Large Group Plans (2018)

Summary of Benefits and Coverage (SBCs)

In compliance with new requirements of the Affordable Care Act, Health First Health Plans 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 Acrobat Reader to view it. You can download Adobe 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

Health First 1000_80 HMO 6001
Health First 1000_80 HMO 6068
Health First 1500_80 HMO 6002
Health First 1500_80 HMO 6070
Health First 2500_80 HMO 6003
Health First 2500_80 HMO 6072
Health First 250D HMO 6044
Health First 5000_65 HMO 6150
Health First 5000_80 HMO 6004
Health First 5000_80 HMO 6074
Health First 500D HMO 6152
Health First 6600_100 HMO 6020
Health First 750D HMO 6046
Health First C1 HMO 6022
Health First C3 HMO 6024
Health First HDHMO 1500 HSA 6081
Health First HDHMO 2500 HSA 6083
Health First HDHMO 6350 HSA 6087
Health First HF1 HMO 6026
Health First HF13 HMO 6036
Health First HF15 HMO 6040
Health First HF16 HMO 6042
Health First HF2 HMO 6028
Health First HF4 HMO 6030
Health First HF5 HMO 6032
Health First HF6 HMO 6034
Health First Value 10D HMO 6066
Health First Value 5 HMO 6048
Health First Value 5D HMO 6050
Health First Value 6 HMO 6052
Health First Value 6D HMO 6054
Health First Value 7 HMO 6056
Health First Value 7D HMO 6058
Health First Value 8 HMO 6060
Health First Value 8D HMO 6062
Health First Value 9D HMO 6064



POS

Health First 1000_80 POS 6005
Health First 1000_80 POS 6089
Health First 1250D POS 6099
Health First 1500_80 POS 6006
Health First 1500_80 POS 6091
Health First 2500_80 POS 6007
Health First 2500_80 POS 6093
Health First 250D POS 6097
Health First 5000_80 POS 6008
Health First 5000_80 POS 6095
Health First 500D POS 6153
Health First Access 1000 POS 6167
Health First Access 1500 POS 6173
Health First Access 2500 POS 6177
Health First Access 3000 POS 6163
Health First Access 500 POS 6165
Health First Access 500 POS 6169
Health First Access 500 POS 6171
Health First Access 500 POS 6175
Health First Access 5000 POS 6179
Health First HDPOS 1500 HSA 6010
Health First HDPOS 2500 HSA 6011
Health First HDPOS 6350 HSA 6139
Health First PS2 POS 6101
Health First PS4 POS 6103
Health First Value 5 POS 6105
Health First Value 5D POS 6107
Health First Value 6 POS 6109
Health First Value 6D POS 6111
Health First Value 7 POS 6113
Health First Value 7D POS 6115
Health First Value 9 POS 6123

PPO

Health First C2 3000 PPO 6125
Health First C3 500 PPO 6126
Health First C4 1000 PPO 6127
Health First HF24 3000 PPO 6128
Health First HF24 4000 PPO 6129
Health First HF24 4500 PPO 6131
Health First HF24 5000 PPO 6130
Health First HF24 5000 PPO 6132
Health First HF24 6350 PPO 6133

A paper copy of your SBC is also available, free of charge, by calling Customer Service toll-free at 1.855.443.4735 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 6 p.m.

Health First Commercial Plans, Inc. and Health First Insurance, Inc. are both doing business under the name of Health First Health Plans. Health First Health Plans has entered into an agreement with CMS to provide health insurance coverage through Qualified Health Plans on the Federally Facilitated Marketplace. Health First Health Plans does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. For more information, contact your agent or your local Health First Health Plans office.

Last updated: 9/27/2017