Summary Of Benefits & Coverage
2025
2024
2023
2022
2021
| Standard Option |
| Core Option |
| High Cost Coverage Option |
| Out-Of-Area Option |
| PPO 80 |
| PPO 90 |
| PPO 80 Out-of-Area Option |
| PPO 90 Out-of-Area Option |
| DFW ConnectedCare Option |
| HMO Plan SBCs can be found on the HMO Page. |
2020
2019
| Standard Option |
| Core Option |
| Value Option |
| Out-Of-Area Option |
| PPO 80 |
| PPO 90 |
| PPO 100 |
| PPO 80 Out-of-Area Option |
| PPO 90 Out-of-Area Option |
| PPO 100 Out-of-Area Option |
| HMO Plan SBCs can be found on the HMO Page. |
2018
| Standard Option |
| Core Option |
| Value Option |
| Out-Of-Area Option |
| PPO 80 |
| PPO 90 |
| PPO 100 |
| PPO 80 Out-of-Area Option |
| PPO 90 Out-of-Area Option |
| PPO 100 Out-of-Area Option |
| HMO Plan SBCs can be found on the HMO Page. |
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