Large Group HMO Plans (2014)

Summary of Benefits and Coverage (SBCs)

In compliance with new 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.

A paper copy of your SBC is also available, free of charge, by calling Customer Service toll-free at 1-800-716-7737 (TTY/TDD relay: 1-800-955-8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. If you call after hours, you can leave a message and we’ll return your call the next business day.

The Affordable Care Act requires most people to have health care coverage that qualifies as “minimum essential coverage.” These plans or policies do provide minimum essential coverage.

In order for certain types of health coverage (for example, individually purchased insurance or job-based coverage) to qualify as minimum essential coverage, the plan must pay, on average, at least 60 percent of allowed charges for covered services. This is called the “minimum value standard.” The health coverage does meet the minimum value standard for the benefits it provides.

Updated 12/2/2014