Your Benefits I Qualified Health Plans

Plan Name	Summary of Benefits	Schedule of Benefits	Evidence of Coverage	Evidencia de cobertura
Platinum	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual Group	Para individuos Para grupos
Gold	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual Group	Para individuos Para grupos
Low Gold	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual Group	Para individuos Para grupos
Silver A	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual	Para individuos
Silver A II	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual Group	Para individuos Para grupos
Silver B	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual	Para individuos
Low Silver	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Group	Para grupos
Bronze	Summary of Benefits Resumen de beneficios	Schedule of Benefits Esquema de beneficios	Individual Group	Para individuos Para grupos
AI/AN Limited Cost-Sharing	Summary of Benefits	Select Network Silver Network Esquema de beneficios (Select) Esquema de beneficios (Silver)	Individual	Para individuos
AI/AN Zero Cost-Sharing	Summary of Benefits	Select Network Silver Network Esquema de beneficios (Select) Esquema de beneficios (Silver)	Individual	Para individuos

Plan Name	Summary of Benefits	Schedule of Benefits	Evidence of Coverage
Platinum	Summary of Benefits	Schedule of Benefits	Individual Group
Gold	Summary of Benefits	Schedule of Benefits	Individual Group
Low Gold	Summary of Benefits	Schedule of Benefits	Individual Group
Silver A	Summary of Benefits	Schedule of Benefits	Individual
Silver A II	Summary of Benefits	Schedule of Benefits	Individual Group
Silver B	Summary of Benefits	Schedule of Benefits	Individual
Low Silver	Summary of Benefits	Schedule of Benefits	Group
Bronze	Summary of Benefits	Schedule of Benefits	Individual Group
AI/AN Limited Cost-Sharing	Summary of Benefits	Select Network Silver Network	Individual
AI/AN Zero Cost-Sharing	Summary of Benefits	Select Network Silver Network	Individual

*Please see the current year's Qualified Health Plan Evidence of Coverage and Schedule of Benefits for specific information on each plan, or additional information including which benefits, services and medications are covered or non-covered on our plan- and any restrictions or guidelines we must follow before providing them. You can find doctors and hospitals in our network here, see our privacy practices, and learn how we make sure you get the right care at the right time with our Utilization Management policy.

Your benefits