Individual Plans (2018)

Summary of Benefits and Coverage (SBC)

In compliance with new requirements of the Affordable Care Act, Florida Hospital Care Advantage 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.

HMO

Florida Hospital Bronze HMO 100 1776
Florida Hospital Bronze HMO 100 HSA 1795
Florida Hospital Bronze HMO 60 1752
Florida Hospital Gold HMO 80 1772
Florida Hospital GYM ACCESS Bronze HMO 100 HSA 1660
Florida Hospital GYM ACCESS Bronze HMO 50 1797
Florida Hospital GYM ACCESS Bronze HMO 70 1657
Florida Hospital GYM ACCESS Bronze HMO 70 HSA 1663
Florida Hospital GYM ACCESS Catastrophic HMO 1748
Florida Hospital GYM ACCESS Gold HMO 100 1738
Florida Hospital GYM ACCESS Gold HMO 70 1743
Florida Hospital GYM ACCESS Gold HMO 80 1741
Florida Hospital GYM ACCESS Gold HMO 90 HSA 1745
Florida Hospital GYM ACCESS Silver AV73 HMO 100 1669
Florida Hospital GYM ACCESS Silver AV73 HMO 100 1677
Florida Hospital GYM ACCESS Silver AV73 HMO 70 1713
Florida Hospital GYM ACCESS Silver AV73 HMO 70 1725
Florida Hospital GYM ACCESS Silver AV73 HMO 80 1697
Florida Hospital GYM ACCESS Silver AV73 HMO 80 HSA 1733
Florida Hospital GYM ACCESS Silver AV73 HMO 90 1685
Florida Hospital GYM ACCESS Silver AV87 HMO 100 1670
Florida Hospital GYM ACCESS Silver AV87 HMO 100 1678
Florida Hospital GYM ACCESS Silver AV87 HMO 70 1714
Florida Hospital GYM ACCESS Silver AV87 HMO 70 1726
Florida Hospital GYM ACCESS Silver AV87 HMO 80 1698
Florida Hospital GYM ACCESS Silver AV87 HMO 80 1734
Florida Hospital GYM ACCESS Silver AV87 HMO 90 1686
Florida Hospital GYM ACCESS Silver AV94 HMO 100 1671
Florida Hospital GYM ACCESS Silver AV94 HMO 100 1679
Florida Hospital GYM ACCESS Silver AV94 HMO 70 1715
Florida Hospital GYM ACCESS Silver AV94 HMO 70 1727
Florida Hospital GYM ACCESS Silver AV94 HMO 80 1699
Florida Hospital GYM ACCESS Silver AV94 HMO 80 1735
Florida Hospital GYM ACCESS Silver AV94 HMO 90 1687
Florida Hospital GYM ACCESS Silver HMO 100 1668
Florida Hospital GYM ACCESS Silver HMO 100 1676
Florida Hospital GYM ACCESS Silver HMO 70 1712
Florida Hospital GYM ACCESS Silver HMO 70 1724
Florida Hospital GYM ACCESS Silver HMO 80 1696
Florida Hospital GYM ACCESS Silver HMO 80 HSA 1732
Florida Hospital GYM ACCESS Silver HMO 90 1684
Florida Hospital Silver AV73 HMO 65 1811
Florida Hospital Silver AV73 HMO 80 1763
Florida Hospital Silver AV73 HMO 80 1787
Florida Hospital Silver AV73 HMO 90 1803
Florida Hospital Silver AV87 HMO 65 1812
Florida Hospital Silver AV87 HMO 80 1764
Florida Hospital Silver AV87 HMO 80 1788
Florida Hospital Silver AV87 HMO 90 1804
Florida Hospital Silver AV94 HMO 65 1813
Florida Hospital Silver AV94 HMO 80 1789
Florida Hospital Silver AV94 HMO 90 1805
Florida Hospital Silver AV94 HMO 95 1765
Florida Hospital Silver HMO 65 1810
Florida Hospital Silver HMO 80 1762
Florida Hospital Silver HMO 80 1786
Florida Hospital Silver HMO 90 1802

HMO - 3000 Series

Florida Hospital GYM ACCESS Silver HMO 100 3668
Florida Hospital GYM ACCESS Silver HMO 100 3676
Florida Hospital GYM ACCESS Silver HMO 70 3712
Florida Hospital GYM ACCESS Silver HMO 70 3724
Florida Hospital GYM ACCESS Silver HMO 80 3696
Florida Hospital GYM ACCESS Silver HMO 80 HSA 3732
Florida Hospital GYM ACCESS Silver HMO 90 3684
Florida Hospital Silver HMO 65 3810
Florida Hospital Silver HMO 80 3762
Florida Hospital Silver HMO 80 3786
Florida Hospital Silver HMO 90 3802

POS

Florida Hospital Bronze POS 100 1777
Florida Hospital Bronze POS 60 1753
Florida Hospital Gold POS 80 1773
Florida Hospital GYM ACCESS Bronze POS 100 HSA 1661
Florida Hospital GYM ACCESS Catastrophic POS 1749
Florida Hospital GYM ACCESS Gold POS 100 1739
Florida Hospital GYM ACCESS Silver AV73 POS 70 1717
Florida Hospital GYM ACCESS Silver AV73 POS 80 1701
Florida Hospital GYM ACCESS Silver AV87 POS 70 1718
Florida Hospital GYM ACCESS Silver AV87 POS 80 1702
Florida Hospital GYM ACCESS Silver AV94 POS 70 1719
Florida Hospital GYM ACCESS Silver AV94 POS 80 1703
Florida Hospital GYM ACCESS Silver POS 70 1716
Florida Hospital GYM ACCESS Silver POS 80 1700
Florida Hospital Silver AV73 POS 80 1767
Florida Hospital Silver AV73 POS 80 1791
Florida Hospital Silver AV87 POS 80 1768
Florida Hospital Silver AV87 POS 80 1792
Florida Hospital Silver AV94 POS 80 1793
Florida Hospital Silver AV94 POS 95 1769
Florida Hospital Silver POS 80 1766
Florida Hospital Silver POS 80 1790

POS - 3000 Series

Florida Hospital GYM ACCESS Silver POS 70 3716
Florida Hospital GYM ACCESS Silver POS 80 3700
Florida Hospital Silver POS 80 3766
Florida Hospital Silver POS 80 3790

 

A paper copy of your SBC is also available, free of charge, by calling Customer Service toll-free at 1.844.522.5269 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 6 p.m.

In compliance with new requirements of the Affordable Care Act, Florida Hospital Care Advantage 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.

Y0089_MP6562FH PENDING
Last updated: 9/21/2017