2017 ACA Summary of Benefits & Coverage (SBC)

The Federal Employees Health Benefits (FEHB) Program offers numerous health benefits plans and coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, this plan makes available a Summary of Benefits and Coverage (SBC) about each of its health coverage options. The SBC summarizes important information in a standard format to help you compare across options. This plan’s SBC is available below. A paper copy is also available, free of charge, by calling 1-800-537-9384. To find out more information about plans available under the FEHB Program please visit www.opm.gov/insure.

Open Access® HMO plans:
Washington, DC Metro Area - DC, MD, VA
        High Option (PDF)
        Basic Option (PDF)
Northeast - DE, NJ, NY, PA (southeastern)
        High Option (PDF)
        Basic Option (PDF)
Southern CA (PDF)
Other (PDF) - AZ, GA, PA (western), TN, WA

Kansas - formerly Coventry Health Care of Kansas) - Kansas City (KS, MO)
        High Option (PDF)
        Standard Option (PDF)

Plans with PPO Networks:
Aetna HealthFund® HDHP with HSA (PDF)
Aetna HealthFund® CDHP (PDF)
Aetna Value Plan (PDF)
Aetna Direct (PDF)

Altius Health Plans:
HMO - UT, ID (Southwest & Eastern), WY (Uinta County)
        High Option (PDF)
        Standard Option (PDF)
HDHP (PDF) - UT, ID (Southwest & Eastern), WY (Uinta County)

Aetna Whole Health:
Milwaukee, WI (PDF)
Houston, TX (PDF)
Newport News, VA (PDF)

Uniform Glossary:
A Glossary of Health Coverage and Medical Terms (Uniform Glossary PDF) that explains terms commonly used in health insurance coverage.