Summary of Benefits and Coverage (SBCs) for Individual and Family Plans
In compliance with requirements of the Affordable Care Act, Health First Health Plans has made available a Summary of Benefits and Coverage (SBC) for your plan. The SBC summarizes important information about your health coverage in a standardized format. Each SBC will display as a PDF, and you will need Adobe Reader to view it. You can download Acrobat Reader for free using the link at the bottom of this page. If you aren't clear about any of the underlined terms used in these forms, see the Glossary.
HMO
Bronze 1826 + Adult Dental + Adult Vision, English | Spanish
Bronze Savings 1820 + Adult Dental + Adult Vision, English | Spanish
Bronze Value 1814 + Adult Dental + Adult Vision, English | Spanish
Gold Savings 1825 + Adult Dental + Adult Vision, English | Spanish
Gold Value 1819 + Adult Dental + Adult Vision, English | Spanish
Silver 1664 + Adult Dental + Adult Vision, English | Spanish
Silver AV73 1665 + Adult Dental + Adult Vision, English | Spanish
Silver AV87 1666 + Adult Dental + Adult Vision, English | Spanish
Silver AV94 1667 + Adult Dental + Adult Vision, English | Spanish
Silver Savings 1821 + Adult Dental + Adult Vision, English | Spanish
Silver Savings AV87 1823 + Adult Dental + Adult Vision, English | Spanish
Silver Savings AV94 1824 + Adult Dental + Adult Vision, English | Spanish
Silver Value 1815 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV73 1816 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV87 1817 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV94 1818 + Adult Dental + Adult Vision, English | Spanish
- Non QHP Silver 5554, English | Spanish
- Non QHP Gold 5574, English | Spanish
- Non QHP Gold 5582, English | Spanish
- Non QHP Gold HSA 5586, English | Spanish
Bronze 1826 + Adult Dental + Adult Vision, English | Spanish
Bronze Savings 1820 + Adult Dental + Adult Vision, English | Spanish
Bronze Value 1814 + Adult Dental + Adult Vision, English | Spanish
Gold Savings 1825 + Adult Dental + Adult Vision, English | Spanish
Gold Value 1819 + Adult Dental + Adult Vision, English | Spanish
Silver 1664 + Adult Dental + Adult Vision, English | Spanish
Silver AV73 1665 + Adult Dental + Adult Vision, English | Spanish
Silver AV87 1666 + Adult Dental + Adult Vision, English | Spanish
Silver AV94 1667 + Adult Dental + Adult Vision, English | Spanish
Silver Savings 1821 + Adult Dental + Adult Vision, English | Spanish
Silver Savings AV87 1823 + Adult Dental + Adult Vision, English | Spanish
Silver Savings AV94 1824 + Adult Dental + Adult Vision, English | Spanish
Silver Value 1815 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV73 1816 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV87 1817 + Adult Dental + Adult Vision, English | Spanish
Silver Value AV94 1818 + Adult Dental + Adult Vision, English | Spanish
A paper copy of your SBC is also available, free of charge, by calling Customer Service toll-free at 1.855.443.4735 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 6 p.m.
In compliance with requirements of the Affordable Care Act, Health First Health Plans has made available a Summary of Benefits and Coverage (SBC) for Limited Cost Share and Zero Cost Share Plans.
Health First Health Plans has entered into an agreement with CMS to provide health insurance coverage through Qualified Health Plans on the Federally Facilitated Marketplace. Health First Health Plans is underwritten by Health First Commercial Plans, Inc. Health First Commercial Plans, Inc. does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.
For more information, contact your agent or your local Health First Health Plans office.