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Legal Notices and Plan Documents
Please see below for notices related to your healthcare and benefits provided by WholesomeCo.
Benefits Summaries:
• Bronze Value Plan Benefits Summary(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_e9f50b292df14fe2ba94f85fd5d50367.pdf)
• Bronze Med Plan Benefits Summary (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_f56c7df4693e4e4abc5040608291dcb6.pdf)
• Silver Value Plan Benefits Summary(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_a4586de02e9c435fa080cb985395402e.pdf)
• Silver Med Plan Benefits Summary(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_a3db8a4b0e2f4e22801cccf968abf70c.pdf)
• Gold Value Plan Benefits Summary (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_0a20214e9f3747389ce9abb332416886.pdf)
• Gold Med Plan Benefits Summary (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_2e39872a43774712a8075a2552824f94.pdf)
Summary of Benefits and Coverage:
• Bronze Value Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_b7d5022463b848e497b9240923eacfea.pdf)
• Bronze Med Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_42e1b14c78ff4dd8b900fdef2b2a948c.pdf)
• Silver Value Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_46231fdcaf32421bbe3483a87340fd15.pdf)
• Silver Med Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_a219bd203f7b41beb44d87d22a2a5d82.pdf)
• Gold Value Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_d6e3dfbf816c47d19932127f06f4bc56.pdf)
• Gold Med Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_e6f42f246a604cf3bc1e1fe3937510bc.pdf)
Other Legal Notices:
• Special Enrollments Rights, Marketplace information, Women's Health & Cancer Rights, and CHIP Notices (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_f97c0e38c5074a4a8021d2f4a7e31a40.pdf)
• Your Rights and Protections Against Surprise Medical Bills(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_6372bdac7a51400e9e4497c9a443b900.pdf)
• HIPAA Privacy Notice
(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_c6031cf09df54a8a96ace239e58837b8.pdf)
• Summary Annual Report: Plan 501,(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_b266e8c1787f49ecb1aebd02334a8c77.pdf) Plan 502,(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_f68575d529be4ac09c36508599dc0529.pdf) and Plan 503(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_4986c97222ae484cb4dec07c153fa487.pdf)
Click here (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_4f4caf23fb1a4f378e4dafd4d11d686d.pdf)
Click here (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_5396bb0962ee4d28bc99876aa1542555.pdf)
Gold & Silver Plans: Medicare creditable coverage disclosure notice(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_75e4cd46adfa4ac79c1bbcafa702deb1.pdf)
Bronze Plan: Medicare non-creditable coverage disclosure notice(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_7ccbecc8475a49e8a28066ebac033890.pdf)
Click here(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_7df45c79a7a940f18b2c5256edd2bfa9.pdf)
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