2024 Summary of Benefits & Coverage
(SBC)
On-Exchange Base Plan SBCs
Click the links below to access the Summary of Benefits & Coverage (SBC) for the On-Exchange 2024 base 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/Allergy Testing and Preventive Dental add-on options. Click here to learn more.
Prescription Drug List | Certificate of Coverage
On-Exchange Cost-Sharing Reduction Plan SBCs
Click the links below to access the Summary of Benefits and Coverage (SBC) for these 2024 CSR 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
Off-Exchange Base Plan SBCs
Click the links below to access the Summary of Benefits and Coverage (SBC) for these Off-Exchange 2024 base plans:
Gold/Platinum 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 + 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)
- 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 + 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 $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)
- 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 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 + 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 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)
- 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, Preventive Dental and/or Allergy Testing add-on option. Click here to learn more.
Prescription Drug List | Certificate of Coverage
2024 Small Group Health Plans from your Employer
Small Group EPO Plan SBCs
Click the links below to access the Summary of Benefits and Coverage (SBC) for these Small Group EPO plans:
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
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
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
Platinum Plans
Small Group EPO Plus Plan SBCs
Click the links below to access the Summary of Benefits and Coverage (SBC) for these Out-of-Area EPO Plus plans:
Bronze Plans
- CGHC EPO Plus Bronze $5500 Deductible/30%
- CGHC EPO Plus Bronze $8550 Deductible/0%
- CGHC EPO Plus HSA Bronze $7100 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%
Gold Plans