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Atlas insurance documents

Read about the details of your insurance plan. This is all the “fine print” for the insurance plans we offer.

Information that’s easy to read

This is all the “fine print” about the insurance plans we offer.

If you’re looking for information that’s easy to read, the column labeled “Summary of Benefits and Coverage" is your best bet. These are also called SBCs. Use this document if you’re looking for detailed information about your plan. Plus, all SBCs are legally required to include the same information, so it’s easy to compare plans.

Here are additional fine print documents:

Questions about your plan? We’re here to help. Call Member Services at 888-360-0622.

2020 Off Marketplace

2020 On Marketplace

Plan name Contract Benefit charts Amendments/ pediatric dental Summary of Benefits and Coverage
Atlas $1000 w/Copay Gold MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW601-20   Atlas $1000 w/Copay Gold
Atlas Gold Zero Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW602-20   Atlas Gold Zero Cost Share Plan
Atlas $1000 w/Copay Gold Limited Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW603-20   Atlas $1000 w/Copay Gold Limited Cost Share Plan
Atlas $3000 Plus Silver MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW604-20   Atlas $3000 Plus Silver
Atlas Silver Zero Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW605-20   Atlas Silver Zero Cost Share Plan
Atlas $3000 Plus Silver Limited Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW606-20   Atlas $3000 Plus Silver Limited Cost Share Plan
Atlas $100 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW607-20   Atlas $100 Silver Cost Share Reduction Plan
Atlas $750 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW608-20   Atlas $750 Silver Cost Share Reduction Plan
Atlas $2900 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW609-20   Atlas $2900 Silver Cost Share Reduction Plan
Atlas $6400 Plus Bronze MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW616-20   Atlas $6400 Plus Bronze
Atlas Bronze Zero Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW617-20   Atlas Bronze Zero Cost Share Plan
Atlas $6400 Plus Bronze Limited Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW618-20   Atlas $6400 Plus Bronze Limited Cost Share Plan
Atlas $8150 Catastrophic MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW622-20   Atlas $8150 Catastrophic
Atlas $3000 HSA Silver MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW623-20   Atlas $3000 HSA Silver
Atlas Silver Zero Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW624-20   Atlas Silver Zero Cost Share Plan
Atlas $3000 Silver Limited Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW625-20   Atlas $3000 Silver Limited Cost Share Plan
Atlas $200 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW626-20   Atlas $200 Silver Cost Share Reduction Plan
Atlas $900 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW627-20   Atlas $900 Silver Cost Share Reduction Plan
Atlas $2200 Silver Cost Share Reduction Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW628-20   Atlas $2200 Silver Cost Share Reduction Plan
Atlas $6750 HSA Bronze MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW629-20   Atlas $6750 HSA Bronze
Atlas Bronze Zero Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW630-20   Atlas Bronze Zero Cost Share Plan
Atlas $6750 Bronze Limited Cost Share Plan MGC-200.3-WI-IND-MK-20 BCH-200.3-WI-IND-IW631-20   Atlas $6750 Bronze Limited Cost Share Plan

2019 Off Marketplace

2019 On Marketplace

Plan name Contract Benefit charts Amendments/ pediatric dental Summary of Benefits and Coverage
Atlas $1000 w/Copay Gold MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW601-19   Atlas $1000 w/Copay Gold
Atlas Gold Zero Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW602-19   Atlas Gold Zero Cost Share Plan
Atlas $1000 w/Copay Gold Limited Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW603-19   Atlas $1000 w/Copay Gold Limited Cost Share Plan
Atlas $3000 Plus Silver MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW604-19   Atlas $3000 Plus Silver
Atlas Silver Zero Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW605-19   Atlas Silver Zero Cost Share Plan
Atlas $3000 Plus Silver Limited Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW606-19   Atlas $3000 Plus Silver Limited Cost Share Plan
Atlas $100 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW607-19   Atlas $100 Silver Cost Share Reduction Plan
Atlas $750 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW608-19   Atlas $750 Silver Cost Share Reduction Plan
Atlas $3000 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW609-19   Atlas $3000 Silver Cost Share Reduction Plan
Atlas $6000 Plus Bronze MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW616-19   Atlas $6000 Plus Bronze
Atlas Bronze Zero Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW617-19   Atlas Bronze Zero Cost Share Plan
Atlas $6000 Plus Bronze Limited Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW618-19   Atlas $6000 Plus Bronze Limited Cost Share Plan
Atlas $7900 Catastrophic MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW622-19   Atlas $7900 Catastrophic
Atlas $3000 HSA Silver MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW623-19   Atlas $3000 HSA Silver
Atlas Silver Zero Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW624-19   Atlas Silver Zero Cost Share Plan
Atlas $3000 Silver Limited Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW625-19   Atlas $3000 Silver Limited Cost Share Plan
Atlas $200 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW626-19   Atlas $200 Silver Cost Share Reduction Plan
Atlas $800 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW627-19   Atlas $800 Silver Cost Share Reduction Plan
Atlas $2200 Silver Cost Share Reduction Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW628-19   Atlas $2200 Silver Cost Share Reduction Plan
Atlas $6650 HSA Bronze MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW629-19   Atlas $6650 HSA Bronze
Atlas Bronze Zero Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW630-19   Atlas Bronze Zero Cost Share Plan
Atlas $6650 Bronze Limited Cost Share Plan MGC-200.2-WI-IND-MK-19 BCH-200.2-WI-IND-IW631-19   Atlas $6650 Bronze Limited Cost Share Plan
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