Individual Member Benefit Plan Documents

Summary of Benefits

• Advantra Freedom (PFFS) 1, 1B, 2, 5, 7
• Advantra Freedom (PFFS) 2, 3, 5
• Advantra Freedom (PFFS) 4
• Advantra Freedom (PFFS) 5 GAP
• Advantra Freedom (PFFS) 5 OTC
• Advantra Freedom (PFFS) 6, 7
• Advantra Freedom (PFFS) 8

Evidence of Coverage

• Advantra Freedom (PFFS) 1
• Advantra Freedom (PFFS) 1B
• Advantra Freedom (PFFS) 2
• Advantra Freedom (PFFS) 3
• Advantra Freedom (PFFS) 4
• Advantra Freedom (PFFS) 5
• Advantra Freedom (PFFS) 5 GAP
• Advantra Freedom (PFFS) 5 OTC
• Advantra Freedom (PFFS) 6
• Advantra Freedom (PFFS) 7
• Advantra Freedom (PFFS) 8

Low Income Subsidy Tables

• Advantra Freedom (PFFS) 4
• Advantra Freedom (PFFS) 5
• Advantra Freedom (PFFS) 5 GAP
• Advantra Freedom (PFFS) 5 OTC
• Advantra Freedom (PFFS) 7

Employer Group Members

The documents listed on this page do not apply to members of employer groups.  If you receive your health care coverage through your former employer, please click here to contact us directly if you have questions or need information concerning your benefit plan.