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2021 Summary of Benefits and Coverage (SBC)

The Summary of Benefits and Coverage document is only a summary. Please read the FEHB Plan brochure (RI 71-009) that contains the complete terms of this plan. All benefits are subject to the definitions, limitations, and exclusions set forth in the FEHB Plan brochure. Benefits may vary if you have other coverage, such as Medicare. Our FEHB Plan brochure is available on our website or by calling 888-636-6252.
 
2021 High Option Summary of Benefits and Coverage (SBC)
2021 CDHP Summary of Benefits and Coverage (SBC)
2021 Value Option Summary of Benefits and Coverage (SBC)