2024 Summary of Benefits & Coverage

Click the links below to access the Summary of Benefits & Coverage (SBC) for these plans:

Gold Plans

• CGHC Copay Gold $0 Ded – Envision Network
• CGHC Gold $3000 – Envision Network
• CGHC Gold $1800 – Envision Network
• CGHC HSA Gold $3200 – Envision Network
• CGHC Gold Standard $1500 – Envision Network
• CGHC Gold $1800 – Envision Network (Vision Exam)
• CGHC Gold $3000 – Envision Network (Vision Exam)
• CGHC HSA Gold $3200 – Envision Network (Vision Exam)
• CGHC Copay Gold $0 Ded – Envision Network (Vision Exam)

Silver Plans

• CGHC Silver $4000 – Envision Network
• CGHC Silver $5000 Ded / $5000 Rx Ded – Envision Network
• CGHC HSA Silver $3200 – Envision Network
• CGHC Silver Standard $5900 – Envision Network
• CGHC Silver $5650 Ded / $6000 Rx Ded – Envision Network
• CGHC Silver $4000 – Envision Network (Vision Exam)
• CGHC Silver $5650 Ded / $6000 Rx Ded – Envision Network (Vision Exam)
• CGHC Silver $5000 Ded / $5000 Rx Ded – Envision Network (Vision Exam)
• CGHC HSA Silver $3200 – Envision Network (Vision Exam)
• CGHC Silver $5650 Ded / $6000 Rx Ded – Envision Network (Dental/Vision Exam)
• CGHC Silver $5000 Ded / $5000 Rx Ded – Envision Network (Dental/Vision Exam)

Bronze/Catastrophic Plans

• CGHC Copay Bronze $0 Ded / $2250 Rx Ded – Envision Network
• CGHC Catastrophic $9450 – Envision Network
• CGHC Bronze $9450 ($35 PCP Copay) – Envision Network
• CGHC HSA Bronze $7500 – Envision Network
• CGHC Bronze $6000 – Envision Network
• CGHC Bronze Standard $7500 – Envision Network
• CGHC Bronze $9450 ($35 PCP Copay) – Envision Network (Vision Exam)
• CGHC Bronze $6000 – Envision Network (Vision Exam)
• CGHC HSA Bronze $7500 – Envision Network (Vision Exam)
• CGHC Copay Bronze $0 Ded / $2250 Rx Ded – Envision Network (Vision Exam)
• CGHC Copay Bronze $0 Ded / $2250 Rx Ded – Envision Network (Dental/Vision Exam)

All On-Exchange plans offer variants with Adult Vision and some with Preventive Dental add-on options. Click here to learn more. 

Prescription Drug List   |   Certificate of Coverage

Click the links below to access the Summary of Benefits and Coverage (SBC) for these plans:

73% CSR Plans

• CGHC Silver $3600 CSR 73% – Envision Network
• CGHC Silver $4000 CSR 73% – Envision Network
• CGHC Silver $2850 CSR 73% – Envision Network
• CGHC Silver Standard $5700 CSR 73% – Envision Network
• CGHC Silver $4050 CSR 73% – Envision Network
• CGHC Silver $3600 CSR 73% – Envision Network (Vision Exam)
• CGHC Silver $4050 CSR 73% – Envision Network (Vision Exam)
• CGHC Silver $4000 CSR 73% – Envision Network (Vision Exam)
• CGHC Silver $2850 CSR 73% – Envision Network (Vision Exam)
• CGHC Silver $4050 CSR 73% – Envision Network (Dental/Vision Exam)
• CGHC Silver $4000 CSR 73% – Envision Network (Dental/Vision Exam)

87% CSR Plans

• CGHC Silver $700 CSR 87% – Envision Network
• CGHC Silver $600 CSR 87% – Envision Network
• CGHC Silver $850 CSR 87% – Envision Network
• CGHC Silver Standard $700 CSR 87% – Envision Network
• CGHC Silver $600 CSR 87% ($25 PCP Copay) – Envision Network
• CGHC Silver $700 CSR 87% – Envision Network (Vision Exam)
• CGHC Silver $600 CSR 87% ($25 PCP Copay) – Envision Network (Vision Exam)
• CGHC Silver $600 CSR 87% – Envision Network (Vision Exam)
• CGHC Silver $850 CSR 87% – Envision Network (Vision Exam)
• CGHC Silver $600 CSR 87% ($25 PCP Copay) – Envision Network (Dental/Vision Exam)
• CGHC Silver $600 CSR 87% – Envision Network (Dental/Vision Exam)

94% CSR Plans

• CGHC Silver $150 CSR 94% – Envision Network
• CGHC Silver $0 CSR 94% – Envision Network
• CGHC Silver $250 CSR 94% – Envision Network
• CGHC Silver Standard $0 CSR 94% – Envision Network
• CGHC Silver $0 CSR 94% ($0 PCP Copay) – Envision Network
• CGHC Silver $150 CSR 94% – Envision Network (Vision Exam)
• CGHC Silver $0 CSR 94% ($0 PCP Copay) – Envision Network (Vision Exam)
• CGHC Silver $0 CSR 94% – Envision Network (Vision Exam)
• CGHC Silver $250 CSR 94% – Envision Network (Vision Exam)
• CGHC Silver $0 CSR 94% ($0 PCP Copay) – Envision Network (Dental/Vision Exam)
• CGHC Silver $0 CSR 94% – Envision Network (Dental/Vision Exam)

Some On-Exchange plans offer variants with Adult Vision and Preventive Dental add-on options. Click here to learn more. 

Prescription Drug List   |   Certificate of Coverage

Click the links below to access the Summary of Benefits and Coverage (SBC) for these plans:

Gold Plans

• CGHC Gold $1800 – Envision Network (Vision Exam + Allergy Test)
• CGHC Gold $3000 – Envision Network (Vision Exam + Allergy Test)
• CGHC HSA Gold $3200 – Envision Network (Vision Exam + Allergy Test)
• CGHC Copay Gold $0 Ded – Envision Network (Vision Exam + Allergy Test)

Silver Plans

• CGHC Silver $4000 – Envision Network (Vision Exam + Allergy Test)
• CGHC Silver $5650 Ded / $6000 Rx Ded – Envision Network (Vision Exam + Allergy Test)
• CGHC Silver $5000 Ded / $5000 Rx Ded – Envision Network (Vision Exam + Allergy Test)
• CGHC HSA Silver $3200 – Envision Network (Vision Exam + Allergy Test)
• CGHC Silver $5650 Ded / $6000 Rx Ded – Envision Network (Dental/Vision Exam + Allergy Test)
• CGHC Silver $5000 Ded / $5000 Rx Ded – Envision Network (Dental/Vision Exam + Allergy Test)

Bronze/Catastrophic Plans

• CGHC Bronze $9450 ($35 PCP Copay) – Envision Network (Vision Exam + Allergy Test)
• CGHC HSA Bronze $7500 – Envision Network (Vision Exam + Allergy Test)
• CGHC Catastrophic $9450 – Envision Network (Vision Exam + Allergy Test)
• CGHC Bronze $6000 – Envision Network (Vision Exam + Allergy Test)
• CGHC Copay Bronze $0 Ded / $2250 Rx Ded – Envision Network (Vision Exam + Allergy Test)
• CGHC Copay Bronze $0 Ded / $2250 Rx Ded – Envision Network (Dental/Vision Exam + Allergy Test)

All Off-Exchange plans offer variants with a Vision Exam and Allergy Testing and some with Preventive Dental as an add-on option. Click here to learn more. 

Prescription Drug List   |   Certificate of Coverage

Click the links below to access the Summary of Benefits and Coverage (SBC) for these plans:

Platinum Plans

• CGHC EPO Platinum $500 Deductible/20% – Envision Network
• CGHC EPO Platinum $500 Deductible/10% – Envision Network
• CGHC EPO Platinum $500 Deductible/20% – Rise Network
• CGHC EPO Platinum $500 Deductible/10% – Rise Network

Gold Plans

• CGHC EPO Gold $0 Deductible/20% – Envision Network
• CGHC EPO Gold $800 Deductible/20% – Envision Network
• CGHC EPO Gold $1500 Deductible/20% – Envision Network
• CGHC EPO Gold $2000 Deductible/20% – Envision Network
• CGHC EPO Gold $2200 Deductible/20% – Envision Network
• CGHC EPO Gold $2600 Deductible/15% – Envision Network
• CGHC EPO Gold $2750 Deductible/15% – ER Copay – Envision Network
• CGHC EPO HSA Gold $3200 Deductible/0% – Envision Network
• CGHC EPO Gold $0 Deductible/20% – Rise Network
• CGHC EPO Gold $800 Deductible/20% – Rise Network
• CGHC EPO Gold $1500 Deductible/20% – Rise Network
• CGHC EPO Gold $2000 Deductible/20% – Rise Network
• CGHC EPO Gold $2200 Deductible/20% – Rise Network
• CGHC EPO Gold $2600 Deductible/15% – Rise Network
• CGHC EPO Gold $2750 Deductible/15% – ER Copay – Rise Network
• CGHC EPO HSA Gold $3200 Deductible/0% – Rise Network

Silver Plans

• CGHC EPO Silver $4000 Deductible/20% – Envision Network
• CGHC EPO Silver $5000 Deductible/20% – Envision Network
• CGHC EPO Silver $5500 Deductible/20% – Envision Network
• CGHC EPO Silver $6000 Deductible/20% – Envision Network
• CGHC EPO HSA Silver $3200 Deductible/20% – Envision Network
• CGHC EPO HSA Silver $5100 Deductible/0% – Envision Network
• CGHC EPO Silver $4000 Deductible/20% – Rise Network
• CGHC EPO Silver $5000 Deductible/20% – Rise Network
• CGHC EPO Silver $5500 Deductible/20% – Rise Network
• CGHC EPO Silver $6000 Deductible/20% – Rise Network
• CGHC EPO HSA Silver $3200 Deductible/20% – Rise Network
• CGHC EPO HSA Silver $5100 Deductible/0% – Rise Network

Bronze Plans

• CGHC EPO Bronze $5500 Deductible/30% – Envision Network
• CGHC EPO Bronze $8550 Deductible/0% – Envision Network
• CGHC EPO HSA Bronze $7100 Deductible/0% – Envision Network
• CGHC EPO Bronze $5500 Deductible/30% – Rise Network
• CGHC EPO Bronze $8550 Deductible/0% – Rise Network
• CGHC EPO HSA Bronze $7100 Deductible/0% – Rise Network

Click the links below to access the Summary of Benefits and Coverage (SBC) for these plans:

Gold Plans

• CGHC EPO Plus Gold $800 Deductible/20%
• CGHC EPO Plus Gold $1500 Deductible/20%
• CGHC EPO Plus Gold $2000 Deductible/20%
• CGHC EPO Plus HSA Gold $3200 Deductible/0%

Silver Plans

• CGHC EPO Plus Silver $4000 Deductible/20%
• CGHC EPO Plus Silver $5000 Deductible/20%
• CGHC EPO Plus HSA Silver $5100 Deductible/0%

Bronze Plans

• CGHC EPO Plus Bronze $5500 Deductible/30%
• CGHC EPO Plus Bronze $8550 Deductible/0%
• CGHC EPO Plus HSA Bronze $7100 Deductible/0%