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Plan Materials

Summary of Benefits and Coverage (SBC)

The SBC provides a summary of benefits, cost shares and important coverage details in an easy-to-read format.

Schedule of Benefits (SOB)

The Schedule of Benefits (“SOB”) is part of the Evidence of Coverage (“EOC”) and shows the amount that you will pay for covered services under your benefit plan. Please refer to both documents f

On-Exchange HMO Plans

On-Exchange American Indian-Alaskan Native (AI-AN) HMO Plans

Off-Exchange HMO Plans

  • Silver 70 (PDF)
  • Gold 80 (PDF)
  • Platinum 90 (PDF)
  • Bronze 60 (PDF)
  • Minimum Coverage (PDF)

Pediatric Dental Schedule of Benefits

Pediatric Dental Schedule of Benefits American Indian-Alaskan Native (AI-AN)

Evidence of Coverage (EOC)

The EOC provides a description of health services provided through IEHP. Benefits apply to eligible members according to the terms and conditions of this EOC.

On-Exchange HMO Plans,

On-Exchange American Indian-Alaskan Native (AI-AN) HMO Plans

 

Pediatric Dental Evidence of Coverage

Off-Exchange HMO Plans

  • Silver 70 (PDF)
  • Gold 80 (PDF)
  • Platinum 90 (PDF)
  • Bronze 60 (PDF)
  • Minimum Coverage (PDF)

Providers

To find all providers accepting IEHP Covered, take a look through our directory or use our Find a Doctor tool.