Evidence of Coverage and Disclosure

The Evidence of Coverage and Disclosure Form provides detailed information about your benefits and how, when and where you access covered health care services.

If you have any questions that are not answered by the Evidence of Coverage and Disclosure Form or the FAQ, please Contact Us.

2018 Evidence of Coverage

Summary of Benefits 2018

For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms see the Glossary at www.healthcare.gov/sbc-glossary/ or call 1-844-805-8700 to request a copy.