Summary of Benefits & Coverage

2023 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 (TTY: 711). To find out more information about plans available under the FEHB Program please visit www.Opm.Gov/Insure.

Open Access® HMO & Aetna Saver plans:

• High Option (PDF)
• Basic Option (PDF)
• Aetna Saver Plan (PDF)

Open Access® HMO plans:

• High Option (PDF)
• Basic Option (PDF)

Southern CA (PDF)

Other (PDF) - AZ, GA, PA (western), TN

• 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)
• Aetna Advantage (PDF)

Altius Health Plans:

• High Option (PDF)
• Standard Option (PDF)

View and Download 2022 SBCs

Uniform Glossary: