Small 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. 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
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AdventHealth Bronze HMO 100 HSA 5552
AdventHealth Silver HMO 50 5597
AdventHealth Gold HMO 50 5583
AdventHealth Gold HMO 80 5575
AdventHealth Gold HMO 80 5577
AdventHealth Gold HMO 80 5580
AdventHealth Platinum HMO 100 5590
AdventHealth Platinum HMO 80 5594
AdventHealth Silver HMO 50 5555
AdventHealth Silver HMO 50 5563
AdventHealth Silver HMO 80 5560
AdventHealth Silver HMO 90 HSA 5567
AdventHealth Silver HMO 90 HSA 5570
AdventHealth Silver HMO 80 HSA 5601
AdventHealth Silver HMO 100 HSA 5603
AdventHealth Silver HMO 50 5599
AdventHealth Gold HMO 90 HSA 5587
AdventHealth Gold HMO 50 5012
AdventHealth Platinum HMO 80 5611
AdventHealth Bronze HMO 100 5014
AdventHealth Platinum HMO 80 5016
AdventHealth Silver HMO 80 5018
POS
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AdventHealth Bronze POS 100 HSA 5553
AdventHealth Bronze POS 50 5549
AdventHealth Gold POS 70 5573
AdventHealth Gold POS 80 5581
AdventHealth Gold POS 90 HSA 5585
AdventHealth Platinum POS 100 5591
AdventHealth Platinum POS 80 5595
AdventHealth Silver POS 100 HSA 5565
AdventHealth Silver POS 50 5557
AdventHealth Silver POS 80 5561
AdventHealth Silver POS 90 HSA 5571
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.