Warning

On/Off Pennie- English

On/Off Pennie- Spanish

Gold PPO Choice Select 2400/0/25

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie- English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish

Silver PPO Choice Select 4450/20/35

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Off Pennie- English

On/Off Pennie- Spanish

Silver PPO Choice Select 4500/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie- English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish
On Pennie 4000/15/25 73% CSR	On Pennie 4000/15/25 73% CSR- English On Pennie 4000/15/25 73% CSR- Spanish	On Pennie 4000/15/25 73% CSR- English On Pennie 4000/15/25 73% CSR- Spanish
On Pennie 1200/0/15 87% CSR	On Pennie 1200/0/15 87% CSR- English On Pennie 1200/0/15 87% CSR- Spanish	On Pennie 1200/0/15 87% CSR- English On Pennie 1200/0/15 87% CSR- Spanish
On Pennie 475/0/5 94% CSR	On Pennie 475/0/5 94% CSR- English On Pennie 475/0/5 94% CSR- Spanish	On Pennie 475/0/5 94% CSR- English On Pennie 475/0/5 94% CSR- Spanish

Bronze PPO Choice Select 7100/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie- English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
PPO Choice Select Zero/Limited CSR	PPO Choice Select Zero/Limited CSR- English	PPO Choice Select Zero/Limited CSR- English
	PPO Choice Select Zero/Limited CSR- Spanish	PPO Choice Select Zero/Limited CSR- Spanish

Performance PPO (Available in Adams, Franklin, Lebanon, Lehigh, Northampton and York counties)

Gold Performance PPO 1800/0/25

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie-English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish

Gold Performance PPO 2400/0/25

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie- English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish

Silver Performance PPO 4450/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie- English	Off Pennie- English
	Off Pennie- Spanish	Off Pennie- Spanish

Silver Performance PPO 4500/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie- English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish
On Pennie 4000/15/25 73% CSR	On Pennie 4000/15/25 73% CSR- English On Pennie 4000/15/25 73% CSR- Spanish	On Pennie 4000/15/25 73% CSR- English On Pennie 4000/15/25 73% CSR- Spanish
On Pennie 1200/0/15 87% CSR	On Pennie 1200/0/15 87% CSR- English On Pennie 1200/0/15 87% CSR- Spanish	On Pennie 1200/0/15 87% CSR- English On Pennie 1200/0/15 87% CSR- Spanish
On Pennie 475/0/5 94% CSR	On Pennie 475/0/5 94% CSR- English On Pennie 475/0/5 94% CSR- Spanish	On Pennie 475/0/5 94% CSR- English On Pennie 475/0/5 94% CSR- Spanish

Bronze Performance PPO 7100/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	On/Off Pennie- English	On/Off Pennie-English
On Pennie	On/Off Pennie- Spanish	On/Off Pennie- Spanish

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Performance PPO Zero/Limited CSR	Performance PPO Zero/Limited CSR- English	Performance PPO Zero/Limited CSR- English
	Performance PPO Zero/Limited CSR- Spanish	Performance PPO Zero/Limited CSR- Spanish

Dental Plans (Available in all 21 counties)

Highlight sheet
Dental Select Basic
Dental PPO Loyalty Plan
Dental PPO Care Plan
Dental PPO Standard Plan
Dental PPO Premium Plan
Dental PPO Preventive Plan

Vision Plans (Available in all 21 counties)

Highlight sheet
Vision Essential Plan

2024 plan year

HMO plans (Available in 21 counties)

Bronze HMO 7450/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

Catastrophic HMO 9450/0/0

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

PPO Plans (Available in all Capital counties except Lancaster)

Gold Simple PPO 0/0/25

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Gold PPO 1800/10/20

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Gold PPO 2400/10/20

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Silver QHDHP PPO 2900/10/40

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

Silver PPO 5950/20/30

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

Silver PPO 6000/20/30

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
On Pennie- 5900/15/20 73% CSR	On Pennie- 5900/15/20 73% CSR	On Pennie- 5900/15/20 73% CSR On Pennie- 5900/15/20 73% CSR Spanish
On Pennie- 1750/5/5 87% CSR	On Pennie- 1750/5/5 87% CSR	On Pennie- 1750/5/5 87% CSR On Pennie- 1750/5/5 87% CSR Spanish
On Pennie- 450/0/3 94% CSR	On Pennie- 450/0/3 94% CSR	On Pennie- 450/0/3 94% CSR On Pennie- 450/0/3 94% CSR Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze QHDHP PPO 6400/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze PPO 7450/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Catastrophic PPO 9450/0/0

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Gold Simple PPO Zero CSR	Gold Simple PPO Zero CSR	Gold Simple PPO Zero CSR
Gold Simple PPO Limited CSR	Gold Simple PPO Limited CSR	Gold Simple PPO Limited CSR
Gold PPO Zero CSR 1	Gold PPO Zero CSR 1	Gold PPO Zero CSR 1
Gold PPO Limited CSR 1	Gold PPO Limited CSR 1	Gold PPO Limited CSR 1
Gold PPO Zero CSR 2	Gold PPO Zero CSR 2	Gold PPO Zero CSR 2
Gold PPO Limited CSR 2	Gold PPO Limited CSR 2	Gold PPO Limited CSR 2
Silver PPO Zero CSR	Silver PPO Zero CSR	Silver PPO Zero CSR
Silver PPO Limited CSR	Silver PPO Limited CSR	Silver PPO Limited CSR
Bronze PPO Zero CSR 1	Bronze PPO Zero CSR 1	Bronze PPO Zero CSR 1
Bronze PPO Limited CSR 1	Bronze PPO Limited CSR 1	Bronze PPO Limited CSR 1
Bronze PPO Zero CSR 2	Bronze PPO Zero CSR 2	Bronze PPO Zero CSR 2
Bronze PPO Limited CSR 2	Bronze PPO Limited CSR 2	Bronze PPO Limited CSR 2

PPO Choice (Available in Lancaster county)

Gold PPO Choice 2000/0/30

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Gold PPO Choice 2650/0/25

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Silver QHDHP PPO Choice 3000/10/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

Silver PPO Choice 4450/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Off Pennie	Off Pennie	Off Pennie Off Pennie- Spanish

Silver PPO Choice 4500/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR On Pennie- 4400/15/30 73% CSR Spanish
On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR On Pennie- 1400/0/15 87% CSR Spanish
On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR On Pennie- 475/0/5 94% CSR Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze QHDHP PPO Choice 6400/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze PPO Choice 7100/0/50

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
Off Pennie	Off Pennie	Off Pennie

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Gold PPO Choice Zero CSR 1	Gold PPO Choice Zero CSR 1	Gold PPO Choice Zero CSR 1
Gold PPO Choice Limited CSR 1	Gold PPO Choice Limited CSR 1	Gold PPO Choice Limited CSR 1
Gold PPO Choice Zero CSR 2	Gold PPO Choice Zero CSR 2	Gold PPO Choice Zero CSR 2
Gold PPO Choice Limited CSR 2	Gold PPO Choice Limited CSR 2	Gold PPO Choice Limited CSR 2
Silver PPO Choice Zero CSR	Silver PPO Choice Zero CSR	Silver PPO Choice Zero CSR
Silver PPO Choice Limited CSR	Silver PPO Choice Limited CSR	Silver PPO Choice Limited CSR
Bronze PPO Choice Zero CSR 1	Bronze PPO Choice Zero CSR 1	Bronze PPO Choice Zero CSR 1
Bronze PPO Choice Limited CSR 1	Bronze PPO Choice Limited CSR 1	Bronze PPO Choice Limited CSR 1
Bronze PPO Choice Zero CSR 2	Bronze PPO Choice Zero CSR 2	Bronze PPO Choice Zero CSR 2
Bronze PPO Choice Limited CSR 2	Bronze PPO Choice Limited CSR 2	Bronze PPO Choice Limited CSR 2

PPO Choice Select (Available in Cumberland, Dauphin, and Perry counties)

Gold PPO Choice Select 1800/0/30

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Gold PPO Choice Select 2650/0/25

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Silver PPO Choice Select 4450/20/35

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Off Pennie- Spanish

Silver PPO Choice Select 4500/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR On Pennie- 4400/15/30 73% CSR Spanish
On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR On Pennie- 1400/0/15 87% CSR Spanish
On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR On Pennie- 475/0/5 94% CSR Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze PPO Choice Select 7100/0/50

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Gold PPO Choice Select Zero CSR 1	Gold PPO Choice Select Zero CSR 1	Gold PPO Choice Select Zero CSR 1
Gold PPO Choice Select Limited CSR 1	Gold PPO Choice Select Limited CSR 1	Gold PPO Choice Select Limited CSR 1
Gold PPO Choice Select Zero CSR 2	Gold PPO Choice Select Zero CSR 2	Gold PPO Choice Select Zero CSR 2
Gold PPO Choice Select Limited CSR 2	Gold PPO Choice Select Limited CSR 2	Gold PPO Choice Select Limited CSR 2
Silver PPO Choice Select Zero CSR	Silver PPO Choice Select Zero CSR	Silver PPO Choice Select Zero CSR
Silver PPO Choice Select Limited CSR	Silver PPO Choice Select Limited CSR	Silver PPO Choice Select Limited CSR
Bronze PPO Choice Select Zero CSR	Bronze PPO Choice Select Zero CSR	Bronze PPO Choice Select Zero CSR
Bronze PPO Choice Select Limited CSR	Bronze PPO Choice Select Limited CSR	Bronze PPO Choice Select Limited CSR

Performance PPO (Available in Adams, Franklin, Lebanon, and York counties)

Gold Performance PPO 1800/0/30

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Gold Performance PPO 2650/0/25

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Silver Performance PPO 4450/20/35

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Off Pennie- Spanish

Silver Performance PPO 4500/20/35

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR	On Pennie- 4400/15/30 73% CSR On Pennie- 4400/15/30 73% CSR Spanish
On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR	On Pennie- 1400/0/15 87% CSR On Pennie- 1400/0/15 87% CSR Spanish
On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR	On Pennie- 475/0/5 94% CSR On Pennie- 475/0/5 94% CSR Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze Performance PPO 7100/0/50

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Zero/Limited Plans (on Pennie)

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
Gold Performance PPO Zero CSR 1	Gold Performance PPO Zero CSR 1	Gold Performance PPO Zero CSR 1
Gold Performance PPO Limited CSR 1	Gold Performance PPO Limited CSR 1	Gold Performance PPO Limited CSR 1
Gold Performance PPO Zero CSR 2	Gold Performance PPO Zero CSR 2	Gold Performance PPO Zero CSR 2
Gold Performance PPO Limited CSR 2	Gold Performance PPO Limited CSR 2	Gold Performance PPO Limited CSR 2
Silver Performance PPO Zero CSR	Silver Performance PPO Zero CSR	Silver Performance PPO Zero CSR
Silver Performance PPO Limited CSR	Silver Performance PPO Limited CSR	Silver Performance PPO Limited CSR
Bronze Performance PPO Zero CSR	Bronze Performance PPO Zero CSR	Bronze Performance PPO Zero CSR
Bronze Performance PPO Limited CSR	Bronze Performance PPO Limited CSR	Bronze Performance PPO Limited CSR

Valley Advantage EPO (Available in Lehigh and Northampton counties)

Gold Valley Advantage EPO 1800/10/20

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Gold Valley Advantage EPO 2400/10/20

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Silver Valley Advantage EPO 5950/20/30

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet

Off Pennie- Spanish

Silver Valley Advantage EPO 6000/20/30

Benefit contracts	Summary of benefits and coverage (SBCs)	Highlight sheet
On Pennie	On Pennie	On Pennie On Pennie- Spanish
On Pennie- 5900/15/20 73% CSR	On Pennie- 5900/15/20 73% CSR	On Pennie- 5900/15/20 73% CSR On Pennie- 5900/15/20 73% CSR Spanish
On Pennie- 1750/5/5 87% CSR	On Pennie- 1750/5/5 87% CSR	On Pennie- 1750/5/5 87% CSR On Pennie- 1750/5/5 87% CSR Spanish
On Pennie- 450/0/3 94% CSR	On Pennie- 450/0/3 94% CSR	On Pennie- 450/0/3 94% CSR On Pennie- 450/0/3 94% CSR Spanish
Off Pennie	Off Pennie	Off Pennie

Bronze Valley Advantage EPO 7450/0/50

Benefit contracts

Summary of benefits and coverage (SBCs)

Highlight sheet