Summary of Benefits and Coverage (SBC)

We list here all of the Summaries of Benefits and Coverage for our health plans. These documents are designed to help you better understand your coverage.

Select Service Area

Clark County WASHINGTON

Evolve Plus

$1,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$5,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$7,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

Evolve Core

$2,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$5,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$7,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$10,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

Evolve HSA

80/60 $2,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
80/60 $3,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

IDAHO

Evolve Core

$2,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$7,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$10,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA

80/60/60 $1,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
50/50/50 $1,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
80/60/60 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
50/50/50 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA 100

$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2

OREGON

Evolve Core

$2,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$7,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$10,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA

80/60/60 $1,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
50/50/50 $1,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
80/60/60 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
50/50/50 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA 100

$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
 

UTAH

Evolve Core 2.0

$2,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$7,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$10,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA 2.0

80/60 $1,250 Medical only Medical with Dental Option 1 Medical with Dental Option 2
60/50 $1,250 Medical only Medical with Dental Option 1 Medical with Dental Option 2
80/60 $2,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
60/50 $2,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
80/60 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
60/50 $3,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2

Evolve HSA 100 2.0

$3,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2

RealValue

$2,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$5,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$7,500 Medical only Medical with Dental Option 1 Medical with Dental Option 2
$10,000 Medical only Medical with Dental Option 1 Medical with Dental Option 2
 

WASHINGTON

Evolve Plus

$1,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$5,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$7,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

Evolve Core

$2,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$5,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$7,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$10,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

Evolve HSA

80/60/60 $2,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
80/60/60 $3,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option

RealValue 2.0

$3,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$5,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$7,500 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option
$10,000 Medical only Medical with Dental Option 2 Medical with Dental Rewards Option