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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.

2020 Large Group HMO Plans: For Plans Effective 1/1/20 Through 12/31/20

  • 2020 Large Group EOC HMO ML50-51
  • 2020 Large Group EOC HMO ML20 – ML28
  • 2020 Large Group EOC HMO ML29, ML54 and ML56 – ML58
  • 2020 Large Group EOC HDHP HMO

2020 SMALL GROUP HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 2020 Small Group EOC HMO
  • 2020 Small Group EOC Plus HMO
  • 2020 Small Group EOC HDHP HMO
  • 2020 Small Group EOC Plus HDHP HMO

2020 INDIVIDUAL AND FAMILY PLAN HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 2020 IFP EOC Platinum MI01 HMO
  • 2020 IFP EOC Gold MI02 HMO
  • 2020 IFP EOC Silver MI03 HMO
  • 2020 IFP EOC Bronze MI04 HMO

2019 Large Group HMO Plans: For Plans Effective 1/1/19 Through 12/31/19

  • 2019 Large Group EOC HMO ML50-ML51
  • 2019 Large Group EOC HMO ML19-ML32 and ML40
  • 2019 Large Group EOC HMO ML34-ML37
  • 2019 Large Group EOC HMO ML54
  • 2019 Large Group EOC HDHP HMO

2019 Small Group HMO Plans: For Plans Effective 1/1/19 Through 12/31/19

  • 2019 Small Group EOC HMO
  • 2019 Small Group EOC HDHP HMO
  • 2019 Small Group EOC Plus HMO
  • 2019 Small Group EOC Plus HDHP HMO

2019 Individual and Family HMO Plans: For Plans Effective 1/1/19 Through 12/31/19

  • 2019 IFP EOC Platinum MI01
  • 2019 IFP EOC Gold MI02
  • 2019 IFP EOC Silver MI03
  • 2019 IFP EOC Bronze MI04

CloseEvidence of Coverage

OpenSummary of Benefits and Coverage

Summary of Benefits and Coverage

2020 LARGE GROUP Summary of Benefits and Coverage (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 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 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 HD18 HDHP HMO
  • Large Group SBC Vista HD19 HDHP HMO

2020 SMALL GROUP Summary of Benefits and Coverage (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • Small Group SBC Platinum MS38 HMO
  • Small Group SBC Platinum MS41 HMO
  • Small Group SBC Platinum MS60 HMO
  • Small Group SBC Gold MS57 HMO
  • Small Group SBC Gold MS42 HMO
  • Small Group SBC Gold MS63 HMO
  • Small Group SBC Silver SD37 HMO
  • Small Group SBC Silver MS64 HMO
  • Small Group SBC Bronze SD28 HMO
  • Small Group SBC Bronze MS66 HMO

2020 INDIVIDUAL AND FAMILY PLAN Summary of Benefits and Coverage (SBC): FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 2020 IFP SBC Platinum MI01 HMO
  • 2020 IFP SBC Gold MI02 HMO
  • 2020 IFP SBC Silver MI03 HMO
  • 2020 IFP SBC Bronze MI04 HMO

2019 LARGE GROUP Summary of Benefits and Coverage (SBC) HMO PLANS: FOR PLANS EFFECTIVE 1/1/19 THROUGH 12/31/19

  • Large Group SBC Summit ML30 HMO
  • Large Group SBC Summit ML31 HMO
  • Large Group SBC Summit ML32 HMO
  • Large Group SBC Summit ML34 HMO
  • Large Group SBC Summit ML50 HMO
  • Large Group SBC Summit ML51 HMO
  • Large Group SBC Summit ML54 HMO
  • Large Group SBC Peak ML19 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 Ridge ML35 HMO
  • Large Group SBC Ridge ML36 HMO
  • Large Group SBC Ridge ML37 HMO
  • Large Group SBC Vista HD11 HDHP HMO
  • Large Group SBC Vista HD12 HDHP HMO
  • Large Group SBC Vista HD13 HDHP HMO
  • Large Group SBC Vista HD14 HDHP HMO
  • Large Group SBC Vista HD16 HDHP HMO

2019 Small Group HMO Summary of Benefits and Coverage (SBC): For Plans Effective 1/1/19 through 12/31/19

  • Small Group SBC Platinum MS38 HMO
  • Small Group SBC Platinum MS50 HMO
  • Small Group SBC Platinum MS41 HMO
  • Small Group SBC Gold MS47 HMO
  • Small Group SBC Gold MS53 HMO
  • Small Group SBC Gold MS42 HMO
  • Small Group SBC Silver MS54 HMO
  • Small Group SBC Silver SD27 HMO
  • Small Group SBC Bronze MS56 HMO
  • Small Group SBC Bronze SD18 HMO

2019 Individual and Family Plan Summary of Benefits and Coverage (SBC): For Plans effective 1/1/19 through 12/31/19

  • IFP SBC Platinum MIO1 HMO
  • IFP SBC Gold MIO2 HMO
  • IFP SBC Silver MIO3 HMO
  • IFP SBC Bronze MIO4 HMO

CloseSummary of Benefits and Coverage

OpenBenefits and Coverage Matrix

Benefits and Coverage Matrix

2020 LARGE GROUP Benefits and Coverage Matrix (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 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 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 HD18 HDHP HMO
  • Large Group BCM Vista HD19 HDHP HMO

2020 SMALL GROUP Benefits and Coverage Matrix (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • Small Group BCM Platinum MS38 HMO
  • Small Group BCM Platinum MS41 HMO
  • Small Group BCM Platinum MS60 HMO
  • Small Group BCM Gold MS57 HMO
  • Small Group BCM Gold MS42 HMO
  • Small Group BCM Gold MS63 HMO
  • Small Group BCM Silver SD37 HMO
  • Small Group BCM Silver MS64 HMO
  • Small Group BCM Bronze SD28 HMO
  • Small Group BCM Bronze MS66 HMO

2020 INDIVIDUAL AND FAMILY PLAN Benefits and Coverage Matrix (BCM): FOR PLANS EFFECTIVE 1/1/20 THROUGH 12/31/20

  • 2020 IFP BCM Platinum MI01 HMO
  • 2020 IFP BCM Gold MI02 HMO
  • 2020 IFP BCM Silver MI03 HMO
  • 2020 IFP BCM Bronze MI04 HMO

2019 LARGE GROUP Benefits and Coverage Matrix (BCM) HMO PLANS: FOR PLANS EFFECTIVE 1/1/19 THROUGH 12/31/19

  • Large Group BCM Summit ML30 HMO
  • Large Group BCM Summit ML31 HMO
  • Large Group BCM Summit ML32 HMO
  • Large Group BCM Summit ML34 HMO
  • Large Group BCM Summit ML50 HMO
  • Large Group BCM Summit ML51 HMO
  • Large Group BCM Summit ML54 HMO
  • Large Group BCM Peak ML19 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 ML35 HMO
  • Large Group BCM Ridge ML36 HMO
  • Large Group BCM Ridge ML37 HMO
  • Large Group BCM Vista HD11 HDHP HMO
  • Large Group BCM Vista HD12 HDHP HMO
  • Large Group BCM Vista HD13 HDHP HMO
  • Large Group BCM Vista HD14 HDHP HMO
  • Large Group BCM Vista HD16 HDHP HMO

2019 Small Group HMO Benefits and Coverage Matrix (BCM): For Plans effective 1/1/19 through 12/31/19

  • Small Group BCM Platinum MS38 HMO
  • Small Group BCM Platinum MS50 HMO
  • Small Group BCM Platinum MS41 HMO
  • Small Group BCM Gold MS47 HMO
  • Small Group BCM Gold MS53 HMO
  • Small Group BCM Gold MS42 HMO
  • Small Group BCM Silver MS54 HMO
  • Small Group BCM Silver SD27 HMO
  • Small Group BCM Bronze MS56 HMO
  • Small Group BCM Bronze SD18 HMO

2019 Individual and Family Plan Benefits and Coverage Matrix (BCM): For Plans effective 1/1/19 through 12/31/19

  • IFP BCM Platinum MIO1 HMO
  • IFP BCM Gold MIO2 HMO
  • IFP BCM Silver MIO3 HMO
  • IFP BCM Bronze MIO4 HMO

CloseBenefits and Coverage Matrix

OpenProduct Portfolio

Sutter Health Plus Product Portfolio

2020 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

2019 Product Portfolio

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

CloseProduct Portfolio

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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