羞羞视频
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Know the Details 2026

Know the Details 2026

Forms and Notices

Understanding the details of your health plan is important. Get better acquainted with your benefits here. If you still have any questions, we are just a phone call away.

听Definition of Terms

  • Evidence of Coverage (EOC):听The EOC documents in detail the health care benefits covered by a plan. It also provides information on plan requirements and cost-sharing for certain benefits.
  • Summary of Benefit and Coverage (SBC): The SBC is an easy-to-read summary document that allows comparison between health plans. This document lists important information about the plan such as cost-sharing, coverage limitations, exceptions and benefits scenarios.
  • Formulary: A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.

Questions?

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8 a.m. 鈥� 5 p.m.

Call Us:
Local: 713.295.6704
Toll-Free 1.855.315.5386

Important Plan Documents鈥�

羞羞视频 Bronze Plans
Evidence of Coverage Deductible

Summary of Benefits:

Summary of Benefits:

听

Summary of Benefits:

羞羞视频 Silver Plans
Evidence of Coverage Deductible

Summary of Benefits:

Harris Summary of Benefits:

Fort Bend Summary of Benefits:

Summary of Benefits:

羞羞视频 Gold Plans Evidence of Coverage Deductible

Summary of Benefits:

Summary of Benefits:

Harris Summary of Benefits:

Fort Bend Summary of Benefits:

Off-Exchange Only Plans

Evidence of Coverage Gold Off-Exchange
Evidence of Coverage Silver Off-Exchange

Summary of Benefits:

Formulary and Other Documents

Marketplace Handbook

Markeplace Application

Marketplace Application Gold Off Exchange

Marketplace Application Silver Off Exchange

Member Guide

Pharmacy Benefits Handbook

Transparency in Coverage

Texas Department of Insurance Disclosure Form

Formulary 鈥� Premier

Formulary 鈥� Select

Ultra Select Plans

Family making emergency hurricane plan.

Important Plan Documents

羞羞视频 Ultra Select Bronze Plans
Evidence of Coverage Deductible

Summary of Benefits:

听

Summary of Benefits:

羞羞视频 Ultra Select听Silver Plans
Evidence of Coverage Deductible

Summary of Benefits:

Summary of Benefits:

羞羞视频 Ultra Select Gold Plans
Evidence of Coverage Deductible

View Quick Reference Guide

Summary of Benefits:

Summary of Benefits:

Off-Exchange Only Plans

Evidence of Coverage Gold Off-Exchange Ultra

Evidence of Coverage Silver Off-Exchange Ultra

Summary of Benefits:

Formulary and Other Documents

Marketplace Application Ultra听

Marketplace Application Ultra Select Gold Off-Exchange

Markeplace Application Ultra Select Silver Off-Exchange

Marketplace Handbook

Member Guide

Pharmacy Benefits Handbook

Transparency in Coverage

Texas Department of Insurance Disclosure Form

Formulary Ultra Select

Why Choose 羞羞视频?

As a local nonprofit health plan, 羞羞视频 gives you plenty of reasons to join our 羞羞视频. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, 羞羞视频 is always working life forward for you and your family.

鈥溞咝呤悠� is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.鈥�

鈥� Cecily
Member of 羞羞视频

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