PPO/HDHP/POS/EPO/ACO Summary of Benefits and Coverage (SBCs)

California Plans

HMO Plans

Aetna Basic HMO (PDF)
Aetna HMO 0-100 (PDF)
Aetna HMO 2000 (PDF)
Aetna Value Network (PDF)

NY Tri-State Plans

High deductible health plans

Aetna HDHP 3500 (PDF)
Aetna HDHP 6350 (PDF)

EPO Plans

Aetna EPO 20 (PDF)
Aetna EPO 45 (PDF)
Aetna EPO 2000 (PDF)
Aetna EPO 4000 (PDF)

POS Plans

Aetna POS 15 (PDF)
Aetna POS 30 (PDF)

PPO Plans

Aetna PPO 750 (PDF)
Aetna PPO 1000 (PDF)
Aetna PPO 2000 (PDF)

Texas Plans

High deductible health plans

Aetna HDHP 3500 (PDF)
Aetna HDHP 3500 Out-of-Area (PDF)
Aetna HDHP 6350 (PDF)

Indemnity Plan

Aetna Indemnity Plan (PDF)

PPO Plans

Aetna PPO 300 (PDF)
Aetna PPO 500 Out-of-Area (PDF)
Aetna PPO 750 (PDF)
Aetna PPO 1000 (PDF)
Aetna PPO 1000 Out-of-Area (PDF)
Aetna PPO 2000 (PDF)
Aetna PPO 3000 (PDF)
Aetna PPO 5000 (PDF)
Aetna PPO 7150 (PDF)
Aetna PPO 7150 Out-of-Area (PDF)

ACO UT Plans

ACO UT PPO 300
ACO UT PPO 1000
ACO UT PPO 2000
ACO UT HDHP 3500

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