Summary of Benefits and Coverage
Large Employer Group Plans
In selecting the appropriate Summary of Benefits and Copayments (SBC) that is applicable to your employer group benefits coverage period, please be aware that coverage periods are based on the employer benefits enrollment anniversary date beginning on or after the dates listed below.
Copayments may or may not change at the time of your group renewal.
If you have any questions regarding your employer group plan SBC, please call the CHP Sales & Account Management Team.
| Plan Name | For Plans Starting 1/1/24 | For Plans Starting 1/1/25 |
|---|---|---|
| Capital Selection 153050 | ||
| Capital Selection 153050 + 20% ER | ||
| Capital Selection 1550100 | ||
| Capital Selection 1550100 + 20% ER | ||
| CHP High Deductible HMO (HSA Compatible) | ||
| Primary Selection 6 Tier Rx | ||
| Principal Choice 1550100 | ||
| Principal Choice 1550100 + 25% ER | ||
| Quality Choice 1550100 | ||
| Quality Choice 1550100 + 25% ER | ||
| Uniform Glossary | View Here | View Here |
Small Employer Group Plans
In selecting the appropriate Summary of Benefits and Copayments (SBC) that is applicable to your employer group benefits coverage period, please be aware that coverage periods are based on the employer benefits enrollment anniversary date beginning on or after the dates listed below.
Copayments may or may not change at the time of your group renewal.
If you have any questions regarding your employer group plan SBC, please call the CHP Sales & Account Management Team.
| Plan Name | For Plans Starting 1/1/24 | For Plans Starting 1/1/25 |
|---|---|---|
| 3101 - Platinum 153050 | ||
| 3102 - Platinum 204060 | ||
| 3104 - Gold 2065100 | ||
| 3107 - Gold 6 Tier Rx | ||
| Basic Option I 1050100 | ||
| Basic Option II 1050100 | ||
| Essential Selection 153050 | ||
| Essential Selection No Rx | ||
| Standard Option I 103050 | ||
| Tiered PCP 153050 | ||
| Tiered PCP No Rx | ||
| Uniform Glossary | View Here | View Here |