Individual Summary of Benefits and Coverage (SBCs)

Platinum

• Choice Plus Platinum
• Choice Plus Platinum Age 29
• FlexFit Platinum
• FlexFit Platinum Age 29
• Standard Platinum SNF 200 Age 29
• Standard Platinum SNF 200 Child Only
• Standard Platinum SNF 200
• Standard Platinum SNF 365 Age 29
• Standard Platinum SNF 365 Child Only
• Standard Platinum SNF 365

Gold

• Activate Gold
• Activate Gold Age 29
• iDirect Gold Copay
• iDirect Gold Copay Age 29
• iDirect Gold Copay HSAQ
• iDirect Gold Copay HSAQ Age 29
• Standard Gold SNF 200 Age 29
• Standard Gold SNF 200 Child Only
• Standard Gold SNF 200
• Standard Gold SNF 365 Age 29
• Standard Gold SNF 365 Child Only
• Standard Gold SNF 365

Silver

• Choice Plus Silver Copay HSAQ
• Choice Plus Silver Copay HSAQ Age 29
• iDirect Silver Copay HSAQ
• iDirect Silver Copay HSAQ Age 29
• Max Silver
• Max Silver Age 29
• Standard Silver SNF 200 Age 29
• Standard Silver SNF 200 Child Only
• Standard Silver SNF 200
• Standard Silver SNF 365 Age 29
• Standard Silver SNF 365 Child Only
• Standard Silver SNF 365

Bronze

• iDirect Bronze Coinsurance HSAQ
• iDirect Bronze Coinsurance HSAQ Age 29
• iDirect Bronze MV
• iDirect Bronze MV Age 29
• Standard Bronze SNF 200 Age 29
• Standard Bronze SNF 200 Child Only
• Standard Bronze SNF 200
• Standard Bronze SNF 365 Age 29
• Standard Bronze SNF 365 Child Only
• Standard Bronze SNF 365