Skip to main content

Summary of Benefits and Coverage (SBCs)

In compliance with 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 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

Health First Bronze HMO 100 1774
Health First Bronze HMO 60 1750
Health First Gold HMO 80 1770
Health First GYM ACCESS Bronze HMO 100 HSA 1658
Health First GYM ACCESS Bronze HMO 60 1656
Health First GYM ACCESS Catastrophic HMO 1746
Health First GYM ACCESS Gold HMO 100 1736
Health First GYM ACCESS Gold HMO 70 1742
Health First GYM ACCESS Gold HMO 80 1740
Health First GYM ACCESS Gold HMO 90 HSA 1744
Health First GYM ACCESS Silver AV73 HMO 100 1665
Health First GYM ACCESS Silver AV73 HMO 80 1689
Health First GYM ACCESS Silver AV87 HMO 100 1666
Health First GYM ACCESS Silver AV87 HMO 80 1690
Health First GYM ACCESS Silver AV94 HMO 100 1667
Health First GYM ACCESS Silver AV94 HMO 80 1691
Health First GYM ACCESS Silver HMO 100 1664
Health First GYM ACCESS Silver HMO 80 1688
Health First GYM ACCESS Bronze HMO 50 1796
Health First Silver HMO 65 1806
Health First Silver AV73 HMO 65 1807
Health First Silver AV87 HMO 65 1808
Health First Silver AV94 HMO 65 1809
Health First Bronze HMO 100 HSA 1794
Health First Gold VALUE 80 1819
Health First Silver VALUE 80 1815
Health First Silver VALUE AV73 80 1816
Health First Silver VALUE AV87 80 1817
Health First Silver VALUE AV94 80 1818
Health First Bronze VALUE 60 1814

HMO Plans - 3000 Series

Health First GYM ACCESS Silver HMO 70 3704
Health First Silver HMO 80 3754

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.

In compliance with requirements of the Affordable Care Act, Health First Health Plans has made available a Summary of Benefits and Coverage (SBC) for Limited Cost Share and Zero Cost Share 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 is underwritten by Health First Commercial Plans, Inc. Health First Commercial Plans, Inc. 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.