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2026 Commercial Benefit Documents

Benefits summary documents

Small group ACA quarterly rates

First quarter

Second quarter

Third quarter

Fourth quarter

Commercial - Summary of Benefits and Coverage (SBCs)

GFA

HMO

June

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

July

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

August

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

September

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

October

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

November

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

December

All Access

GFA All Access HMO Extra $0 Plan

GFA All Access HMO Extra $250 Plan

GFA All Access HMO Extra $500 Plan

GFA All Access HMO Extra $1000 Plan

GFA All Access HMO Extra $1500 Plan

GFA All Access HMO Extra $2000 Plan

GFA All Access HMO Extra $2500 Plan

GFA All Access HMO Extra $2500 1X Plan

GFA All Access HMO Extra $3000 Plan

GFA All Access HMO Extra $3500 1X Plan

GFA All Access HMO Extra $4000 Plan

GFA All Access HMO Extra $5000 Plan

GFA All Access HMO Extra $5000 1X Plan

GFA All Access HMO Extra $6000 Plan

GFA All Access HMO Extra $6000 1X Plan

GFA All Access HMO Extra $7000 Plan

GFA All Access HMO Extra $8000 Plan

Choices

GFA Choices HMO $0_$500 Plan

GFA Choices HMO $0_$750 Plan

GFA Choices HMO $250 Plan

GFA Choices HMO $500 Plan

GFA Choices HMO $1000 Plan

GFA Choices HMO $1500 Plan

GFA Choices HMO $2000 Plan

GFA Choices HMO $2500 Plan

GFA Choices HMO $2500 1x Plan

GFA Choices HMO $3000 Plan

GFA Choices HMO $3500 1x Plan

GFA Choices HMO $4000 Plan

Premier

GFA Premier HMO $250 Plan

GFA Premier HMO $500 Plan

GFA Premier HMO $1000 Plan

GFA Premier HMO $1500 Plan

GFA Premier HMO $2000 Plan

GFA Premier HMO $2500 Plan

GFA Premier HMO $2500 1X Plan

GFA Premier HMO $3000 Plan

GFA Premier HMO $3500 1X Plan

GFA Premier HMO $4000 Plan

GFA Premier HMO $5000 Plan

GFA Premier HMO $5000 1X Plan

GFA Premier HMO $6000 Plan

GFA Premier HMO $6000 1X Plan

GFA Premier HMO $7000 Plan

GFA Premier HMO $8000 Plan

PPO

June

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

July

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $5000 1X Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

August

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $5000 1X Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

September

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $5000 1X Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

October

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $5000 1X Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

November

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

December

All Access

GFA All Access PPO $0 Plan

GFA All Access PPO $250 Plan

GFA All Access PPO $500 Plan

GFA All Access PPO $1000 Plan

GFA All Access PPO $1500 Plan

GFA All Access PPO $2000 Plan

GFA All Access PPO $2500 Plan

GFA All Access PPO $2500 1X Plan

GFA All Access PPO $3000 Plan

GFA All Access PPO $3500 1X Plan

GFA All Access PPO $4000 Plan

GFA All Access PPO $5000 Plan

GFA All Access PPO $5000 1X Plan

GFA All Access PPO $6000 Plan

GFA All Access PPO $7000 Plan

GFA All Access PPO $8000 Plan

Choices

GFA Choices PPO $1000 Plan

GFA Choices PPO $2000 Plan

GFA Choices PPO $3000 Plan

GFA Choices PPO $4000 Plan

Premier

GFA Premier PPO $250 Plan

GFA Premier PPO $500 Plan

GFA Premier PPO $1000 Plan

GFA Premier PPO $1500 Plan

GFA Premier PPO $2000 Plan

GFA Premier PPO $2500 Plan

GFA Premier PPO $2500 1X Plan

GFA Premier PPO $3000 Plan

GFA Premier PPO $3500 1X Plan

GFA Premier PPO $4000 Plan

GFA Premier PPO $5000 Plan

GFA Premier PPO $5000 1X Plan

GFA Premier PPO $6000 Plan

GFA Premier PPO $7000 Plan

GFA Premier PPO $8000 Plan

QDPHP

June

HMO

GFA All Access HMO QHDHP E $3500

GFA All Access HMO QHDHP E $4000

GFA All Access HMO QHDHP E $5000

GFA All Access HMO QHDHP E $6900

GFA All Access HMO QHDHP NE $2000

GFA All Access HMO QHDHP NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

July

HMO

GFA All Access HMO QHDHP E $3500

GFA All Access HMO QHDHP E $4000

GFA All Access HMO QHDHP E $5000

GFA All Access HMO QHDHP E $6900

GFA All Access HMO QHDHP NE $2000

GFA All Access HMO QHDHP NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

August

HMO

GFA All Access HMO QHDHP E $3500

GFA All Access HMO QHDHP E $4000

GFA All Access HMO QHDHP E $5000

GFA All Access HMO QHDHP E $6900

GFA All Access HMO QHDHP NE $2000

GFA All Access HMO QHDHP NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

September

HMO

GFA All Access HMO QHDHP E $3500

GFA All Access HMO QHDHP E $4000

GFA All Access HMO QHDHP E $5000

GFA All Access HMO QHDHP E $6900

GFA All Access HMO QHDHP NE $2000

GFA All Access HMO QHDHP NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

October

HMO

GFA All Access HMO QHDHP-E $3500

GFA All Access HMO QHDHP-E $4000

GFA All Access HMO QHDHP-E $5000

GFA All Access HMO QHDHP-E $6900

GFA All Access HMO QHDHP-NE $2000

GFA All Access HMO QHDHP-NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

November

HMO

GFA All Access HMO QHDHP-E $3500

GFA All Access HMO QHDHP-E $4000

GFA All Access HMO QHDHP-E $5000

GFA All Access HMO QHDHP-E $6900

GFA All Access HMO QHDHP-NE $2000

GFA All Access HMO QHDHP-NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

December

HMO

GFA All Access HMO QHDHP-E $3500

GFA All Access HMO QHDHP-E $4000

GFA All Access HMO QHDHP-E $5000

GFA All Access HMO QHDHP-E $6900

GFA All Access HMO QHDHP-NE $2000

GFA All Access HMO QHDHP-NE $3000

PPO

GFA All Access PPO QHDHP E $3500

GFA All Access PPO QHDHP E $4000

GFA All Access PPO QHDHP E $5000

GFA All Access PPO QHDHP E $6900

GFA All Access PPO QHDHP NE $2000

GFA All Access PPO QHDHP NE $3000

Small Group ACA

HMO

All Access

Premier

PPO

All Access

Choices

Extra

QHDHP

HMO

QHDHP POS

QHDHP PPO

Commercial - Summary of Benefits (SOBs)

Fully Insured & GFA

HMO

All Access

All Access HMO $0 Plan

All Access HMO $250 Plan

All Access HMO $500 Plan

All Access HMO $1000 Plan

All Access HMO $1500 Plan

All Access HMO $2000 Plan

All Access HMO $2500 Plan

All Access HMO $2500 1X Plan

All Access HMO $3000 Plan

All Access HMO $3500 1X Plan

All Access HMO $4000 Plan

All Access HMO $5000 Plan

All Access HMO $5000 1X Plan

All Access HMO $6000 Plan

All Access HMO $6000 1X Plan

All Access HMO $7000 Plan

All Access HMO $8000 Plan

Choices

Choices HMO $0-500 Plan

Choices HMO $0-750 Plan

Choices HMO $250 Plan

Choices HMO $500 Plan

Choices HMO $1000 Plan

Choices HMO $1500 Plan

Choices HMO $2000 Plan

Choices HMO $2500 Plan

Choices HMO $2500 1x Plan

Choices HMO $3000 Plan

Choices HMO $3500 1x Plan

Choices HMO $4000 Plan

Extra

All Access HMO Extra $0 Plan

All Access HMO Extra $250 Plan

All Access HMO Extra $500 Plan

All Access HMO Extra $1000 Plan

All Access HMO Extra $1500 Plan

All Access HMO Extra $2000 Plan

All Access HMO Extra $2500 Plan

All Access HMO Extra $2500 1X Plan

All Access HMO Extra $3000 Plan

All Access HMO Extra $3500 1X Plan

All Access HMO Extra $4000 Plan

All Access HMO Extra $5000 Plan

All Access HMO Extra $5000 1X Plan

All Access HMO Extra $6000 Plan

All Access HMO Extra $6000 1X Plan

All Access HMO Extra $7000 Plan

All Access HMO Extra $8000 Plan

Premier

Premier HMO $250 Plan

Premier HMO $500 Plan

Premier HMO $1000 Plan

Premier HMO $1500 Plan

Premier HMO $2000 Plan

Premier HMO $2500 Plan

Premier HMO $2500 1X Plan

Premier HMO $3000 Plan

Premier HMO $3500 1X Plan

Premier HMO $4000 Plan

Premier HMO $5000 Plan

Premier HMO $5000 1X Plan

Premier HMO $6000 Plan

Premier HMO $6000 1X Plan

Premier HMO $7000 Plan

Premier HMO $8000 Plan

PPO

All Access

All Access PPO $0 Plan

All Access PPO $250 Plan

All Access PPO $500 Plan

All Access PPO $1000 Plan

All Access PPO $1500 Plan

All Access PPO $2000 Plan

All Access PPO $2500 Plan

All Access PPO $2500 1X Plan

All Access PPO $3000 Plan

All Access PPO $3500 1X Plan

All Access PPO $4000 Plan

All Access PPO $5000 Plan

All Access PPO $5000 1X Plan

All Access PPO $6000 Plan

All Access PPO $7000 Plan

All Access PPO $8000 Plan

Choices

Choices PPO $1000 Plan

Choices PPO $2000 Plan

Choices PPO $3000 Plan

Choices PPO $4000 Plan

Premier

Premier PPO $250 Plan

Premier PPO $500 Plan

Premier PPO $1000 Plan

Premier PPO $1500 Plan

Premier PPO $2000 Plan

Premier PPO $2500 Plan

Premier PPO $2500 1X Plan

Premier PPO $3000 Plan

Premier PPO $3500 1X Plan

Premier PPO $4000 Plan

Premier PPO $5000 Plan

Premier PPO $5000 1X Plan

Premier PPO $6000 Plan

Premier PPO $7000 Plan

Premier PPO $8000 Plan

QHDHP

HMO

All Access HMO QHDHP-E $3500

All Access HMO QHDHP-E $4000

All Access HMO QHDHP-E $5000

All Access HMO QHDHP-E $6900

All Access HMO QHDHP-NE $2000

All Access HMO QHDHP-NE $3000

PPO

All Access PPO QHDHP E $3500

All Access PPO QHDHP E $4000

All Access PPO QHDHP E $5000

All Access PPO QHDHP E $6900

All Access PPO QHDHP NE $2000

All Access PPO QHDHP NE $3000

Small Group ACA

HMO

All Access

Premier

PPO

All Access

Choices

Extra

QHDHP

HMO

QHDHP POS

QHDHP PPO

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