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Anthem Benefit Summaries

Anthem - https://www.anthem.com/ca

EPO Plans

Plan Type	Copay	Document
EPO	10	SOB
EPO	10	SBC
EPO	10	EOC
EPO	15	SOB
EPO	15	SBC
EPO	15	EOC
EPO	25	SOB
EPO	25	SBC
EPO	25	EOC
EPO + Infertility	25	EOC
EPO	30	SOB
EPO	30	SBC

PPO Plans

Plan Type	Deductible	Document
PPO - Select	250	SOB
PPO - Prudent Buyer	250	SOB
PPO	250	SBC
PPO	250	EOC
PPO + Infertility	250	EOC
PPO	300	SOB
PPO	300	SBC
PPO + Infertility	300	EOC
PPO	500	SOB
PPO	500	SBC
PPO	500	EOC
PPO	750	SOB

HMO Plans

Plan Type	Copay	Document
HMO	10	SBC
HMO	10	EOC
HMO	10	SOB
HMO	20	SOB
HMO Select	20	SBC
HMO	20	SBC
HMO	20	EOC
HMO	30	SOB
HMO	30	SBC
HMO	30	EOC
HMO	35	SOB
HMO	35	SBC

HDHP-HSA Compatible Plans

Plan Type	Deductible	Document
HDHP-HSA	1700	SBC
HDHP-HSA	1750	SOB
HDHP-HSA	3400	SBC
HDHP-HSA	3500	SOB
HDHP-HSA	5000	SBC
HDHP-HSA	5000	SOB

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