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Plan documents

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2022 plan year

Gold Valley Advantage EPO 2150/10/20 (Available in Lehigh and Northampton Counties)

Gold Capital Advantage EPO 2150/10/20 (Available in Cumberland, Dauphin and Perry Counties)

Gold Valley Advantage EPO 3250/10/25 (Available in Lehigh and Northampton Counties)

Gold Capital Advantage EPO 3250/10/25 (Available in Cumberland, Dauphin and Perry Counties)

Silver QHDHP PPO 2200/10/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver QHDHP PPO Choice 2200/10/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO Choice 3950/20/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver Valley Advantage EPO 5950/20/40 (Available in Lehigh and Northampton Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish


Silver Capital Advantage EPO 5950/20/40 (Available in Cumberland, Dauphin and Perry Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO 5950/20/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Bronze Valley Advantage EPO 7450/0/50 (Available in Lehigh and Northampton Counties)

Bronze Capital Advantage EPO 7450/0/50 (Available in Cumberland, Dauphin and Perry Counties)

Bronze HMO 7450/0/50 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Catastrophic PPO 8700/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie - Spanish

Off Pennie

Off Pennie

Off Pennie

Catastrophic HMO 8700/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Vision Plans (Available in all 21 counties)

Highlight sheet

Vision Essential Plan


2021 plan year

Gold Valley Advantage EPO 2150/10/20 (Available in Lehigh and Northampton counties)

Silver PPO Choice 3950/20/35 (Available in Lancaster county)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

On Pennie - Spanish

Silver Valley Advantage EPO 5950/20/40 (Available in Lehigh and Northampton counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO 5950/20/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

On Pennie - Spanish


Bronze Valley Advantage EPO 8000/0/50 (Available in Lehigh and Northampton counties)

Bronze HMO 8000/0/50 (Available in all 21 counties)

Subscriber agreements Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie -Spanish


Catastrophic PPO 8550/0/75 (Available in all 21 counties)

Benefit Contracts Summary of Benefits and Coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie - Spanish

Off Pennie

Off Pennie

Off Pennie

Catastrophic HMO 8550/0/75 (Available in all 21 counties)

Subscriber agreements Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Vision Plans (Available in all counties)

Highlight sheet

Vision Essential Plan