Summary of Benefits and Coverage: What this Plan Covers ...

State Health Plan : Standard Plan Coverage for: Family | Plan Type: PPO . OMB Control Numbers 1545-2229, 1210-0147, and 0938-1146 . 1 of 7. Released on April 6, 2016 . The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. ................
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