Find the plan information you’re looking for
Here you’ll find all the specifics about your plan – including benefits, what’s covered and legal information – plus additional member forms and documents.
You’ll find these documents below:
- Summary of Benefits and Coverage (SBC) – This is information that’s easiest to read. It includes detailed information about your plan’s benefits and coverage. All SBCs are legally required to include the same information, so it’s easy to use SBCs to compare plans.
- Contract – This is the legal contract between you and HealthPartners UnityPoint Health. It includes all the details about your insurance plan.
- Benefit charts – Use these charts to find the exact legal terms of everything your plan covers.
- Amendments and pediatric dental – Some insurance plans have dental benefits that only apply to people younger than 19. Those benefits are explained here. This also shows you if things have changed with your plans.
Deductible-Copay Plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $500-$20 Platinum | |||
| $500-$60 Gold |
Deductible-Copay Primary Specialty
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $1,500-$30/$60 Gold | |||
| $2,000-$30/$60 Gold | |||
| $3,000-$30/$60 Gold | |||
| $4,000-$30/$60 Gold | |||
| $5,500-$50/$100 Silver | |||
| $6,500-$50/$100 Silver | |||
| $7,500-$50/$100 Silver |
Three for Free plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $2,000-70% Silver | |||
| $4,000-70% Silver | |||
| $5,000-70% Silver |
HSA-Copay Embedded plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $3,200-100% $50/$100 Silver | |||
| $6,250-100% $50/$100 Bronze |
HSA Non-Embedded Plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $2,500-100% Gold | |||
$4,500-100% Silver |
HSA Embedded plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $3,200-100% Gold | |||
$5,000-100% Silver | |||
$7,000-100% Bronze | |||
$3,200-70% Silver |
HSA Plus Non-Embedded plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $3,000-100% Gold |
HSA Plus Embedded plans
| Plan name | SBCs | Contract | Benefit Chart |
|---|---|---|---|
| $3,200-100% Gold | |||
| $5,200-100% Silver | |||
| $5,000-70% Silver |
Need help?
If you need help finding a document, our team can assist. Call the Member Services number on the back of your HealthPartners UnityPoint Health insurance ID card or
To request copies of your plan documents, please contact us.
If you need help, call the Member Services number on the back of your HealthPartners UnityPoint Health insurance ID card or 866-843-3461.
Looking for a form to help manage your plan or spending account? These documents are available when you sign in or at healthpartners.com.