Large Group Plans (2021)
Summary of Benefits and Coverage (SBC)
In compliance with new requirements of the Affordable Care Act, AdventHealth Advantage 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. Please contact your employer for any benefit changes or other plans that may be available to you.
HMO
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AdventHealth 1500/80 HMO 6077
AdventHealth 2500/80 HMO 6078
AdventHealth 5000/65 HMO 6151
AdventHealth 6600/100 HMO 6080
AdventHealth 750D HMO 6047
AdventHealth HDHMO 1500 HSA 6082
AdventHealth HDHMO 2500 HSA 6084
AdventHealth HF16 HMO 6043
AdventHealth HF2 HMO 6029
AdventHealth HF6 HMO 6035
AdventHealth Value 5 HMO 6049
AdventHealth Value 6 HMO 6053
AdventHealth Value 7 HMO 6057
AdventHealth Value 8 HMO 6061
AdventHealth Value 8D HMO 6063
AdventHealth Value 6D HMO 6055
AdventHealth Value 7D HMO 6059
AdventHealth Value 9D HMO 6065
AdventHealth 5000/80 HMO 6075
AdventHealth 5000/80 HMO 6079
AdventHealth 500D HMO 6154
AdventHealth 1000/80 HMO 6069
AdventHealth 1000/80 HMO 6076
AdventHealth C3 HMO 6025
AdventHealth HDHMO 6350 HSA 6088
AdventHealth HF1 HMO 6027
AdventHealth HF15 HMO 6041
AdventHealth HF4 HMO 6031
AdventHealth HF5 HMO 6033
AdventHealth Value 10D HMO 6067
AdventHealth 1500/80 HMO 6071
AdventHealth Value 5D HMO 6051
AdventHealth 2500_80 HMO 6073
AdventHealth 250D HMO 6045
AdventHealth 4500_80 HMO 6184
AdventHealth 3500_80 HMO 6182
AdventHealth 4000_80 HMO 6187
AdventHealth HDHMO 3500 HSA 6193
AdventHealth HDHMO 4500 HSA 6195
AdventHealth HDHMO 5000 HSA 6197
POS
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AdventHealth 1000/80 POS 6090
AdventHealth 1500_80 POS 6092
AdventHealth 1000/80 POS 6119
AdventHealth 2500/80 POS 6094
AdventHealth 5000/80 POS 6096
AdventHealth 5000/80 POS 6122
AdventHealth HDPOS 2500 HSA 6118
AdventHealth HDPOS 6350 HSA 6140
AdventHealth PS2 POS 6102
AdventHealth Value 5 POS 6106
AdventHealth Value 6D POS 6112
AdventHealth Value 7D POS 6116
AdventHealth Value 9 POS 6124
AdventHealth 500D POS 6155
AdventHealth HDPOS 1500 HSA 6117
AdventHealth PS4 POS 6104
AdventHealth 1250D POS 6100
AdventHealth 1500_80 POS 6120
AdventHealth Value 5D POS 6108
AdventHealth 2500_80 POS 6121
AdventHealth 3500_80 POS 6189
AdventHealth 4500_80 POS 6191
AdventHealth HDPOS 3500 HSA 6199
AdventHealth HDPOS 4500 HSA 6201
AdventHealth HDPOS 5000 HSA 6203
Note: Each SBC will display as a PDF, and you will need Adobe Acrobat Reader to view it. If you aren't clear about any of the underlined terms used in these forms, see the Glossary. A paper copy of your SBC is also available, free of charge, by calling Customer Service toll-free at 1.844.522.5279 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 6 p.m.