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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.

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

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

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

2018 Individual and Family HMO Plans: For Plans Effective 1/1/18 Through 12/31/18

  • 2018 IFP EOC Platinum MI01
  • 2018 IFP EOC Gold MI02
  • 2018 IFP EOC Silver MI03
  • 2018 IFP EOC Bronze MI04

2018 Large Group HMO Plans: For Plans Effective 1/1/18 Through 12/31/18

  • 2018 Large Group EOC HMO
  • 2018 Large Group EOC HDHP HMO
  • 2018 Large Group EOC HMO ML34-ML37
  • 2018 Large Group EOC HMO ML50-ML51

2018 Small Group HMO Plans: For Plans Effective 1/1/18 Through 12/31/18

  • 2018 Small Group EOC HMO
  • 2018 Small Group EOC HDHP HMO
  • 2018 Small Group EOC Plus HMO
  • 2018 Small Group EOC Plus HDHP HMO

CloseEvidence of Coverage

OpenSummary of Benefits

Summary of Benefits

2018 Small Group HMO Summary of Benefits: For Plans Effective 1/1/18 through 12/31/18

  • Small Group SBC Platinum MS38 HMO
  • Small Group SBC Platinum MS50 HMO
  • Small Group SBC Platinum MS41 HMO
  • Small Group SBC Gold MS37 HMO
  • Small Group SBC Gold MS43 HMO
  • Small Group SBC Gold MS42 HMO
  • Small Group SBC Silver MS44 HMO
  • Small Group SBC Silver SD17 HMO
  • Small Group SBC Bronze MS46 HMO
  • Small Group SBC Bronze SD08 HMO

2018 LARGE GROUP SBC HMO PLANS: FOR PLANS EFFECTIVE 1/1/18 THROUGH 12/31/18

  • 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 ML40 HMO
  • Large Group SBC Summit ML50 HMO
  • Large Group SBC Summit ML51 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: 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 LARGE GROUP 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 Individual and Family Plan Summary of Benefits: 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

OpenBenefits and Coverage Matrix

Benefits and Coverage Matrix

2018 Small Group HMO Benefits and Coverage Matrix: For Plans effective 1/1/18 through 12/31/18

  • Small Group BCM Platinum MS38 HMO
  • Small Group BCM Platinum MS50 HMO
  • Small Group BCM Platinum MS41 HMO
  • Small Group BCM Gold MS37 HMO
  • Small Group BCM Gold MS43 HMO
  • Small Group BCM Gold MS42 HMO
  • Small Group BCM Silver MS44 HMO
  • Small Group BCM Silver SD17 HMO
  • Small Group BCM Bronze MS46 HMO
  • Small Group BCM Bronze SD08 HMO

2018 LARGE GROUP BCM HMO PLANS: FOR PLANS EFFECTIVE 1/1/18 THROUGH 12/31/18

  • 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 ML40 HMO
  • Large Group BCM Summit ML50 HMO
  • Large Group BCM Summit ML51 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: 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 LARGE GROUP 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 Individual and Family Plan Benefits and Coverage Matrix: 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

2019 Product Portfolio

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

2018 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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