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Summary of Benefits and Coverages (SBC)
Insurance companies and group health plans are required to provide consumers with a concise document detailing, in plain language, simple and consistent information about health plan benefits and coverage. This summary of benefits and coverage document (SBC) will help consumers better understand the coverage they have and, allow them to easily compare different coverage options. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.

 

 Qualified High Deductible Health Plan (QHDHP)

 

 Member Services Phone

 Group # (Town)

Group # (School)

SBC Document

 Fallon SelectCare

800-868-5200 5550868 5550855   SBC

 Fallon DirectCare

5550865 5550854  SBC

 Harvard Pilgrim

 888-333-4742  189920008 189920006   SBC

 Blue Cross Blue Shield

 800-262-BLUE  00-4062726 00-4064459   SBC

 Tufts Health Plan

 800-462-0224  57527-114 57527-194   SBC
 

Benchmark Plan

 

 Member Services Phone

 Group # (Town)

Group # (School)

SBC Document

Fallon SelectCare

 800-868-5200 5550755   5550753 SBC 

Fallon DirectCare

 5550751 5550749  SBC

Harvard Pilgrim

 888-333-4742  288480016 288480017  SBC

Blue Cross Blue Shield

 800-262-BLUE 00-4053585T   00-4053585 SBC

Tufts Health Plan

 800-462-0224 45843-114   45843-194 SBC

Member Services Phone

 PPO Plan (out-of-network / non-HMO)

 Harvard Pilgrim

  800-782-3675     SBC 

For more information on plan offerings please visit the West Suburban Health Group website.