Your Plan Documents
Quickly and easily view only the plan documents that apply to you in our Member Portal. Custom plan documents are not included on this page, but can also be found in the Member Portal.
All Documents
Primary Care Physician (PCP) referrals are not required for any of our plans.
Individual Plans
Gold Plans
- BSW Elite Gold HMO 001 - Off Exchange
- BSW Elite Gold HMO 001
- BSW Elite Gold HMO 001 - Native American Zero
- BSW Elite Gold HMO 001 - Native American Limited
- BSW Elite Gold HMO 004 - Off Exchange
- BSW Elite Gold HMO 004
- BSW Elite Gold HMO 004 - Native American Zero
- BSW Elite Gold HMO 004 - Native American Limited
- BSW Elite Gold HMO 012 - Off Exchange
- BSW Elite Gold HMO 012
- BSW Elite Gold HMO 012- Native American Zero
- BSW Elite Gold HMO 012 - Native American Limited
- BSW Elite Gold HMO 002 - Off Exchange
- BSW Elite Gold HMO 001 - Off Exchange
- BSW Elite Gold HMO 001
- BSW Elite Gold HMO 001 - Native American Zero
- BSW Elite Gold HMO 001 - Native American Limited
- BSW Elite Gold HMO 004 - Off Exchange
- BSW Elite Gold HMO 004
- BSW Elite Gold HMO 004 - Native American Zero
- BSW Elite Gold HMO 004 - Native American Limited
- BSW Elite Gold HMO 012 - Off Exchange
- BSW Elite Gold HMO 012
- BSW Elite Gold HMO 012- Native American Zero
- BSW Elite Gold HMO 012 - Native American Limited
- BSW Elite Gold HMO 002 - Off Exchange
- BSW Elite Gold HMO 001 - Off Exchange
- BSW Elite Gold HMO 001
- BSW Elite Gold HMO 001 - Native American Zero
- BSW Elite Gold HMO 001 - Native American Limited
- BSW Elite Gold HMO 004 - Off Exchange
- BSW Elite Gold HMO 004
- BSW Elite Gold HMO 004 - Native American Zero
- BSW Elite Gold HMO 004 - Native American Limited
- BSW Elite Gold HMO 012 - Off Exchange
- BSW Elite Gold HMO 012
- BSW Elite Gold HMO 012 - Native American Zero
- BSW Elite Gold HMO 012 - Native American Limited
- BSW Elite Gold HMO 002 - Off Exchange
- BSW Elite Gold HMO 001 - Off Exchange
- BSW Elite Gold HMO 001
- BSW Elite Gold HMO 001 - Native American Zero
- BSW Elite Gold HMO 001 - Native American Limited
- BSW Elite Gold HMO 004 - Off Exchange
- BSW Elite Gold HMO 004
- BSW Elite Gold HMO 004 - Native American Zero
- BSW Elite Gold HMO 004 - Native American Limited
- BSW Elite Gold HMO 012 - Off Exchange
- BSW Elite Gold HMO 012
- BSW Elite Gold HMO 012- Native American Zero
- BSW Elite Gold HMO 012 - Native American Limited
- BSW Elite Gold HMO 002 - Off Exchange
- BSW Elite Gold HMO 001
- BSW Elite Gold HMO 001 - Native American Zero
- BSW Elite Gold HMO 001 - Native American Limited
- BSW Elite Gold HMO 002 - Off Exchange
- BSW Elite Gold HMO 004
- BSW Elite Gold HMO 004 - Native American Zero
- BSW Elite Gold HMO 004 - Native American Limited
- BSW Elite Gold HMO 012 - Off Exchange
- BSW Elite Gold HMO 012
- BSW Elite Gold HMO 012- Native American Zero
- BSW Elite Gold HMO 012 - Native American Limited
Silver Plans
- BSW Prime Silver HMO 008 - Off Exchange
- BSW Prime Silver HMO 008
- BSW Prime Silver HMO 008 - Native American Zero
- BSW Prime Silver HMO 008 - Native American Limited
- BSW Prime Silver HMO 008 - CSR 73% AV
- BSW Prime Silver HMO 008 - CSR 87% AV
- BSW Prime Silver HMO 008 - CSR 94% AV
- BSW Prime Silver HMO 003 - Off Exchange
- BSW Prime Silver HMO 003
- BSW Prime Silver HMO 003 - Native American Zero
- BSW Prime Silver HMO 003 - Native American Limited
- BSW Prime Silver HMO 003 - CSR 73% AV
- BSW Prime Silver HMO 003 - CSR 87% AV
- BSW Prime Silver HMO 003 - CSR 94% AV
- BSW Prime Silver HMO 005 - Off Exchange
- BSW Prime Silver HMO 005
- BSW Prime Silver HMO 005 - Native American Zero
- BSW Prime Silver HMO 005 - Native American Limited
- BSW Prime Silver HMO 005 - CSR 73% AV
- BSW Prime Silver HMO 005 - CSR 87% AV
- BSW Prime Silver HMO 005 - CSR 94% AV
- BSW Prime Silver HMO 010 - Off Exchange
- BSW Prime Silver HMO 011 - Off Exchange
- BSW Prime Silver HMO 008 - Off Exchange
- BSW Prime Silver HMO 008
- BSW Prime Silver HMO 008 - Native American Zero
- BSW Prime Silver HMO 008 - Native American Limited
- BSW Prime Silver HMO 008 - CSR 73% AV
- BSW Prime Silver HMO 008 - CSR 87% AV
- BSW Prime Silver HMO 008 - CSR 94% AV
- BSW Prime Silver HMO 003 - Off Exchange
- BSW Prime Silver HMO 003
- BSW Prime Silver HMO 003 - Native American Zero
- BSW Prime Silver HMO 003 - Native American Limited
- BSW Prime Silver HMO 003 - CSR 73% AV
- BSW Prime Silver HMO 003 - CSR 87% AV
- BSW Prime Silver HMO 003 - CSR 94% AV
- BSW Prime Silver HMO 005 - Off Exchange
- BSW Prime Silver HMO 005
- BSW Prime Silver HMO 005 - Native American Zero
- BSW Prime Silver HMO 005 - Native American Limited
- BSW Prime Silver HMO 005 - CSR 73% AV
- BSW Prime Silver HMO 005 - CSR 87% AV
- BSW Prime Silver HMO 005 - CSR 94% AV
- BSW Prime Silver HMO 010 - Off Exchange
- BSW Prime Silver HMO 011 - Off Exchange
- BSW Prime Silver HMO 008 - Off Exchange
- BSW Prime Silver HMO 008
- BSW Prime Silver HMO 008 - Native American Zero
- BSW Prime Silver HMO 008 - Native American Limited
- BSW Prime Silver HMO 008 - CSR 73% AV
- BSW Prime Silver HMO 008 - CSR 87% AV
- BSW Prime Silver HMO 008 - CSR 94% AV
- BSW Prime Silver HMO 003 - Off Exchange
- BSW Prime Silver HMO 003
- BSW Prime Silver HMO 003 - Native American Zero
- BSW Prime Silver HMO 003 - Native American Limited
- BSW Prime Silver HMO 003 - CSR 73% AV
- BSW Prime Silver HMO 003 - CSR 87% AV
- BSW Prime Silver HMO 003 - CSR 94% AV
- BSW Prime Silver HMO 005 - Off Exchange
- BSW Prime Silver HMO 005
- BSW Prime Silver HMO 005 - Native American Zero
- BSW Prime Silver HMO 005 - Native American Limited
- BSW Prime Silver HMO 005 - CSR 73% AV
- BSW Prime Silver HMO 005 - CSR 87% AV
- BSW Prime Silver HMO 005 - CSR 94% AV
- BSW Prime Silver HMO 010 - Off Exchange
- BSW Prime Silver HMO 011 - Off Exchange
- BSW Prime Silver HMO 008 - Off Exchange
- BSW Prime Silver HMO 008
- BSW Prime Silver HMO 008 - Native American Zero
- BSW Prime Silver HMO 008 - Native American Limited
- BSW Prime Silver HMO 008 - CSR 73% AV
- BSW Prime Silver HMO 008 - CSR 87% AV
- BSW Prime Silver HMO 008 - CSR 94% AV
- BSW Prime Silver HMO 003 - Off Exchange
- BSW Prime Silver HMO 003
- BSW Prime Silver HMO 003 - Native American Zero
- BSW Prime Silver HMO 003 - Native American Limited
- BSW Prime Silver HMO 003 - CSR 73% AV
- BSW Prime Silver HMO 003 - CSR 87% AV
- BSW Prime Silver HMO 003 - CSR 94% AV
- BSW Prime Silver HMO 005 - Off Exchange
- BSW Prime Silver HMO 005
- BSW Prime Silver HMO 005 - Native American Zero
- BSW Prime Silver HMO 005 - Native American Limited
- BSW Prime Silver HMO 005 - CSR 73% AV
- BSW Prime Silver HMO 005 - CSR 87% AV
- BSW Prime Silver HMO 005 - CSR 94% AV
- BSW Prime Silver HMO 010 - Off Exchange
- BSW Prime Silver HMO 011 - Off Exchange
- BSW Prime Silver HMO 008 - Off Exchange
- BSW Prime Silver HMO 008
- BSW Prime Silver HMO 008 - Native American Zero
- BSW Prime Silver HMO 008 - Native American Limited
- BSW Prime Silver HMO 008 - CSR 73% AV
- BSW Prime Silver HMO 008 - CSR 87% AV
- BSW Prime Silver HMO 008 - CSR 94% AV
- BSW Prime Silver HMO 003 - Off Exchange
- BSW Prime Silver HMO 003
- BSW Prime Silver HMO 003 - Native American Zero
- BSW Prime Silver HMO 003 - Native American Limited
- BSW Prime Silver HMO 003 - CSR 73% AV
- BSW Prime Silver HMO 003 - CSR 87% AV
- BSW Prime Silver HMO 003 - CSR 94% AV
- BSW Prime Silver HMO 005 - Off Exchange
- BSW Prime Silver HMO 005
- BSW Prime Silver HMO 005 - Native American Zero
- BSW Prime Silver HMO 005 - Native American Limited
- BSW Prime Silver HMO 005 - CSR 73% AV
- BSW Prime Silver HMO 005 - CSR 87% AV
- BSW Prime Silver HMO 005 - CSR 94% AV
- BSW Prime Silver HMO 010 - Off Exchange
- BSW Prime Silver HMO 011 - Off Exchange
Bronze Plans
- BSW Savers Bronze HMO HSA 006 - Off Exchange
- BSW Savers Bronze HMO HSA 006
- BSW Savers Bronze HMO 006 - Native American Zero
- BSW Savers Bronze HMO H S A 006 - Native American Limited
- BSW Vital Bronze HMO 007 - Off Exchange
- BSW Vital Bronze HMO 007
- BSW Vital Bronze HMO 007 - Native American Zero
- BSW Vital Bronze HMO 007 - Native American Limited
- BSW Vital Bronze HMO 009 - Off Exchange
- BSW Vital Bronze HMO 009
- BSW Vital Bronze HMO 009 - Native American Zero
- BSW Vital Bronze HMO 009 - Native American Limited
- BSW Savers Bronze HMO HSA 006 - Off Exchange
- BSW Savers Bronze HMO HSA 006
- BSW Savers Bronze HMO 006 - Native American Zero
- BSW Savers Bronze HMO H S A 006 - Native American Limited
- BSW Vital Bronze HMO 007 - Off Exchange
- BSW Vital Bronze HMO 007
- BSW Vital Bronze HMO 007 - Native American Zero
- BSW Vital Bronze HMO 007 - Native American Limited
- BSW Vital Bronze HMO 009 - Off Exchange
- BSW Vital Bronze HMO 009
- BSW Vital Bronze HMO 009 - Native American Zero
- BSW Vital Bronze HMO 009 - Native American Limited
- Bronze PPO 100 9450 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 7300 BSW Plus PPO
- Bronze HMO 100 9450 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 7300 BSW Premier HMO
- Bronze HMO 100 9450 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 7300 BSW Plus HMO
- BSW Vital Bronze HMO 001 - Off Exchange
- BSW Vital Bronze EPO 001 - Off Exchange
- BSW Vital Bronze HMO 001 - Off Exchange
- BSW Vital Bronze EPO 001 - Off Exchange
- BSW Savers Bronze HMO HSA 006 - Off Exchange
- BSW Savers Bronze HMO HSA 006
- BSW Savers Bronze HMO 006 - Native American Zero
- BSW Savers Bronze HMO H S A 006 - Native American Limited
- BSW Vital Bronze HMO 007 - Off Exchange
- BSW Vital Bronze HMO 007
- BSW Vital Bronze HMO 007 - Native American Zero
- BSW Vital Bronze HMO 007 - Native American Limited
- BSW Vital Bronze HMO 009 - Off Exchange
- BSW Vital Bronze HMO 009
- BSW Vital Bronze HMO 009 - Native American Zero
- BSW Vital Bronze HMO 009 - Native American Limited
- BSW Savers Bronze HMO HSA 006 - Off Exchange
- BSW Savers Bronze HMO HSA 006
- BSW Savers Bronze HMO 006 - Native American Zero
- BSW Savers Bronze HMO H S A 006 - Native American Limited
- BSW Vital Bronze HMO 007 - Off Exchange
- BSW Vital Bronze HMO 007
- BSW Vital Bronze HMO 007 - Native American Zero
- BSW Vital Bronze HMO 007 - Native American Limited
- BSW Vital Bronze HMO 009 - Off Exchange
- BSW Vital Bronze HMO 009
- BSW Vital Bronze HMO 009 - Native American Zero
- BSW Vital Bronze HMO 009 - Native American Limited
- Bronze PPO 100 9450 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 7300 BSW Plus PPO
- Bronze HMO 100 9450 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 7300 BSW Premier HMO
- Bronze HMO 100 9450 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 7300 BSW Plus HMO
- BSW Vital Bronze HMO 001 - Off Exchange
- BSW Vital Bronze HMO 001 - Off Exchange
- BSW Vital Bronze EPO 001 - Off Exchange
- BSW Savers Bronze HMO HSA 006 - Off Exchange
- BSW Savers Bronze HMO HSA 006
- BSW Savers Bronze HMO 006 - Native American Zero
- BSW Savers Bronze HMO H S A 006 - Native American Limited
- BSW Vital Bronze HMO 007 - Off Exchange
- BSW Vital Bronze HMO 009 - Off Exchange
- BSW Vital Bronze HMO 009
- BSW Vital Bronze HMO 009 - Native American Limited
- BSW Vital Bronze HMO 001 - Off Exchange
- BSW Vital Bronze EPO 001 - Off Exchange
MyPlan PPO Transitional
- PPO 70%/$2,500/$5,000/30%/30% with RXINDPPO
- PPO 70%/$5,000/$10,000/30%/30% with RXINDPPO
- PPO 80%/$1,500/$3,000/$25/$50 with RXINDPPO
- PPO 80%/$2,500/$5,000/$25/$50 with RXINDPPO
- PPO 80%/$5,000/$10,000/$25/$50 with RXINDPPO
- PPO 80%/$7,500/$15,000/$25/$50 with RXINDPPO
- PPO 80%/$10,000/$20,000/$25/$50 with RXINDPPO
- PPO 100%/$7,500/$15,000/$30/$30 with RXINDPPO
- PPO 100%/$10,000/$20,000/$30/$30 with RXINDPPO
- PPO 100%/$15,000/$30,000/$30/$30 with RXINDPPO
- PPO 100%/$20,000/$40,000/$30/$30 with RXINDPPO
- PPO HSA 100%/$2,500/$5,000/$30/$30 with RXPPOHD1
- PPO HSA 100%/$3,500/$7,000/0%/0% with RXPPOHD1
- PPO HSA 100%/$5,000/$10,000/0%/0% with RXPPOHD1
- PPO 80%/$500/$1,000/$25/$25 with RXINPPO1
- PPO 80%/$750/$1,500/$25/$25 with RXINPPO1
- PPO 80%/$1,000/$2,000/$25/$25 with RXINPPO1
- PPO 70%/$2,500/$5,000/30%/30% with RXINDPPO
- PPO 70%/$5,000/$10,000/30%/30% with RXINDPPO
- PPO 80%/$1,500/$3,000/$25/$50 with RXINDPPO
- PPO 80%/$2,500/$5,000/$25/$50 with RXINDPPO
- PPO 80%/$5,000/$10,000/$25/$50 with RXINDPPO
- PPO 80%/$7,500/$15,000/$25/$50 with RXINDPPO
- PPO 80%/$10,000/$20,000/$25/$50 with RXINDPPO
- PPO 100%/$7,500/$15,000/$30/$30 with RXINDPPO
- PPO 100%/$10,000/$20,000/$30/$30 with RXINDPPO
- PPO 100%/$15,000/$30,000/$30/$30 with RXINDPPO
- PPO 100%/$20,000/$40,000/$30/$30 with RXINDPPO
- PPO HSA 100%/$2,500/$5,000/$30/$30 with RXPPOHD1
- PPO HSA 100%/$3,500/$7,000/0%/0% with RXPPOHD1
- PPO HSA 100%/$5,000/$10,000/0%/0% with RXPPOHD1
- PPO 80%/$500/$1,000/$25/$25 with RXINPPO1
- PPO 80%/$750/$1,500/$25/$25 with RXINPPO1
- PPO 80%/$1,000/$2,000/$25/$25 with RXINPPO1
Small Group Plans
Gold Plans
- Gold PPO 90 4500 BSW Plus PPO
- Gold PPO 100 4000 BSW Plus PPO
- Gold PPO 100 3500 BSW Plus PPO
- Gold PPO HSA 3700 BSW Plus PPO
- Gold PPO 100 3000 BSW Plus PPO
- Gold PPO HSA 3200 BSW Plus PPO
- Gold PPO 100 2300 BSW Plus PPO
- Gold PPO 90 2000 BSW Plus PPO
- Gold PPO 90 1800 BSW Plus PPO
- Gold PPO 80 1500 BSW Plus PPO
- Gold PPO 80 1000 BSW Plus PPO
- Gold PPO 80 750 BSW Plus PPO
- Gold PPO copayment 0 7000 BSW Plus PPO
- Gold HMO 90 4500 BSW Premier HMO
- Gold HMO 100 4000 BSW Premier HMO
- Gold HMO 100 3500 BSW Premier HMO
- Gold HMO HSA 3700 BSW Premier HMO
- Gold HMO 100 3000 BSW Premier HMO
- Gold HMO HSA 3200 BSW Premier HMO
- Gold HMO 100 2300 BSW Premier HMO
- Gold HMO 90 2000 BSW Premier HMO
- Gold HMO 90 1800 BSW Premier HMO
- Gold HMO 80 1500 BSW Premier HMO
- Gold HMO 80 1000 BSW Premier HMO
- Gold HMO 80 750 BSW Premier HMO
- Gold HMO copayment 0 7000 BSW Premier HMO
- Gold HMO SM 0 9450 BSW Premier HMO
- Gold HMO 90 4500 BSW Plus HMO
- Gold HMO 100 4000 BSW Plus HMO
- Gold HMO 100 3500 BSW Plus HMO
- Gold HMO HSA 3700 BSW Plus HMO
- Gold HMO 100 3000 BSW Plus HMO
- Gold HMO HSA 3200 BSW Plus HMO
- Gold HMO 100 2300 BSW Plus HMO
- Gold HMO 90 2000 BSW Plus HMO
- Gold HMO 90 1800 BSW Plus HMO
- Gold HMO 80 1500 BSW Plus HMO
- Gold HMO 80 1000 BSW Plus HMO
- Gold HMO 80 750 BSW Plus HMO
- Gold HMO copayment 0 7000 BSW Plus HMO
- Gold HMO SM 0 9450 BSW Plus HMO
- Gold PPO 90 4500 BSW Access PPO
- Gold PPO 100 4000 BSW Access PPO
- Gold PPO 100 3500 BSW Access PPO
- Gold PPO HSA 3700 BSW Access PPO
- Gold PPO 100 3000 BSW Access PPO
- Gold PPO HSA 3200 BSW Access PPO
- Gold PPO 100 2300 BSW Access PPO
- Gold PPO 90 2000 BSW Access PPO
- Gold PPO 90 1800 BSW Access PPO
- Gold PPO 80 1500 BSW Access PPO
- Gold PPO 80 1000 BSW Access PPO
- Gold PPO 80 750 BSW Access PPO
- Gold PPO copayment 0 7000 BSW Access PPO
- Gold PPO 90 4500 BSW Plus PPO
- Gold PPO 100 4000 BSW Plus PPO
- Gold PPO 100 3500 BSW Plus PPO
- Gold PPO HSA 3700 BSW Plus PPO
- Gold PPO 100 3000 BSW Plus PPO
- Gold PPO HSA 3200 BSW Plus PPO
- Gold PPO 100 2300 BSW Plus PPO
- Gold PPO 90 2000 BSW Plus PPO
- Gold PPO 90 1800 BSW Plus PPO
- Gold PPO 80 1500 BSW Plus PPO
- Gold PPO 80 1000 BSW Plus PPO
- Gold PPO 80 750 BSW Plus PPO
- Gold PPO copayment 0 7000 BSW Plus PPO
- Gold HMO 90 4500 BSW Premier HMO
- Gold HMO 100 4000 BSW Premier HMO
- Gold HMO 100 3500 BSW Premier HMO
- Gold HMO HSA 3700 BSW Premier HMO
- Gold HMO 100 3000 BSW Premier HMO
- Gold HMO HSA 3200 BSW Premier HMO
- Gold HMO 100 2300 BSW Premier HMO
- Gold HMO 90 2000 BSW Premier HMO
- Gold HMO 90 1800 BSW Premier HMO
- Gold HMO 80 1500 BSW Premier HMO
- Gold HMO 80 1000 BSW Premier HMO
- Gold HMO 80 750 BSW Premier HMO
- Gold HMO copayment 0 7000 BSW Premier HMO
- Gold HMO SM 0 9450 BSW Premier HMO
- Gold HMO 90 4500 BSW Plus HMO
- Gold HMO 100 4000 BSW Plus HMO
- Gold HMO 100 3500 BSW Plus HMO
- Gold HMO HSA 3700 BSW Plus HMO
- Gold HMO 100 3000 BSW Plus HMO
- Gold HMO HSA 3200 BSW Plus HMO
- Gold HMO 100 2300 BSW Plus HMO
- Gold HMO 90 2000 BSW Plus HMO
- Gold HMO 90 1800 BSW Plus HMO
- Gold HMO 80 1500 BSW Plus HMO
- Gold HMO 80 1000 BSW Plus HMO
- Gold HMO 80 750 BSW Plus HMO
- Gold HMO copayment 0 7000 BSW Plus HMO
- Gold HMO SM 0 9450 BSW Plus HMO
- Gold PPO 90 4500 BSW Access PPO
- Gold PPO 100 4000 BSW Access PPO
- Gold PPO 100 3500 BSW Access PPO
- Gold PPO HSA 3700 BSW Access PPO
- Gold PPO 100 3000 BSW Access PPO
- Gold PPO HSA 3200 BSW Access PPO
- Gold PPO 100 2300 BSW Access PPO
- Gold PPO 90 2000 BSW Access PPO
- Gold PPO 90 1800 BSW Access PPO
- Gold PPO 80 1500 BSW Access PPO
- Gold PPO 80 1000 BSW Access PPO
- Gold PPO 80 750 BSW Access PPO
- Gold PPO copayment 0 7000 BSW Access PPO
- Gold PPO 90 4500 BSW Plus PPO
- Gold PPO 100 4000 BSW Plus PPO
- Gold PPO 100 3500 BSW Plus PPO
- Gold PPO HSA 3700 BSW Plus PPO
- Gold PPO 100 3000 BSW Plus PPO
- Gold PPO HSA 3200 BSW Plus PPO
- Gold PPO 100 2300 BSW Plus PPO
- Gold PPO 90 2000 BSW Plus PPO
- Gold PPO 90 1800 BSW Plus PPO
- Gold PPO 80 1500 BSW Plus PPO
- Gold PPO 80 1000 BSW Plus PPO
- Gold PPO 80 750 BSW Plus PPO
- Gold PPO copayment 0 7000 BSW Plus PPO
- Gold HMO 90 4500 BSW Premier HMO
- Gold HMO 100 4000 BSW Premier HMO
- Gold HMO 100 3500 BSW Premier HMO
- Gold HMO HSA 3700 BSW Premier HMO
- Gold HMO 100 3000 BSW Premier HMO
- Gold HMO HSA 3200 BSW Premier HMO
- Gold HMO 100 2300 BSW Premier HMO
- Gold HMO 90 2000 BSW Premier HMO
- Gold HMO 90 1800 BSW Premier HMO
- Gold HMO 80 1500 BSW Premier HMO
- Gold HMO 80 1000 BSW Premier HMO
- Gold HMO 80 750 BSW Premier HMO
- Gold HMO copayment 0 7000 BSW Premier HMO
- Gold HMO SM 0 9450 BSW Premier HMO
- Gold HMO 90 4500 BSW Plus HMO
- Gold HMO 100 4000 BSW Plus HMO
- Gold HMO 100 3500 BSW Plus HMO
- Gold HMO HSA 3700 BSW Plus HMO
- Gold HMO 100 3000 BSW Plus HMO
- Gold HMO HSA 3200 BSW Plus HMO
- Gold HMO 100 2300 BSW Plus HMO
- Gold HMO 90 2000 BSW Plus HMO
- Gold HMO 90 1800 BSW Plus HMO
- Gold HMO 80 1500 BSW Plus HMO
- Gold HMO 80 1000 BSW Plus HMO
- Gold HMO 80 750 BSW Plus HMO
- Gold HMO copayment 0 7000 BSW Plus HMO
- Gold HMO SM 0 9450 BSW Plus HMO
- Gold PPO 90 4500 BSW Access PPO
- Gold PPO 100 4000 BSW Access PPO
- Gold PPO 100 3500 BSW Access PPO
- Gold PPO HSA 3700 BSW Access PPO
- Gold PPO 100 3000 BSW Access PPO
- Gold PPO HSA 3200 BSW Access PPO
- Gold PPO 100 2300 BSW Access PPO
- Gold PPO 90 2000 BSW Access PPO
- Gold PPO 90 1800 BSW Access PPO
- Gold PPO 80 1500 BSW Access PPO
- Gold PPO 80 1000 BSW Access PPO
- Gold PPO 80 750 BSW Access PPO
- Gold PPO copayment 0 7000 BSW Access PPO
Silver Plans
- Silver PPO 80 8900 BSW Plus PPO
- Silver PPO 80 7500 BSW Plus PPO
- Silver PPO 100 7300 BSW Plus PPO
- Silver PPO 90 7000 BSW Plus PPO
- Silver PPO 80 6900 BSW Plus PPO
- Silver PPO 70 6700 BSW Plus PPO
- Silver PPO 90 6500 BSW Plus PPO
- Silver PPO 80 6250 BSW Plus PPO
- Silver PPO HSA 6200 BSW Plus PPO
- Silver PPO 90 5900 BSW Plus PPO
- Silver PPO 80 5000 BSW Plus PPO
- Silver PPO HSA 5100 BSW Plus PPO
- Silver PPO 70 4500 BSW Plus PPO
- Silver PPO 80 4250 BSW Plus PPO
- Silver PPO 70 3800 BSW Plus PPO
- Silver PPO 60 3250 BSW Plus PPO
- Silver PPO 90 650 BSW Plus PPO
- Silver HMO 80 8900 BSW Premier HMO
- Silver HMO 80 7500 BSW Premier HMO
- Silver HMO 100 7300 BSW Premier HMO
- Silver HMO 90 7000 BSW Premier HMO
- Silver HMO 80 6900 BSW Premier HMO
- Silver HMO 70 6700 BSW Premier HMO
- Silver HMO 90 6500 BSW Premier HMO
- Silver HMO 80 6250 BSW Premier HMO
- Silver HMO HSA 6200 BSW Premier HMO
- Silver HMO 90 5900 BSW Premier HMO
- Silver HMO 80 5000 BSW Premier HMO
- Silver HMO HSA 5100 BSW Premier HMO
- Silver HMO 70 4500 BSW Premier HMO
- Silver HMO 80 4250 BSW Premier HMO
- Silver HMO 70 3800 BSW Premier HMO
- Silver HMO 60 3250 BSW Premier HMO
- Silver HMO 90 650 BSW Premier HMO
- Silver HMO 80 8900 BSW Plus HMO
- Silver HMO 80 7500 BSW Plus HMO
- Silver HMO 100 7300 BSW Plus HMO
- Silver HMO 90 7000 BSW Plus HMO
- Silver HMO 80 6900 BSW Plus HMO
- Silver HMO 70 6700 BSW Plus HMO
- Silver HMO 90 6500 BSW Plus HMO
- Silver HMO 80 6250 BSW Plus HMO
- Silver HMO HSA 6200 BSW Plus HMO
- Silver HMO 90 5900 BSW Plus HMO
- Silver HMO 80 5000 BSW Plus HMO
- Silver HMO HSA 5100 BSW Plus HMO
- Silver HMO 70 4500 BSW Plus HMO
- Silver HMO 80 4250 BSW Plus HMO
- Silver HMO 70 3800 BSW Plus HMO
- Silver HMO 60 3250 BSW Plus HMO
- Silver HMO 90 650 BSW Plus HMO
- Silver PPO 80 8900 BSW Access PPO
- Silver PPO 80 7500 BSW Access PPO
- Silver PPO 100 7300 BSW Access PPO
- Silver PPO 90 7000 BSW Access PPO
- Silver PPO 80 6900 BSW Access PPO
- Silver PPO 70 6700 BSW Access PPO
- Silver PPO 90 6500 BSW Access PPO
- Silver PPO 80 6250 BSW Access PPO
- Silver PPO HSA 6200 BSW Access PPO
- Silver PPO 90 5900 BSW Access PPO
- Silver PPO 80 5000 BSW Access PPO
- Silver PPO HSA 5100 BSW Access PPO
- Silver PPO 70 4500 BSW Access PPO
- Silver PPO 80 4250 BSW Access PPO
- Silver PPO 70 3800 BSW Access PPO
- Silver PPO 60 3250 BSW Access PPO
- Silver PPO 90 650 BSW Access PPO
- Silver PPO 80 8900 BSW Plus PPO
- Silver PPO 80 7500 BSW Plus PPO
- Silver PPO 100 7300 BSW Plus PPO
- Silver PPO 90 7000 BSW Plus PPO
- Silver PPO 80 6900 BSW Plus PPO
- Silver PPO 70 6700 BSW Plus PPO
- Silver PPO 90 6500 BSW Plus PPO
- Silver PPO 80 6250 BSW Plus PPO
- Silver PPO HSA 6200 BSW Plus PPO
- Silver PPO 90 5900 BSW Plus PPO
- Silver PPO 80 5000 BSW Plus PPO
- Silver PPO HSA 5100 BSW Plus PPO
- Silver PPO 70 4500 BSW Plus PPO
- Silver PPO 80 4250 BSW Plus PPO
- Silver PPO 70 3800 BSW Plus PPO
- Silver PPO 60 3250 BSW Plus PPO
- Silver PPO 90 650 BSW Plus PPO
- Silver HMO 80 8900 BSW Premier HMO
- Silver HMO 80 7500 BSW Premier HMO
- Silver HMO 100 7300 BSW Premier HMO
- Silver HMO 90 7000 BSW Premier HMO
- Silver HMO 80 6900 BSW Premier HMO
- Silver HMO 70 6700 BSW Premier HMO
- Silver HMO 90 6500 BSW Premier HMO
- Silver HMO 80 6250 BSW Premier HMO
- Silver HMO HSA 6200 BSW Premier HMO
- Silver HMO 90 5900 BSW Premier HMO
- Silver HMO 80 5000 BSW Premier HMO
- Silver HMO HSA 5100 BSW Premier HMO
- Silver HMO 70 4500 BSW Premier HMO
- Silver HMO 80 4250 BSW Premier HMO
- Silver HMO 70 3800 BSW Premier HMO
- Silver HMO 60 3250 BSW Premier HMO
- Silver HMO 90 650 BSW Premier HMO
- Silver HMO 80 8900 BSW Plus HMO
- Silver HMO 80 7500 BSW Plus HMO
- Silver HMO 100 7300 BSW Plus HMO
- Silver HMO 90 7000 BSW Plus HMO
- Silver HMO 80 6900 BSW Plus HMO
- Silver HMO 70 6700 BSW Plus HMO
- Silver HMO 90 6500 BSW Plus HMO
- Silver HMO 80 6250 BSW Plus HMO
- Silver HMO HSA 6200 BSW Plus HMO
- Silver HMO 90 5900 BSW Plus HMO
- Silver HMO 80 5000 BSW Plus HMO
- Silver HMO HSA 5100 BSW Plus HMO
- Silver HMO 70 4500 BSW Plus HMO
- Silver HMO 80 4250 BSW Plus HMO
- Silver HMO 70 3800 BSW Plus HMO
- Silver HMO 60 3250 BSW Plus HMO
- Silver HMO 90 650 BSW Plus HMO
- Silver PPO 80 8900 BSW Access PPO
- Silver PPO 80 7500 BSW Access PPO
- Silver PPO 100 7300 BSW Access PPO
- Silver PPO 90 7000 BSW Access PPO
- Silver PPO 80 6900 BSW Access PPO
- Silver PPO 70 6700 BSW Access PPO
- Silver PPO 90 6500 BSW Access PPO
- Silver PPO 80 6250 BSW Access PPO
- Silver PPO HSA 6200 BSW Access PPO
- Silver PPO 90 5900 BSW Access PPO
- Silver PPO 80 5000 BSW Access PPO
- Silver PPO HSA 5100 BSW Access PPO
- Silver PPO 70 4500 BSW Access PPO
- Silver PPO 80 4250 BSW Access PPO
- Silver PPO 70 3800 BSW Access PPO
- Silver PPO 60 3250 BSW Access PPO
- Silver PPO 90 650 BSW Access PPO
- Silver PPO 80 8900 BSW Plus PPO
- Silver PPO 80 7500 BSW Plus PPO
- Silver PPO 100 7300 BSW Plus PPO
- Silver PPO 90 7000 BSW Plus PPO
- Silver PPO 80 6900 BSW Plus PPO
- Silver PPO 70 6700 BSW Plus PPO
- Silver PPO 90 6500 BSW Plus PPO
- Silver PPO 80 6250 BSW Plus PPO
- Silver PPO HSA 6200 BSW Plus PPO
- Silver PPO 90 5900 BSW Plus PPO
- Silver PPO 80 5000 BSW Plus PPO
- Silver PPO HSA 5100 BSW Plus PPO
- Silver PPO 70 4500 BSW Plus PPO
- Silver PPO 80 4250 BSW Plus PPO
- Silver PPO 70 3800 BSW Plus PPO
- Silver PPO 60 3250 BSW Plus PPO
- Silver PPO 90 650 BSW Plus PPO
- Silver HMO 80 8900 BSW Premier HMO
- Silver HMO 80 7500 BSW Premier HMO
- Silver HMO 100 7300 BSW Premier HMO
- Silver HMO 90 7000 BSW Premier HMO
- Silver HMO 80 6900 BSW Premier HMO
- Silver HMO 70 6700 BSW Premier HMO
- Silver HMO 90 6500 BSW Premier HMO
- Silver HMO 80 6250 BSW Premier HMO
- Silver HMO HSA 6200 BSW Premier HMO
- Silver HMO 90 5900 BSW Premier HMO
- Silver HMO 80 5000 BSW Premier HMO
- Silver HMO HSA 5100 BSW Premier HMO
- Silver HMO 70 4500 BSW Premier HMO
- Silver HMO 80 4250 BSW Premier HMO
- Silver HMO 70 3800 BSW Premier HMO
- Silver HMO 60 3250 BSW Premier HMO
- Silver HMO 90 650 BSW Premier HMO
- Silver HMO 80 8900 BSW Plus HMO
- Silver HMO 80 7500 BSW Plus HMO
- Silver HMO 100 7300 BSW Plus HMO
- Silver HMO 90 7000 BSW Plus HMO
- Silver HMO 80 6900 BSW Plus HMO
- Silver HMO 70 6700 BSW Plus HMO
- Silver HMO 90 6500 BSW Plus HMO
- Silver HMO 80 6250 BSW Plus HMO
- Silver HMO HSA 6200 BSW Plus HMO
- Silver HMO 90 5900 BSW Plus HMO
- Silver HMO 80 5000 BSW Plus HMO
- Silver HMO HSA 5100 BSW Plus HMO
- Silver HMO 70 4500 BSW Plus HMO
- Silver HMO 80 4250 BSW Plus HMO
- Silver HMO 70 3800 BSW Plus HMO
- Silver HMO 60 3250 BSW Plus HMO
- Silver HMO 90 650 BSW Plus HMO
- Silver PPO 80 8900 BSW Access PPO
- Silver PPO 80 7500 BSW Access PPO
- Silver PPO 100 7300 BSW Access PPO
- Silver PPO 90 7000 BSW Access PPO
- Silver PPO 80 6900 BSW Access PPO
- Silver PPO 70 6700 BSW Access PPO
- Silver PPO 90 6500 BSW Access PPO
- Silver PPO 80 6250 BSW Access PPO
- Silver PPO HSA 6200 BSW Access PPO
- Silver PPO 90 5900 BSW Access PPO
- Silver PPO 80 5000 BSW Access PPO
- Silver PPO HSA 5100 BSW Access PPO
- Silver PPO 70 4500 BSW Access PPO
- Silver PPO 80 4250 BSW Access PPO
- Silver PPO 70 3800 BSW Access PPO
- Silver PPO 60 3250 BSW Access PPO
- Silver PPO 90 650 BSW Access PPO
Bronze Plans
- Bronze HMO 100 9450 INV
- Bronze PPO 100 9450 INV
- Bronze PPO 100 9450 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 7300 BSW Plus PPO
- Bronze HMO 100 9450 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 7300 BSW Premier HMO
- Bronze HMO 100 9450 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 7300 BSW Plus HMO
- Bronze PPO 100 9450 BSW Access PPO
- Bronze PPO 90 7900 BSW Access PPO
- Bronze PPO 80 7500 BSW Access PPO
- Bronze PPO HSA 7300 BSW Access PPO
- Bronze HMO 100 9450 INV
- Bronze PPO 100 9450 INV
- Bronze PPO 100 9450 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 7300 BSW Plus PPO
- Bronze HMO 100 9450 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 7300 BSW Premier HMO
- Bronze HMO 100 9450 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 7300 BSW Plus HMO
- Bronze PPO 100 9450 BSW Access PPO
- Bronze PPO 90 7900 BSW Access PPO
- Bronze PPO 80 7500 BSW Access PPO
- Bronze PPO HSA 7300 BSW Access PPO
- Bronze PPO 100 9450 BSW Plus PPO
- Bronze PPO 90 7900 BSW Plus PPO
- Bronze PPO 80 7500 BSW Plus PPO
- Bronze PPO HSA 7300 BSW Plus PPO
- Bronze HMO 100 9450 BSW Premier HMO
- Bronze HMO 90 7900 BSW Premier HMO
- Bronze HMO 80 7500 BSW Premier HMO
- Bronze HMO HSA 7300 BSW Premier HMO
- Bronze HMO 100 9450 BSW Plus HMO
- Bronze HMO 90 7900 BSW Plus HMO
- Bronze HMO 80 7500 BSW Plus HMO
- Bronze HMO HSA 7300 BSW Plus HMO
- Bronze PPO 100 9450 BSW Access PPO
- Bronze PPO 90 7900 BSW Access PPO
- Bronze PPO 80 7500 BSW Access PPO
- Bronze PPO HSA 7300 BSW Access PPO
POS Transitional
- POS 80%/$0/$3,000/$40/$40 with RXSPS01Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS03Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS04Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS05Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS01Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS02Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS03Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS04Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS05Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS01Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS02Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS03Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS04Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS05Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS01Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS03Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS04Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS05Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS01Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS03Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS04Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS05Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS01Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS03Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS04Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS05Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS01Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS02Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS03Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS04Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS05Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS02Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS04Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS05Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS01Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS02Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS03Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS04Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS05Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS03Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS04Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS05Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS01Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS02Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS03Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS04Y
- POS 70%/$500/$5,500/$30/$50 with RXSPS01Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS02Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS04Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS05Y
- POS 70%/$1,500/$6,500/$30/$50 with RXSPS04Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS04Y
- POS 70%/$2,500/$7,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS01Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS02Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS05Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS01Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS01Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS03Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS05Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS03Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS04Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS05Y
- POS HSA 100%/$3,000/$5,500/0%/0% with SHDPRUY1
- POS HSA 100%/$5,000/$5,950/0%/0% with SHDPRUY1
- POS HSA 80%/$1,500/$3,000/$30/$30 with SHDPRUY2
- POS HSA 80%/$2,500/$5,000/$30/$50 with SHDPRUY2
- POS HSA 100%/$2,500/$5,000/0%/0% with SHDPRUY1
- POS HSA 80%/$3,000/$5,500/$30/$30 with SHDPRUY2
- POS HSA 80%/$5,000/$5,950/$30/$30 with SHDPRUY2
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS02Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS01Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS01Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS03Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS04Y
- POS 80%/$0/$3,000/$40/$40 with RXSPS05Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS01Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS02Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS03Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS04Y
- POS 80%/$500/$3,500/$30/$50 with RXSPS05Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS01Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS02Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS03Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS04Y
- POS 80%/$1,000/$4,000/$30/$50 with RXSPS05Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS01Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS03Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS04Y
- POS 80%/$1,500/$4,500/$30/$50 with RXSPS05Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS01Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS03Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS04Y
- POS 80%/$2,000/$5,000/$30/$50 with RXSPS05Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS01Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS03Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS04Y
- POS 80%/$2,500/$5,500/$30/$50 with RXSPS05Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS01Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS02Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS03Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS04Y
- POS 80%/$3,000/$6,000/$30/$50 with RXSPS05Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS02Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS04Y
- POS 80%/$4,000/$8,000/$30/$50 with RXSPS05Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS01Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS02Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS03Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS04Y
- POS 80%/$5,000/$10,000/$30/$50 with RXSPS05Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS03Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS04Y
- POS 80%/$7,500/$15,000/$30/$50 with RXSPS05Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS01Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS02Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS03Y
- POS 80%/$750/$3,750/$30/$50 with RXSPS04Y
- POS 70%/$500/$5,500/$30/$50 with RXSPS01Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS02Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS04Y
- POS 70%/$1,000/$6,000/$30/$50 with RXSPS05Y
- POS 70%/$1,500/$6,500/$30/$50 with RXSPS04Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS04Y
- POS 70%/$2,500/$7,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS01Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS02Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS04Y
- POS 70%/$3,000/$8,500/$30/$50 with RXSPS05Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS01Y
- POS 70%/$4,000/$11,000/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS01Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS03Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS04Y
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS05Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS03Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS04Y
- POS 70%/$10,000/$26,000/$30/$50 with RXSPS05Y
- POS HSA 100%/$3,000/$5,500/0%/0% with SHDPRUY1
- POS HSA 100%/$5,000/$5,950/0%/0% with SHDPRUY1
- POS HSA 80%/$1,500/$3,000/$30/$30 with SHDPRUY2
- POS HSA 80%/$2,500/$5,000/$30/$50 with SHDPRUY2
- POS HSA 100%/$2,500/$5,500/0%/0% with SHDPRUY1
- POS HSA 80%/$3,000/$5,500/$30/$30 with SHDPRUY2
- POS HSA 80%/$5,000/$5,950/$30/$30 with SHDPRUY2
- POS 70%/$5,000/$13,500/$30/$50 with RXSPS02Y
- POS 70%/$2,000/$7,000/$30/$50 with RXSPS01Y