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NHP Benefit Plan Grid
Freedom Plans
HMO Co-Insurance
HMO Summaries of Benefits
POS Summaries of Benefits
POS Plus Summaries of Benefits (Large Group Only)
Statewide
Standard / Basic Summaries of Benefits
Deductible Plans

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	Freedom Plans	File Size	Download
	FS-50-2500 Select Plan	64 kb
	FS-50-5000 Select Plan	64 kb
	Freedom 2500 Select Plan	231 kb
	Freedom 5000 Select Plan	230 kb
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	HMO Co-Insurance	File Size	Download
	$45 / $80 / $500 / 75%	114 K
	$45 / $80 / $500 / 80%	114 K
	$45 / $80 / $500 / 85%	114 K
	$45 / $80 / $1000 / 75%	114 K
	$45 / $80 / $1000 / 80%	114 K
	$45 / $80 / $1000 / 85%	114 K
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	HMO Summaries of Benefits	File Size	Download
	$25 / $45 / $200 / $1000 / 80%	60 K
	$25 / $45 / $200 / $1500 / 80%	60 K
	$25 / $45 / $200 / $2000 / 80%	60 K
	$25 / $45 / $200 / $1000	64 K
	$25 / $45 / $200 / $1500	64 K
	$25 / $45 / $200 / $2000	64 K
	$25 / $45 / $500 / 80%	60 K
	$25 / $45 / $1000 / 80%	60 K
	$25 / $45 / $1500 / 80%	60 K
	$25 / $45 / $2000 / 80%	60 K
	$25 / $45 / $2500 / 80%	60 K
	$25 / $45 / $3000 / 80%	60 K
	$25 / $45 / $500	69 K
	$25 / $45 / $1000	70 K
	$25 / $45 / $1500	477 K
	$25 / $45 / $2000	477 K
	$25 / $45 / $2500	477 K
	$25 / $45 / $3000	477 K
	$5 / $0	162 K
	$10 / $0	162 K
	$10 / $250	163  K
	$15 / $500	162 K
	$15 / $1000	163 K
	$15 / $25 / $250X5	162 K
	$25 / $45 / $500X5	179 K
	$35 / $65 / $750X5	178 K
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	POS Summaries of Benefits	File Size	Download
	$25 / $45 / $200 / $1000 / 80%	65 K
	$25 / $45 / $200 / $1500 / 80%	65 K
	$25 / $45 / $200 / $2000 / 80%	65 K
	$25 / $45 / $200 / $1000	92 K
	$25 / $45 / $200 / $1500	92 K
	$25 / $45 / $200 / $2000	92 K
	$25 / $45 / $500 / 80%	62 K
	$25 / $45 / $1000 / 80%	62 K
	$25 / $45 / $1500 / 80%	62 K
	$25 / $45 / $2000 / 80%	62 K
	$25 / $45 / $2500 / 80%	62 K
	$25 / $45 / $3000 / 80%	62 K
	$25 / $45 / $500 / 70%	84 K
	$25 / $45 / $1000 / 70%	83 K
	$25 / $45 / $1500 / 70%	503 K
	$25 / $45 / $2000 / 70%	503 K
	$25 / $45 / $2500 / 70%	503 K
	$25 / $45 / $3000 / 70%	503 K
	$5 / $0 / $250 / 50%	194 K
	$5 / $0 / $500 / 50%	195 K
	$5 / $0 / $250 / 70%	196 K
	$5 / $0 / $500 / 70%	196 K
	$10 / $0 / $250 / 50%	179 K
	$10 / $0 / $500 / 50%	179 K
	$10 / $0 / $250 / 70%	180 K
	$10 / $0 / $500 / 70%	178 K
	$10 / $250 / $250 / 50%	178 K
	$10 / $250 / $500 / 50%	125 K
	$10 / $250 / $250 / 70%	178 K
	$10 / $250 / $500 / 70%	176 K
	$15 / $500 / $250 / 50%	178 K
	$15 / $500 / $250 / 70%	178 K
	$15 / $500 / $500 / 50%	178 K
	$15 / $500 / $500 / 70%	178 K
	$15 / $1000 / $250 / 50%	179 K
	$15 / $1000 / $500 / 50%	178 K
	$15 / $1000 / $500 / 70%	178 K
	$15 / $1000 / $250 / 70%	178 K
	$15 / $25 / $250X5 / $500 / 50%	179 K
	$10 / $250 / $300 / 60%	179 K
	$25 / $45/ $500X5/ $500 / 50%	176 K
	$35 / $65 / $750X5 / $500 / 50%	212 K
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	POS Plus Summaries of Benefits (Large Group Only)	Size	Download
	Option I - Large Group Only	184 K
	Option II - Large Group Only	183 K
	Option III - Large Group Only	183 K
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	Statewide	Size	Download
	Plan Option 1	550 K
	Plan Option 2	550 K
	Plan Option 3	550 K
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	Standard / Basic Summaries of Benefits	Size	Download
	Standard HMO CO-Payment Plan Option I	237 KB
	Standard HMO CO-Payment Plan Option II	229 KB
	Basic HMO CO-Payment Plan Option I	234 KB
	Basic HMO CO-Payment Plan Option II	236 KB
	Standard HMO Deductible Plan Option I	236 KB
	Standard HMO Deductible Plan Option II	228 KB
	Basic HMO Deductible Plan Option I	233 KB
	Basic HMO Deductible Plan Option II	235 KB
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	Deductible Plans	Size	Printable Version
	$500 / $100	10 K
	$1000 / $200	10 K
	$2500 / $500	10 K
	$5000 / $1000	10 K
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