Your plan documents
Quickly and easily view only the plan documents that apply to you in our member portal. Custom plan documents are not included on this page, but can also be found in the member portal.
All documents
Primary care physician (PCP) referrals are not required for any of our plans.
Small Group plans
Platinum plans
- Platinum PPO 80 1250 BSW Access PPO
- Platinum PPO 80 750 BSW Access PPO
- Platinum PPO 80 450 BSW Access PPO
- Platinum PPO Copayment 0 6000 BSW Access PPO
- Platinum HMO 80 1250 BSW Plus HMO
- Platinum HMO 80 750 BSW Plus HMO
- Platinum HMO 80 450 BSW Plus HMO
- Platinum HMO Copayment 0 6000 BSW Plus HMO
- Platinum PPO 80 1250 BSW Plus PPO
- Platinum PPO 80 750 BSW Plus PPO
- Platinum PPO 80 450 BSW Plus PPO
- Platinum PPO Copayment 0 6000 BSW Plus PPO
- Platinum HMO 80 1250 BSW Premier HMO
- Platinum HMO 80 750 BSW Premier HMO
- Platinum HMO 80 450 BSW Premier HMO
- Platinum HMO Copayment 0 6000 BSW Premier HMO
Coming soon...
Gold plans
- Gold PPO 90 4500 BSW Access PPO
- Gold PPO 100 4250 BSW Access PPO
- Gold PPO 90 3500 BSW Access PPO
- Gold PPO HSA 4100 BSW Access PPO
- Gold PPO HSA 3750 BSW Access PPO
- Gold PPO 100 3000 BSW Access PPO
- Gold PPO 80 3000 BSW Access PPO
- Gold PPO 100 2550 BSW Access PPO
- Gold PPO 90 2000 BSW Access PPO
- Gold PPO 90 1975 BSW Access PPO
- Gold PPO 80 1500 BSW Access PPO
- Gold PPO 80 1000 BSW Access PPO
- Gold PPO 80 950 BSW Access PPO
- Gold PPO Copayment 0 9800 BSW Access PPO
- Gold HMO 90 4500 BSW Plus HMO
- Gold HMO 100 4250 BSW Plus HMO
- Gold HMO 90 3500 BSW Plus HMO
- Gold HMO HSA 4100 BSW Plus HMO
- Gold HMO HSA 3750 BSW Plus HMO
- Gold HMO 100 3000 BSW Plus HMO
- Gold HMO 80 3000 BSW Plus HMO
- Gold HMO 100 2550 BSW Plus HMO
- Gold HMO 90 2000 BSW Plus HMO
- Gold HMO 90 1975 BSW Plus HMO
- Gold HMO 80 1500 BSW Plus HMO
- Gold HMO 80 1000 BSW Plus HMO
- Gold HMO 80 950 BSW Plus HMO
- Gold HMO Copayment 0 9800 BSW Plus HMO
- Gold HMO SM 0 11500 BSW Plus HMO
- Gold PPO 90 4500 BSW Plus PPO
- Gold PPO 100 4250 BSW Plus PPO
- Gold PPO 90 3500 BSW Plus PPO
- Gold PPO HSA 4100 BSW Plus PPO
- Gold PPO HSA 3750 BSW Plus PPO
- Gold PPO 100 3000 BSW Plus PPO
- Gold PPO 80 3000 BSW Plus PPO
- Gold PPO 100 2550 BSW Plus PPO
- Gold PPO 90 2000 BSW Plus PPO
- Gold PPO 90 1975 BSW Plus PPO
- Gold PPO 80 1500 BSW Plus PPO
- Gold PPO 80 1000 BSW Plus PPO
- Gold PPO 80 950 BSW Plus PPO
- Gold PPO Copayment 0 9800 BSW Plus PPO
- Gold HMO 90 4500 BSW Premier HMO
- Gold HMO 100 4250 BSW Premier HMO
- Gold HMO 90 3500 BSW Premier HMO
- Gold HMO HSA 4100 BSW Premier HMO
- Gold HMO HSA 3750 BSW Premier HMO
- Gold HMO 100 3000 BSW Premier HMO
- Gold HMO 80 3000 BSW Premier HMO
- Gold HMO 100 2550 BSW Premier HMO
- Gold HMO 90 2000 BSW Premier HMO
- Gold HMO 90 1975 BSW Premier HMO
- Gold HMO 80 1500 BSW Premier HMO
- Gold HMO 80 1000 BSW Premier HMO
- Gold HMO 80 950 BSW Premier HMO
- Gold HMO Copayment 0 9800 BSW Premier HMO
- Gold HMO SM 0 11500 BSW Premier HMO
Coming soon...
Coming Soon>...
Silver plans
- Silver PPO 80 8900 BSW Access PPO
- Silver PPO 80 7500 BSW Access PPO
- Silver PPO 100 7300 BSW Access PPO
- Silver PPO 90 7000 BSW Access PPO
- Silver PPO 80 6900 BSW Access PPO
- Silver PPO 70 6700 BSW Access PPO
- Silver PPO 90 6500 BSW Access PPO
- Silver PPO 80 6250 BSW Access PPO
- Silver PPO HSA 6950 BSW Access PPO
- Silver PPO 90 5900 BSW Access PPO
- Silver PPO 80 5000 BSW Access PPO
- Silver PPO HSA 5800 BSW Access PPO
- Silver PPO 70 4500 BSW Access PPO
- Silver PPO 80 4250 BSW Access PPO
- Silver PPO 60 4200 BSW Access PPO
- Silver PPO 70 3800 BSW Access PPO
- Silver PPO 70 3600 BSW Access PPO
- Silver PPO 60 3250 BSW Access PPO
- Silver PPO 90 850 BSW Access PPO
- Silver HMO 80 8900 BSW Plus HMO
- Silver HMO 80 7500 BSW Plus HMO
- Silver HMO 100 7300 BSW Plus HMO
- Silver HMO 90 7000 BSW Plus HMO
- Silver HMO 80 6900 BSW Plus HMO
- Silver HMO 70 6700 BSW Plus HMO
- Silver HMO 90 6500 BSW Plus HMO
- Silver HMO 80 6250 BSW Plus HMO
- Silver HMO HSA 6950 BSW Plus HMO
- Silver HMO 90 5900 BSW Plus HMO
- Silver HMO 80 5000 BSW Plus HMO
- Silver HMO HSA 5800 BSW Plus HMO
- Silver HMO 70 4500 BSW Plus HMO
- Silver HMO 80 4250 BSW Plus HMO
- Silver HMO 60 4200 BSW Plus HMO
- Silver HMO 70 3800 BSW Plus HMO
- Silver HMO 70 3600 BSW Plus HMO
- Silver HMO 60 3250 BSW Plus HMO
- Silver HMO 90 850 BSW Plus HMO
- Silver PPO 80 8900 BSW Plus PPO
- Silver PPO 80 7500 BSW Plus PPO
- Silver PPO 100 7300 BSW Plus PPO
- Silver PPO 90 7000 BSW Plus PPO
- Silver PPO 80 6900 BSW Plus PPO
- Silver PPO 70 6700 BSW Plus PPO
- Silver PPO 90 6500 BSW Plus PPO
- Silver PPO 80 6250 BSW Plus PPO
- Silver PPO HSA 6950 BSW Plus PPO
- Silver PPO 90 5900 BSW Plus PPO
- Silver PPO 80 5000 BSW Plus PPO
- Silver PPO HSA 5800 BSW Plus PPO
- Silver PPO 70 4500 BSW Plus PPO
- Silver PPO 80 4250 BSW Plus PPO
- Silver PPO 60 4200 BSW Plus PPO
- Silver PPO 70 3800 BSW Plus PPO
- Silver PPO 70 3600 BSW Plus PPO
- Silver PPO 60 3250 BSW Plus PPO
- Silver PPO 90 850 BSW Plus PPO
- Silver HMO 80 8900 BSW Premier HMO
- Silver HMO 80 7500 BSW Premier HMO
- Silver HMO 100 7300 BSW Premier HMO
- Silver HMO 90 7000 BSW Premier HMO
- Silver HMO 80 6900 BSW Premier HMO
- Silver HMO 70 6700 BSW Premier HMO
- Silver HMO 90 6500 BSW Premier HMO
- Silver HMO 80 6250 BSW Premier HMO
- Silver HMO HSA 6950 BSW Premier HMO
- Silver HMO 90 5900 BSW Premier HMO
- Silver HMO 80 5000 BSW Premier HMO
- Silver HMO HSA 5800 BSW Premier HMO
- Silver HMO 70 4500 BSW Premier HMO
- Silver HMO 80 4250 BSW Premier HMO
- Silver HMO 60 4200 BSW Premier HMO
- Silver HMO 70 3800 BSW Premier HMO
- Silver HMO 70 3600 BSW Premier HMO
- Silver HMO 60 3250 BSW Premier HMO
- Silver HMO 90 850 BSW Premier HMO
Coming soon...
Bronze plans
- Bronze PPO 100 10250 BSW Access PPO
- Bronze PPO 90 7900 BSW Access PPO
- Bronze PPO 80 7500 BSW Access PPO
- Bronze PPO HSA 8250 BSW Access PPO
- Bronze HMO 100 10250 INV
- Bronze PPO 100 10250 INV
- Bronze HMO 100 10250 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 8250 BSW Plus HMO
- Bronze HMO 100 10250 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 8250 BSW Premier HMO
- Bronze PPO 100 10250 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 8250 BSW Plus PPO
Coming soon...
POS Transitional
- POS 80%/$0/$3,000/$40/$40 with RXSPS01Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS03Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS04Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS05Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS01Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS02Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS03Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS04Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS05Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS01Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS02Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS03Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS04Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS05Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS01Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS03Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS04Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS05Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS01Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS03Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS04Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS05Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS01Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS03Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS04Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS05Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS01Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS02Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS03Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS04Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS05Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS02Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS04Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS05Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS01Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS02Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS03Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS04Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS05Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS03Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS04Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS05Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS01Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS02Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS03Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS04Y
- POS 70%/$500/$5,500/$30/$50 with RXSPS01Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS02Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS04Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS05Y
- POS 70%/$1,500/$6,500/$30/$50 with RXSPS04Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS04Y
- POS 70%/$2,500/$7,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS01Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS02Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS05Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS01Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS01Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS03Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS05Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS03Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS04Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS05Y
- POS HSA 100%/$3,000/$5,500/0%/0% with SHDPRUY1
- POS HSA 100%/$5,000/$5,950/0%/0% with SHDPRUY1
- POS HSA 80%/$1,500/$3,000/$30/$30 with SHDPRUY2
- POS HSA 80%/$2,500/$5,000/$30/$50 with SHDPRUY2
- POS HSA 100%/$2,500/$5,500/0%/0% with SHDPRUY1
- POS HSA 80%/$3,000/$5,500/$30/$30 with SHDPRUY2
- POS HSA 80%/$5,000/$5,950/$30/$30 with SHDPRUY2
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS02Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS01Y
Coming soon...