Large Employer Group Plans
To ensure you are selecting the appropriate Summary of Benefits and Copayments (SBC) that is applicable to your coverage period, please be aware that coverage periods are based on the employer 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 SBC, please call the Sales & Account Management Team.
| Plan Name | For Plans Starting 10/1/2022 | For Plans Starting 1/1/2023 |
|---|
| Capital Selection 153050 | PDF | PDF |
| Capital Selection 153050 + 20% ER | PDF | PDF |
| Capital Selection 1550100 | PDF | PDF |
| Capital Selection 1550100 + 20% ER | PDF | PDF |
| Premier Plus 153050 | PDF | PDF |
| Premier Selection 153050 | PDF | PDF |
| CHP High Deductible HMO (HSA Compatible) | PDF | PDF |
| Primary Selection 6 Tier Rx | PDF | PDF |
| Principal Choice 1550100 | PDF | PDF |
| Principal Choice 1550100 + 25% ER | PDF | PDF |
| Quality Choice 1550100 | PDF | PDF |
| Quality Choice 1550100 + 25% ER | PDF | PDF |
| Uniform Glossary | View Here | View Here |
Small Employer Group Plans