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    Content

    Products, Plans and Benefits

    An Affordable, Convenient Way to Access Quality Care

    Sutter Health Plus offers a variety of health plan options to help meet your needs and budgets. Choose from traditional HMO plans or high-deductible health plans (HDHP) that are compatible with a health savings account (HSA):

    • Individual and Family HMO Plans
    • Small Group HMO Plans (1-100 employees)
    • Large Group HMO Plans (101+ employees)

    Plan designs include:

    • Copayment plans that feature a set dollar amount for seeking medical care
    • Deductible plans that include a set deductible that must be paid before copayments or coinsurance and affordable monthly premiums
    • HDHPs that offer affordable monthly premiums

    We provide coverage for hospitalization, outpatient services, prescription drug coverage and no out-of-pocket cost preventive services, among others. Optional benefit plans include coverage for dental, vision, acupuncture and chiropractic, and infertility services.

    A Focus on Prevention

    Sutter Health Plus members have access to a variety of no-cost preventive care services. These services may help you and your family prevent or detect health problems early on. Here are some of the no-cost preventive services we cover:

    • Certain over-the-counter vitamins, supplements and products when prescribed by a participating provider
    • Health education counseling and programs
    • Immunizations administered by a participating provider
    • Maternity and newborn care
    • Routine physical maintenance exams, including well-woman exams
    • Routine preventive imaging services
    • Routine preventive laboratory tests and screenings (cervical cancer screenings, cholesterol tests, diabetes screening, fecal occult blood tests, HIV tests, prostate specific antigen tests, certain sexually transmitted disease tests)
    • Smoking cessation interventions, including medications and counseling
    • Tuberculosis tests
    • Well-child preventive care exams

    OpenEvidence of Coverage

    Evidence of Coverage

    For more information about Sutter Health Plus’ health plans, you may download and view the Evidence of Coverage for individuals, small and large groups. For assistance or if you have difficulty accessing the information you need, please contact Sutter Health Plus Member Services, weekdays, 8:00 am – 7:00 pm at (855) 315-5800 or TTY: (855) 830-3500.

    2022 LARGE GROUP EVIDENCE OF COVERAGE (EOC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • 2022 Large Group EOC HDHP HMO
    • 2022 Large Group EOC HMO ML50-51
    • 2022 Large Group EOC HMO ML20 – ML28
    • 2022 Large Group EOC HMO ML29, ML54 and ML56 – ML60

    2022 SMALL GROUP EVIDENCE OF COVERAGE (EOC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • 2022 Small Group EOC HDHP HMO
    • 2022 Small Group EOC HMO
    • 2022 Small Group EOC Plus HDHP HMO
    • 2022 Small Group EOC Plus HMO

    2022 INDIVIDUAL AND FAMILY PLAN HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • 2022 IFP EOC Platinum MI01 HMO
    • 2022 IFP EOC Gold MI02 HMO
    • 2022 IFP EOC Silver MI03 HMO
    • 2022 IFP EOC Bronze MI04 HMO

    2021 LARGE GROUP HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • 2021 Large Group EOC HDHP HMO
    • 2021 Large Group EOC HMO ML50-51
    • 2021 Large Group EOC HMO ML20 – ML28
    • 2021 Large Group EOC HMO ML29, ML54 and ML56 – ML60

    2021 SMALL GROUP HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • 2021 Small Group EOC HDHP HMO
    • 2021 Small Group EOC HMO
    • 2021 Small Group EOC Plus HDHP HMO
    • 2021 Small Group EOC Plus HMO

    CloseEvidence of Coverage

    OpenSummary of Benefits and Coverage

    Summary of Benefits and Coverage

    2022 LARGE GROUP SUMMARY OF BENEFITS AND COVERAGE (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • Large Group SBC Summit ML26 HMO
    • Large Group SBC Summit ML27 HMO
    • Large Group SBC Summit ML28 HMO
    • Large Group SBC Summit ML29 HMO
    • Large Group SBC Summit ML50 HMO
    • Large Group SBC Summit ML51 HMO
    • Large Group SBC Summit ML54 HMO
    • Large Group SBC Peak ML20 HMO
    • Large Group SBC Peak ML21 HMO
    • Large Group SBC Peak ML22 HMO
    • Large Group SBC Peak ML24 HMO
    • Large Group SBC Peak ML25 HMO
    • Large Group SBC Peak ML59 HMO
    • Large Group SBC Peak ML60 HMO
    • Large Group SBC Ridge ML56 HMO
    • Large Group SBC Ridge ML57 HMO
    • Large Group SBC Ridge ML58 HMO
    • Large Group SBC Vista HD08 HDHP HMO
    • Large Group SBC Vista HD09 HDHP HMO
    • Large Group SBC Vista HD10 HDHP HMO
    • Large Group SBC Vista HD15 HDHP HMO
    • Large Group SBC Vista HD17 HDHP HMO
    • Large Group SBC Vista HD18 HDHP HMO
    • Large Group SBC Vista HD19 HDHP HMO

    2022 SMALL GROUP SUMMARY OF BENEFITS AND COVERAGE (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • Small Group SBC Platinum MS58 HMO
    • Small Group SBC Platinum MS70 HMO
    • Small Group SBC Gold MS67 HMO
    • Small Group SBC Gold MS52 HMO
    • Small Group SBC Gold MS73 HMO
    • Small Group SBC Silver SD47 HMO
    • Small Group SBC Silver MS74 HMO
    • Small Group SBC Bronze SD38 HMO
    • Small Group SBC Bronze MS76 HMO

    2022 INDIVIDUAL AND FAMILY PLAN SUMMARY OF BENEFITS AND COVERAGE (SBC): FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • 2022 IFP SBC Platinum MI01 HMO
    • 2022 IFP SBC Gold MI02 HMO
    • 2022 IFP SBC Silver MI03 HMO
    • 2022 IFP SBC Bronze MI04 HMO

    2021 LARGE GROUP SUMMARY OF BENEFITS AND COVERAGE (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • Large Group SBC Summit ML26 HMO
    • Large Group SBC Summit ML27 HMO
    • Large Group SBC Summit ML28 HMO
    • Large Group SBC Summit ML29 HMO
    • Large Group SBC Summit ML50 HMO
    • Large Group SBC Summit ML51 HMO
    • Large Group SBC Summit ML54 HMO
    • Large Group SBC Peak ML20 HMO
    • Large Group SBC Peak ML21 HMO
    • Large Group SBC Peak ML22 HMO
    • Large Group SBC Peak ML24 HMO
    • Large Group SBC Peak ML25 HMO
    • Large Group SBC Peak ML59 HMO
    • Large Group SBC Peak ML60 HMO
    • Large Group SBC Ridge ML56 HMO
    • Large Group SBC Ridge ML57 HMO
    • Large Group SBC Ridge ML58 HMO
    • Large Group SBC Vista HD08 HDHP HMO
    • Large Group SBC Vista HD09 HDHP HMO
    • Large Group SBC Vista HD10 HDHP HMO
    • Large Group SBC Vista HD15 HDHP HMO
    • Large Group SBC Vista HD17 HDHP HMO
    • Large Group SBC Vista HD18 HDHP HMO
    • Large Group SBC Vista HD19 HDHP HMO

    2021 SMALL GROUP SUMMARY OF BENEFITS AND COVERAGE (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • Small Group SBC Platinum MS48 HMO
    • Small Group SBC Platinum MS41 HMO
    • Small Group SBC Platinum MS70 HMO
    • Small Group SBC Gold MS67 HMO
    • Small Group SBC Gold MS42 HMO
    • Small Group SBC Gold MS73 HMO
    • Small Group SBC Silver SD47 HDHP HMO
    • Small Group SBC Silver MS74 HMO
    • Small Group SBC Bronze SD38 HDHP HMO
    • Small Group SBC Bronze MS76 HMO

    CloseSummary of Benefits and Coverage

    OpenBenefits and Coverage Matrix

    Benefits and Coverage Matrix

    2022 LARGE GROUP BENEFITS AND MATRIX (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • Large Group BCM Summit ML26 HMO
    • Large Group BCM Summit ML27 HMO
    • Large Group BCM Summit ML28 HMO
    • Large Group BCM Summit ML29 HMO
    • Large Group BCM Summit ML50 HMO
    • Large Group BCM Summit ML51 HMO
    • Large Group BCM Summit ML54 HMO
    • Large Group BCM Peak ML20 HMO
    • Large Group BCM Peak ML21 HMO
    • Large Group BCM Peak ML22 HMO
    • Large Group BCM Peak ML24 HMO
    • Large Group BCM Peak ML25 HMO
    • Large Group BCM Ridge ML59 HMO
    • Large Group BCM Ridge ML60 HMO
    • Large Group BCM Ridge ML56 HMO
    • Large Group BCM Ridge ML57 HMO
    • Large Group BCM Ridge ML58 HMO
    • Large Group BCM Vista HD08 HDHP HMO
    • Large Group BCM Vista HD09 HDHP HMO
    • Large Group BCM Vista HD10 HDHP HMO
    • Large Group BCM Vista HD15 HDHP HMO
    • Large Group BCM Vista HD17 HDHP HMO
    • Large Group BCM Vista HD18 HDHP HMO
    • Large Group BCM Vista HD19 HDHP HMO

    2022 SMALL GROUP BENEFITS AND COVERAGE MATRIX (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • Small Group BCM Platinum MS58 HMO
    • Small Group BCM Platinum MS70 HMO
    • Small Group BCM Gold MS67 HMO
    • Small Group BCM Gold MS52 HMO
    • Small Group BCM Gold MS73 HMO
    • Small Group BCM Silver SD47 HMO
    • Small Group BCM Silver MS74 HMO
    • Small Group BCM Bronze SD38 HMO
    • Small Group BCM Bronze MS76 HMO

    2022 INDIVIDUAL AND FAMILY PLAN BENEFITS AND COVERAGE MATRIX (BCM): FOR PLANS EFFECTIVE 1/1/22 THROUGH 12/31/22

    • 2022 IFP BCM Platinum MI01 HMO
    • 2022 IFP BCM Gold MI02 HMO
    • 2022 IFP BCM Silver MI03 HMO
    • 2022 IFP BCM Bronze MI04 HMO

    2021 LARGE GROUP Benefits and Coverage Matrix (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • Large Group BCM Summit ML26 HMO
    • Large Group BCM Summit ML27 HMO
    • Large Group BCM Summit ML28 HMO
    • Large Group BCM Summit ML29 HMO
    • Large Group BCM Summit ML50 HMO
    • Large Group BCM Summit ML51 HMO
    • Large Group BCM Summit ML54 HMO
    • Large Group BCM Peak ML20 HMO
    • Large Group BCM Peak ML21 HMO
    • Large Group BCM Peak ML22 HMO
    • Large Group BCM Peak ML24 HMO
    • Large Group BCM Peak ML25 HMO
    • Large Group BCM Peak ML59 HMO
    • Large Group BCM Peak ML60 HMO
    • Large Group BCM Ridge ML56 HMO
    • Large Group BCM Ridge ML57 HMO
    • Large Group BCM Ridge ML58 HMO
    • Large Group BCM Vista HD08 HDHP HMO
    • Large Group BCM Vista HD09 HDHP HMO
    • Large Group BCM Vista HD10 HDHP HMO
    • Large Group BCM Vista HD15 HDHP HMO
    • Large Group BCM Vista HD17 HDHP HMO
    • Large Group BCM Vista HD18 HDHP HMO
    • Large Group BCM Vista HD19 HDHP HMO

    2021 SMALL GROUP BENEFITS AND COVERAGE MATRIX (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/21 THROUGH 12/31/21

    • Small Group BCM Platinum MS48 HMO
    • Small Group BCM Platinum MS41 HMO
    • Small Group BCM Platinum MS70 HMO
    • Small Group BCM Gold MS67 HMO
    • Small Group BCM Gold MS42 HMO
    • Small Group BCM Gold MS73 HMO
    • Small Group BCM Silver SD47 HDHP HMO
    • Small Group BCM Silver MS74 HMO
    • Small Group BCM Bronze SD38 HDHP HMO
    • Small Group BCM Bronze MS76 HMO

    CloseBenefits and Coverage Matrix

    OpenProduct Portfolio

    Sutter Health Plus Product Portfolio

    2023 Product Portfolio

    • Large Group Plans
    • Small Group Plans
    • Individual and Family Plans
    • Optional Benefit Plans
    • Large Group Underwriting Guidelines
    • Small Group Underwriting Guidelines
    • Individual and Family Plan Underwriting Guidelines

    2022 Product Portfolio

    • Large Group Plans
    • Small Group Plans
    • Individual and Family Plans
    • Optional Benefit Plans
    • Large Group Underwriting Guidelines
    • Small Group Underwriting Guidelines
    • Individual and Family Plan Underwriting Guidelines

    2021 Product Portfolio

    • Large Group Plans
    • Small Group Plans
    • Individual and Family Plans
    • Optional Benefit Plans
    • Large Group Underwriting Guidelines
    • Small Group Underwriting Guidelines
    • Individual and Family Plan Underwriting Guidelines

    CloseProduct Portfolio

    Healthcare Coverage Cost Transparency

    Offering access to high-value care while controlling healthcare costs is an important focus for Sutter Health Plus. Sutter Health Plus is disclosing in-network provider negotiated rates and historical out-of-network allowed amounts and the associated billed charges through machine-readable files in accordance with the federal Transparency in Coverage Rule.

    Contact Us

    Employer Group
    For more information about Sutter Health Plus’ products, plans, benefits and services or for a list of our broker partners, please contact Account Services, weekdays, 8:00 am – 5:00 pm at (855) 325-5200.

    Individual or Family Plan
    If you’re looking for information or a quote for an individual or family plan, please contact Member Services, weekdays, 8:00 am – 7:00 pm at (855) 320-2350, or email us at shpifp@sutterhealth.org.

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