Plan Documents

Individual & Family Plan Documents

2023 Plans:

SummaCare Value with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000 with SCConnect Network 
SummaCare Bronze 8000-100 with SCConnect Network 
SummaCare Bronze 8000-Limited with SCConnect Network 
SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Bronze 9100-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Bronze 9100-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits 
SummaCare Bronze 9100-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Bronze 9100-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Bronze 7000 HSA with SCConnect Network and Travel Assistance + Adult Vision Exam 
SummaCare Bronze 7000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam 
SummaCare Bronze 7000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam 
SummaCare Bronze 7000 HSA with SCConnect Network
SummaCare Bronze 7000-100 with SCConnect Network
SummaCare Bronze 7000-Limited with SCConnect Network
SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-73 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-87 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-94 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-73 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-87 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-94 with SCConnect Network and 3 Free PCP Visits 
SummaCare Silver 3500-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 3500-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-73 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-87 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-94 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Silver 5000 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited 40 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 40 with SCConnect Network
SummaCare Silver 5000-73 40 with SCConnect Network
SummaCare Silver 5000-87 40 with SCConnect Network
SummaCare Silver 5000-94 40 with SCConnect Network
SummaCare Silver 5000-100 40 with SCConnect Network
SummaCare Silver 5000-Limited 40 with SCConnect Network
SummaCare Silver 6000 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-73 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-87 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-94 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-100 with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-Limited with SCConnect Network and Travel Assistance + Adult Vision Exam
SummaCare Silver 6000 with SCConnect Network
SummaCare Silver 6000-73 with SCConnect Network
SummaCare Silver 6000-87 with SCConnect Network
SummaCare Silver 6000-94 with SCConnect Network
SummaCare Silver 6000-100 with SCConnect Network
SummaCare Silver 6000-Limited with SCConnect Network
SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000-Limited with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000-100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits
SummaCare Gold 2000-100 with SCConnect Network and 3 Free PCP Visits
SummaCare Gold 2000-Limited with SCConnect Network and 3 Free PCP Visits
SummaCare Standard Bronze
SummaCare Standard Silver-73
SummaCare Standard Silver-87
SummaCare Standard Silver-94
SummaCare Standard Gold

2022 plans:

SummaCare Value with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000 with Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-100 with Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000-Limited with Travel Assistance + Adult Vision Exam
SummaCare Bronze 8000
SummaCare Bronze 8000-100 
SummaCare Bronze 8000-Limited
SummaCare Bronze 8700 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Bronze 8700-100 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Bronze 8700-Limited with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Bronze 8700 with 3 Free PCP Visits;
SummaCare Bronze 8700-100 with 3 Free PCP Visits
SummaCare Bronze 8700-Limited with 3 Free PCP Visits
SummaCare Bronze 7000 HSA with Travel Assistance + Adult Vision Exam 
SummaCare Bronze 7000-100 with Travel Assistance + Adult Vision Exam
SummaCare Bronze 7000-Limited HSA with Travel Assistance + Adult Vision Exam
SummaCare Bronze 7000 HSA
SummaCare Bronze 7000-100
SummaCare Bronze 7000-Limited HSA
SummaCare Silver 3500 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-73 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-87 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-94 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500-100 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 3500-Limited with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam 
SummaCare Silver 3500 with 3 Free PCP Visits
SummaCare Silver 3500-73 with 3 Free PCP Visits
SummaCare Silver 3500-87 with 3 Free PCP Visits
SummaCare Silver 3500-94 with 3 Free PCP Visits 
SummaCare Silver 3500-100 with 3 Free PCP Visits
SummaCare Silver 3500-Limited with 3 Free PCP Visits
SummaCare Silver 5000 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 with 3 Free PCP Visits
SummaCare Silver 5000-73 with 3 Free PCP Visits
SummaCare Silver 5000-87 with 3 Free PCP Visits
SummaCare Silver 5000-94 with 3 Free PCP Visits
SummaCare Silver 5000-100 with 3 Free PCP Visits
SummaCare Silver 5000-Limited with 3 Free PCP Visits
SummaCare Silver 5000 40 with Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-73 40 with Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-87 40 with Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-94 40 with Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-100 40 with Travel Assistance + Adult Vision Exam
SummaCare Silver 5000-Limited 40 Travel Assistance + Adult Vision Exam
SummaCare Silver 5000 40
SummaCare Silver 5000-73 40
SummaCare Silver 5000-87 40
SummaCare Silver 5000-94 40
SummaCare Silver 5000-100 40
SummaCare Silver 5000-Limited 40
SummaCare Silver 6000 with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-73 with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-87 with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-94 with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-100 with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000-Limited with Travel Assistance + Adult Vision Exam
SummaCare Silver 6000
SummaCare Silver 6000-73
SummaCare Silver 6000-87
SummaCare Silver 6000-94
SummaCare Silver 6000-100
SummaCare Silver 6000-Limited
SummaCare Gold 2000 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Gold 2000-Limited with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Gold 2000-100 with 3 Free PCP Visits + Travel Assistance + Adult Vision Exam
SummaCare Gold 2000 with 3 Free PCP Visits
SummaCare Gold 2000-100 with 3 Free PCP Visits
SummaCare Gold 2000-Limited with 3 Free PCP Visits