Benefit Documents

Use the tabs below to select your plan type and view your plan's benefit documents.
Plan Name Covered Services List Member Handbook
BMC HealthNet Plan Community Alliance

Standard
Family Assistance
Care Plus

Member Handbook 
BMC HealthNet Plan Mercy Alliance

Standard
Family Assistance
Care Plus

Member Handbook 
BMC HealthNet Plan Signature Alliance 

Standard
Family Assistance
Care Plus

Member Handbook
BMC HealthNet Plan Southcoast Alliance 

Standard
Family Assistance
Care Plus

Member Handbook
BMC HealthNet Plan MCO 

Standard
Family Assistance
Care Plus 

Member Handbook 

Plan Name

 Evidence of        Coverage      

2020 Summary of
Benefits and Coverage

2020 Schedule of    Benefits   

ConnectorCare Type I Evidence of Coverage  Summary of Benefits and Coverage Schedule of Benefits
Esquema De Beneficios 
ConnectorCare Type II Evidence of Coverage Summary of Benefits and Coverage Schedule of Benefits
Esquema De Beneficios 
ConnectoreCare Type III Evidence of Coverage  Summary of Benefits and Coverage Schedule of Benefits
Esquema De Beneficios 
ConnectorCare Zero
& Limited Cost Share Select
Evidence of Coverage Summary of Benefits and Coverage Schedule of Benefits
Esquema De Beneficios 
ConnectorCare Zero
& Limited Cost Share Silver
Evidence of Coverage Summary of Benefits and Coverage Schedule of Benefits
Esquema De Beneficios 

Summary of Benefits - The Summary of Benefits document will help you choose a health plan. It shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately.

Schedule of Benefits - The Schedule of Benefits is a document for current members that provides a summary of your benefits and member cost-sharing. It also tells you the name of your provider network, which tells you the doctors you can see. Please be sure to read the BMC HealthNet Plan Evidence of Coverage (EOC) for a full description of your benefits, including exclusions, and other plan provisions.

Plan Name               
Evidence of Coverage  2020 Benefit Documents 2019 Schedule of Benefits
Platinum

Evidence of Coverage

Evidence of Coverage for
Employer Choice

Summary of Benefits 

Schedule of Benefits 
Esquema De Beneficios 

 

Schedule of Benefits

 

Gold

Evidence of Coverage

Evidence of Coverage for
Employer Choice

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Low Gold

Evidence of Coverage

Evidence of Coverage for
Employer Choice

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Silver A Evidence of Coverage

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Silver A II

Evidence of Coverage

Evidence of Coverage for
Employer Choice

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Silver B Evidence of Coverage

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Bronze

Evidence of Coverage

Evidence of Coverage for
Employer Choice

Summary of Benefits

Schedule of Benefits 
Esquema De Beneficios

 

Schedule of Benefits

 

Summary of Benefits - The Summary of Benefits document will help you choose a health plan. It shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately.

Schedule of Benefits - The Schedule of Benefits is a document for current members that provides a summary of your benefits and member cost-sharing. It also tells you the name of your provider network, which tells you the doctors you can see. Please be sure to read the BMC HealthNet Plan Evidence of Coverage (EOC) for a full description of your benefits, including exclusions, and other plan provisions.

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