PPO/HDHP/POS/EPO/ACO Summary of Benefits and Coverage (SBCs)
National Plans
High deductible health plans
EPO Plans
Aetna EPO 20 (PDF)
Aetna EPO 500* (PDF)
Aetna EPO 1000 (PDF)
Aetna EPO 2000 (PDF)
*Limited benefit offering availability.
Indemnity Plan
PPO Plans
Aetna PPO 0-100* (PDF)
Aetna PPO 300 (PDF)
Aetna PPO 300 Out-of-Area (PDF)
Aetna PPO 500* (PDF)
Aetna PPO 500 Out-of-Area* (PDF)
Aetna PPO 750 (PDF)
Aetna PPO 1000 (PDF)
Aetna PPO 1000 Out-of-Area (PDF)
Aetna PPO 1500* (PDF)
Aetna PPO 2000 (PDF)
Aetna PPO 2000 Out-of-Area (PDF)
Aetna PPO 3000 (PDF)
Aetna PPO 3000 Out-of-Area (PDF)
Aetna PPO 3000-70 (PDF)
Aetna PPO 3000-70 Out-of-Area* (PDF)
Aetna PPO 4000* (PDF)
Aetna PPO 4000 Out-of-Area* (PDF)
Aetna PPO 5000 (PDF)
Aetna PPO 7150 (PDF)
Aetna PPO 7150 Out-of-Area (PDF)
Aetna PPO 8000* (PDF)
*Limited benefit offering availability.
California Plans
NY Tri-State Plans
High deductible health plans
EPO Plans
Aetna EPO 20 (PDF)
Aetna EPO 45 (PDF)
Aetna EPO 500* (PDF)
Aetna EPO 2000 (PDF)
Aetna EPO 4000 (PDF)
*Limited benefit offering availability.
POS Plans
Texas Plans
High deductible health plans
Indemnity Plan
PPO Plans
Aetna PPO 0-100* (PDF)
Aetna PPO 300 (PDF)
Aetna PPO 300 Out-of-Area (PDF)
Aetna PPO 500* (PDF)
Aetna PPO 500 Out-of-Area* (PDF)
Aetna PPO 750 (PDF)
Aetna PPO 1000 (PDF)
Aetna PPO 1000 Out-of-Area (PDF)
Aetna PPO 1500* (PDF)
Aetna PPO 2000 (PDF)
Aetna PPO 2000 Out-of-Area (PDF)
Aetna PPO 3000 (PDF)
Aetna PPO 3000 Out-of-Area (PDF)
Aetna PPO 3000-70 (PDF)
Aetna PPO 3000-70 Out-of-Area* (PDF)
Aetna PPO 4000* (PDF)
Aetna PPO 4000 Out-of-Area* (PDF)
Aetna PPO 5000 (PDF)
Aetna PPO 7150 (PDF)
Aetna PPO 7150 Out-of-Area (PDF)
Aetna PPO 8000* (PDF)
*Limited benefit offering availability.
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