Standard coverage documents

Below are our standard certificates of coverage (COC), insurance policies, and other comprehensive plan documents. Employer groups, especially self-funded employer groups, modify some of the coverage in these plans, so they will not apply 100% to all members. 

Large group (51+ employees) coverage documents for 2019

EPO Certificate of Coverage HMO Certificate of Coverage

HMO (retiree only) Certificate of Coverage

2017 POS-A Certificate of Coverage

POS-B Insurance Policy

PPO Insurance Policy 

Small group coverage documents for 2019

HMO Certificate of Coverage

POS Certificate of Coverage

PPO Insurance Policy

MyPriority coverage documents for 2020

HMO Agreement

HMO Agreement (MP) 

HSA HMO Agreement

HSA HMO Agreement (MP) 

POS Agreement  

POS Agreement (MP)

HSA POS Agreement

HSA POS Agreement (MP)

Short-term PPO Policy

PriorityMedicare^® Evidence of Coverage (EOC) documents for 2021

PriorityMedicare Vital EOC

PriorityMedicare D-SNP EOC

PriorityMedicare^® Evidence of Coverage (EOC) documents for 2020

PriorityMedicare EOC

PriorityMedicare Key EOC

PriorityMedicare Edge EOC

PriorityMedicare Ideal EOC

PriorityMedicare Merit EOC

PriorityMedicare Select EOC

PriorityMedicare Value EOC

PriorityMedicare D-SNP EOC 

Medigap plan certicicates effective 2021

Medigap Plan A

Medigap Plan C

Medigap Plan D

Medigap Plan F

Medigap Plan G 

Medigap Plan N

Medigap plan certificates effective 2020

Medigap Plan A 

Medigap Plan C

Medigap Plan D

Medigap Plan F

Medigap Plan G

Medigap Plan N

Medicaid coverage documents 2020

Medicaid COC 2020