage

• Trio ACO/HMO 40
• Summary of Benefits – Medical and pharmacy
• Summary of Benefits and Coverage

PPO plan

2025 – 2026

• PPO 300
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• PPO 500
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• PPO 700
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• PPO 1000
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• PPO 1500
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• PPO 5000
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

2024 – 2025

• PPO 300
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• PPO 500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• PPO 700
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• PPO 1000
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• PPO 1500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• PPO 5000
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

High Deductible Health Plan

2025 – 2026

• HDHP 3300
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

• HDHP 3500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

• HDHP 4000
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

• HDHP 5500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

2024 – 2025

• HDHP 3500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• HDHP 5500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

Tandem ACO/PPO plan

2025 – 2026

• Tandem ACO/PPO 300
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• Tandem ACO/PPO 1700
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• Tandem ACO/PPO 5000
• Summary of Benefits – Medical, acupuncture, and chiropractic services
• Summary of Benefits – Pharmacy

• Tandem ACO/HDHP 3300
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

• Tandem ACO/HDHP 3500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

• Tandem ACO/HDHP 4000
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services

2024 – 2025

• Tandem ACO/PPO 300
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• Tandem ACO/PPO 1700
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• Tandem ACO/PPO 5000
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage

• Tandem ACO/HDHP 3500
• Summary of Benefits – Medical, pharmacy, acupuncture, and chiropractic services
• Summary of Benefits and Coverage