Breadcrumb Home Members Summary of Benefits and Coverage (SBC) and Schedule of Benefits and Coverage Matrix (SOBM) for Covered CA plans Summary of Benefits and Coverage (SBC) and Schedule of Benefits and Coverage Matrix (SOBM) for Covered CA plans 2022 Summaries of Benefits & Coverage SBC 2022- English VHP Minimum Coverage VHP $0 Cost Share AI-AN VHP Bronze 60 VHP Bronze 60 AI-AN VHP Gold 80 VHP Gold 80 AI-AN VHP Platinum 90 VHP Platinum 90 AI-AN VHP Silver 70 HMO VHP Silver 70 AI-AN VHP Silver 73 VHP Silver 87 VHP Silver 94 2022 Schedule of Benefits Matrixes SOBM 2022-English VHP Minimum Coverage VHP $0 Cost Share HMO AI-AN VHP Bronze 60 HMO AI-AN VHP Bronze 60 HMO VHP Gold 80 HMO AI-AN VHP Gold 80 HMO VHP Platinum 90 HMO AI-AN VHP Platinum 90 HMO VHP Silver 70 HMO AI-AN VHP Silver 70 HMO VHP Silver 73 HMO VHP Silver 87 HMO VHP Silver 94 HMO 2021 Summaries of Benefits & Coverage SBC 2021 - English VHP Minimum Coverage VHP Bronze 60 VHP Silver 70 VHP Silver 73 VHP Silver 87 VHP Silver 94 VHP Gold 80 VHP Platinum 90 VHP Platinum 90 AI-AN SBC 2021 - Spanish VHP Minimum Coverage-Spa VHP Bronze 60-Spa VHP Silver 70-Spa VHP Silver 73-Spa VHP Silver 87-Spa VHP Silver 94-Spa VHP Gold 80-Spa VHP Platinum 90-Spa SBC 2021 - Vietnamese VHP Minimum Coverage-Viet VHP Bronze 60-Viet VHP Silver 70-Viet VHP Silver 73-Viet VHP Silver 87-Viet VHP Silver 94-Viet VHP Gold 80-Viet VHP Platinum-Viet SBC 2021 - Chinese VHP Minimum Coverage-Chi VHP Bronze 60-Chi VHP Silver 70-Chi VHP Silver 73-Chi VHP Silver 87-Chi VHP Silver 94-Chi VHP Gold 80-Chi VHP Platinum 90-Chi SBC 2021 - American Indian/Alaska Native VHP Bronze 60-AI/AN VHP Zero-AI/AN VHP Silver 70-AI/AN VHP Gold 80-AI/AN VHP Platinum 90-AI/AN 2021 Schedule of Benefits Matrixes SOBM 2021 - English VHP Minimum Coverage VHP Bronze 60 VHP Silver 70 VHP Silver 73 VHP Silver 87 VHP Silver 94 VHP Gold 80 VHP Platinum 90 SOBM 2021 - Spanish VHP Minimum Coverage-Spa VHP Bronze 60-Spa VHP Silver 70-Spa VHP Silver 73-Spa VHP Silver 87-Spa VHP Silver 94-Spa VHP Gold 80-Spa VHP Platinum-Spa SOBM 2021 - Vietnamese VHP Minimum Coverage - Viet VHP Bronze 60 - Viet VHP Silver 70-Viet VHP Silver 73-Viet VHP Silver 87-Viet VHP Gold 80-Viet VHP Platinum 90-Viet SOBM 2021 - Chinese VHP Minimum Coverage-Chi VHP Bronze 60-Chi VHP Silver 70-Chi VHP Silver 73-Chi VHP Silver 87-Chi VHP Silver 94-Chi VHP Gold 80-Chi VHP Platinum 90-Chi SOBM 2021 - American Indian/Alaska Native VHP Bronze 60 AI/AN VHP Zero AI/AN VHP Silver 70 AI/AN VHP Gold 80 AI/AN VHP Platinum 90 AI/AN Related Links Members Home PageContact Us24/7 Nurse Advice LineCare Management ProgramForms and ResourcesHealth and WellnessMDLIVE TelehealthMember MaterialsPlan InformationPharmacyProvider Search
