Minnesota individual and family plan documents

Find all the documents and details for your plan

The documents below provide up-to-date details about your plan:

  • Summary of Benefits and Coverage (SBC) – Your SBC gives you general information about your plan, such as what’s covered, your out-of-pocket limits, prescription drug coverage, where to find in-network providers and more. This document is often the easiest-to-read summary of your plan.
  • Your legal contract with HealthPartners – Your contract contains all of the details about your insurance plan, including terms and conditions of your plan, your rights and responsibilities, and more.
  • Benefit chart – Your benefit chart includes the exact legal definition of coverage-related terms used in your plan documents. It also contains complete and comprehensive information about what your plan does and doesn’t cover.
  • Pediatric dental amendment – Some of our plans have dental benefits that only apply to people younger than 19, and those benefits are explained in this amendment.

2024 Minnesota plan documents

Apex plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Apex $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE173-24 (PDF)
Apex $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE174-24 (PDF)
Apex $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF)
BCH-103.10-MN-IND-IE175-24 (PDF)
Apex $5,350 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF)
BCH-103.10-MN-IND-IE177-24 (PDF)
Apex $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF)
BCH-103.10-MN-IND-IE178-24 (PDF)
Apex $9,450 Catastrophic SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE179-24 (PDF)
Apex $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE176-24 (PDF)
Apex $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-OMKHSAA-24 (PDF) BCH-103.10-MN-IND-IE180-24 (PDF)
Apex $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-OMKHSAA-24 (PDF) BCH-103.10-MN-IND-IE181-24 (PDF)
Apex $2,300 Rx Copay Gold SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE209-24 (PDF)
Apex $3,000 Rx Copay Silver SBC (PDF) CON-103.10-MN-IND-OMKA-24 (PDF) BCH-103.10-MN-IND-IE210-24 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Apex $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE778-24 (PDF)
Apex Zero Cost Share Gold (IE839) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE779-24 (PDF)
Apex $1,000 w/Copay P-S Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE780-24 (PDF)
Apex $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE781-24 (PDF)
Apex Zero Cost Share Gold (IE842) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE782-24 (PDF)
Apex $2,000 w/Copay Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE783-24 (PDF)
Apex $2,300 Rx Copay Gold SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE898-24 (PDF)
Apex Zero Cost Share Gold (IE899) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE899-24 (PDF)
Apex $2,300 Rx Copay Gold Limited Cost Share SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE900-24 (PDF)
Apex $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE784-24 (PDF)
Apex Zero Cost Share Silver (IE845) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE785-24 (PDF)
Apex $3,500 Plus Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE786-24 (PDF)
Apex $50 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE787-24 (PDF)
Apex $750 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE788-24 (PDF)
Apex $3,150 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE789-24 (PDF)
Apex $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE796-24 (PDF)
Apex Zero Cost Share Bronze (IE857) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE797-24 (PDF)
Apex $6,350 Plus Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE798-24 (PDF)
Apex $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-MKHSAA-24 (PDF) BCH-103.10-MN-IND-IE799-24 (PDF)
Apex Zero Cost Share Silver (IE860) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE800-24 (PDF)
Apex $3,800 Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE801-24 (PDF)
Apex $200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE802-24 (PDF)
Apex $1,200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE803-24 (PDF)
Apex $3,000 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKHSAA-24 (PDF) BCH-103.10-MN-IND-IE804-24 (PDF)
Apex $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-MKHSAA-24 (PDF) BCH-103.10-MN-IND-IE805-24 (PDF)
Apex Zero Cost Share Bronze (IE866) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE806-24 (PDF)
Apex $7,800 Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE807-24 (PDF)
Apex $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE790-24 (PDF)
Apex Zero Cost Share Silver (IE851) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE791-24 (PDF)
Apex $3,000 w/Copay P-S Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE792-24 (PDF)
Apex $2,800 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE793-24 (PDF)
Apex $850 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE794-24 (PDF)
Apex $50 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE795-24 (PDF)
Apex $3,000 Rx Copay Silver (IE901) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE901-24 (PDF)
Apex Zero Cost Share Silver (IE902) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE902-24 (PDF)
Apex $3,000 Rx Copay Silver (IE903) SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE903-24 (PDF)
Apex $2,550 Rx Copay Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE906-24 (PDF)
Apex $550 Rx Copay Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE905-24 (PDF)
Apex $50 Rx Copay Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKA-24 (PDF) BCH-103.10-MN-IND-IE904-24 (PDF)

Peak plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Peak $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE173-24 (PDF)
Peak $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE174-24 (PDF)
Peak $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE175-24 (PDF)
Peak $5,350 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE177-24 (PDF)
Peak $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE178-24 (PDF)
Peak $9,450 Catastrophic SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE179-24 (PDF)
Peak $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-OMK-24 (PDF) BCH-103.10-MN-IND-IE176-24 (PDF)
Peak $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-OMKHSA-24 (PDF) BCH-103.10-MN-IND-IE180-24 (PDF)
Peak $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-OMKHSA-24 (PDF) BCH-103.10-MN-IND-IE181-24 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Peak $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE778-24 (PDF)
Peak Zero Cost Share Gold (IE779) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE779-24 (PDF)
Peak $1,000 w/Copay P-S Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE780-24 (PDF)
Peak $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE781-24 (PDF)
Peak Zero Cost Share Gold (IE782) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE782-24 (PDF)
Peak $2,000 w/Copay Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE783-24 (PDF)
Peak $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE784-24 (PDF)
Peak Zero Cost Share Silver (IE785) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE785-24 (PDF)
Peak $3,500 Plus Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE786-24 (PDF)
Peak $50 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE787-24 (PDF)
Peak $750 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE788-24 (PDF)
Peak $3,150 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE789-24 (PDF)
Peak $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE796-24 (PDF)
Peak Zero Cost Share Bronze (IE797) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE797-24 (PDF)
Peak $6,350 Plus Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE798-24 (PDF)
Peak $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE790-24 (PDF)
Peak Zero Cost Share Silver (IE791) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE791-24 (PDF)
Peak $3,000 w/Copay P-S Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE792-24 (PDF)
Peak $50 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE793-24 (PDF)
Peak $850 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE794-24 (PDF)
Peak $2,800 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE795-24 (PDF)
Peak $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-MKHSA-24 (PDF) BCH-103.10-MN-IND-IE799-24 (PDF)
Peak Zero Cost Share Silver (IE800) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE800-24 (PDF)
Peak $3,800 Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE801-24 (PDF)
Peak $200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE802-24 (PDF)
Peak $1,200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE803-24 (PDF)
Peak $3,000 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKHSA-24 (PDF) BCH-103.10-MN-IND-IE804-24 (PDF)
Peak $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-MKHSA-24 (PDF) BCH-103.10-MN-IND-IE805-24 (PDF)
Peak Zero Cost Share Bronze (IE806) SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE806-24 (PDF)
Peak $7,800 Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MK-24 (PDF) BCH-103.10-MN-IND-IE807-24 (PDF)

Select plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Select $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE173-24 (PDF)
Select $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE174-24 (PDF)
Select $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE175-24 (PDF)
Select $5,350 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE177-24 (PDF)
Select $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE178-24 (PDF)
Select $9,450 Catastrophic SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE179-24 (PDF)
Select $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-OMKS-24 (PDF) BCH-103.10-MN-IND-IE176-24 (PDF)
Select $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-OMKHSAS-24 (PDF) BCH-103.10-MN-IND-IE180-24 (PDF)
Select $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-OMKHSAS-24 (PDF) BCH-103.10-MN-IND-IE181-24 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Select $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE778-24 (PDF)
Select Zero Cost Share Gold (IE809) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE779-24 (PDF)
Select $1,000 w/Copay P-S Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE780-24 (PDF)
Select $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE781-24 (PDF)
Select Zero Cost Share Gold (IE812) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE782-24 (PDF)
Select $2,000 w/Copay Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE783-24 (PDF)
Select $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE784-24 (PDF)
Select Zero Cost Share Silver (IE815) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE785-24 (PDF)
Select $3,500 Plus Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE786-24 (PDF)
Select $50 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE787-24 (PDF)
Select $750 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE788-24 (PDF)
Select $3,150 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE789-24 (PDF)
Select $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE796-24 (PDF)
Select Zero Cost Share Bronze (IE827) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE797-24 (PDF)
Select $6,350 Plus Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE798-24 (PDF)
Select $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE790-24 (PDF)
Select Zero Cost Share Silver (IE821) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE791-24 (PDF)
Select $3,000 w/Copay P-S Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE792-24 (PDF)
Select $50 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE793-24 (PDF)
Select $850 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE794-24 (PDF)
Select $2,800 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE795-24 (PDF)
Select $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-MKHSAS-24 (PDF) BCH-103.10-MN-IND-IE799-24 (PDF)
Select Zero Cost Share Silver (IE830) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE800-24 (PDF)
Select $3,800 Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE801-24 (PDF)
Select $200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE802-24 (PDF)
Select $1,200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE803-24 (PDF)
Select $3,000 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKHSAS-24 (PDF) BCH-103.10-MN-IND-IE804-24 (PDF)
Select $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-MKHSAS-24 (PDF) BCH-103.10-MN-IND-IE805-24 (PDF)
Select Zero Cost Share Bronze (IE836) SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE806-24 (PDF)
Select $7,800 Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKS-24 (PDF) BCH-103.10-MN-IND-IE807-24 (PDF)

Cornerstone plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Cornerstone $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE173-24 (PDF)
Cornerstone $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE174-24 (PDF)
Cornerstone $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE176-24 (PDF)
Cornerstone $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE175-24 (PDF)
Cornerstone $5,350 Plus Silver SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE177-24 (PDF)
Cornerstone $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE178-24 (PDF)
Cornerstone $9,450 Catastrophic SBC (PDF) CON-103.10-MN-IND-OMKC-24 (PDF) BCH-103.10-MN-IND-IE179-24 (PDF)
Cornerstone $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-OMKHSAC-24 (PDF) BCH-103.10-MN-IND-IE180-24 (PDF)
Cornerstone $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-OMKHSAC-24 (PDF) BCH-103.10-MN-IND-IE181-24 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Cornerstone $1,000 w/Copay P-S Gold SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE778-24 (PDF)
Cornerstone Zero Cost Share Gold (IE869) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE779-24 (PDF)
Cornerstone $1,000 w/Copay P-S Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE780-24 (PDF)
Cornerstone $2,000 w/Copay Gold SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE781-24 (PDF)
Cornerstone Zero Cost Share Gold (IE872) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE782-24 (PDF)
Cornerstone $2,000 w/Copay Limited Cost Share Gold SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE783-24 (PDF)
Cornerstone $3,000 w/Copay P-S Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE790-24 (PDF)
Cornerstone Zero Cost Share Silver (IE881) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE791-24 (PDF)
Cornerstone $3,000 w/Copay P-S Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE792-24 (PDF)
Cornerstone $2,800 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE793-24 (PDF)
Cornerstone $850 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE794-24 (PDF)
Cornerstone $50 w/Copay P-S Cost Share Reduction Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE795-24 (PDF)
Cornerstone $3,500 Plus Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE784-24 (PDF)
Cornerstone Zero Cost Share Silver (IE875) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE785-24 (PDF)
Cornerstone $3,500 Plus Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE786-24 (PDF)
Cornerstone $50 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE787-24 (PDF)
Cornerstone $750 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE788-24 (PDF)
Cornerstone $3,150 Plus Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE789-24 (PDF)
Cornerstone $6,350 Plus Bronze SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE796-24 (PDF)
Cornerstone Zero Cost Share Bronze (IE887) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE797-24 (PDF)
Cornerstone $6,350 Plus Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE798-24 (PDF)
Cornerstone $3,800 HSA Silver SBC (PDF) CON-103.10-MN-IND-MKHSAC-24 (PDF) BCH-103.10-MN-IND-IE799-24 (PDF)
Cornerstone Zero Cost Share Silver (IE890) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE800-24 (PDF)
Cornerstone $3,800 Limited Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE801-24 (PDF)
Cornerstone $200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE802-24 (PDF)
Cornerstone $1,200 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE803-24 (PDF)
Cornerstone $3,000 Cost Share Silver SBC (PDF) CON-103.10-MN-IND-MKHSAC-24 (PDF) BCH-103.10-MN-IND-IE804-24 (PDF)
Cornerstone $7,800 HSA Bronze SBC (PDF) CON-103.10-MN-IND-MKHSAC-24 (PDF) BCH-103.10-MN-IND-IE805-24 (PDF)
Cornerstone Zero Cost Share Bronze (IE896) SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE806-24 (PDF)
Cornerstone $7,800 Limited Cost Share Bronze SBC (PDF) CON-103.10-MN-IND-MKC-24 (PDF) BCH-103.10-MN-IND-IE807-24 (PDF)

Legal information

In Minnesota, HealthPartners is required to meet certain state standards for geographic access in each of the counties we offer networks to individuals, families and small employer groups. The plans on this page may have waivers filed with the Minnesota Department of Health in areas where geographic standards have not been completely met for one or more specialties.