Information:

If your HealthPartners plan covers prescription drugs, you received a new 2026 member ID card. Start using your new card now. Learn more

Wisconsin 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.

2026 Wisconsin plan documents

Atlas plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Atlas $1,300 Gold SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW110-26 (PDF)
Atlas $2,000 Standard Gold SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW113-26 (PDF)
Atlas $3,050 Plus Silver SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF) BCH-200.9-WI-IND-IW102-26 (PDF)
Atlas $4,300 Plus Silver SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW112-26 (PDF)
Atlas $6,000 Standard Silver SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW115-26 (PDF)
Atlas $6,800 Plus Bronze HSA SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW116-26 (PDF)
Atlas $7,500 Standard Bronze HSA SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF) BCH-200.9-WI-IND-IW117-26 (PDF)
Atlas $3,800 HSA Silver SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW106-26 (PDF)
Atlas $8,400 HSA Bronze SBC (PDF) MGC-200.9-WI-IND-OMK-26 (PDF)
BCH-200.9-WI-IND-IW107-26 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Atlas $1,300 Gold SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW644-26 (PDF)
Atlas Zero Cost Share Gold (IW602) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW602-26 (PDF)
Atlas $1,300 Limited Cost Share Gold SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW645-26 (PDF)
Atlas $2,000 Standard Gold SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW655-26 (PDF)
Atlas Zero Cost Share Gold (IW656) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW656-26 (PDF)
Atlas $2,000 Standard Limited Cost Share Gold SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW657-26 (PDF)
Atlas $3,050 Plus Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW604-26 (PDF)
Atlas Zero Cost Share Silver (IW605) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW605-26 (PDF)
Atlas $3,050 Plus Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW606-26 (PDF)
Atlas $50 Plus Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW607-26 (PDF)
Atlas $700 Plus Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW608-26 (PDF)
Atlas $2,650 Plus Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW609-26 (PDF)
Atlas $6,000 Standard Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW658-26 (PDF)
Atlas Zero Cost Share Silver (IW659) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW659-26 (PDF)
Atlas $6,000 Standard Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW660-26 (PDF)
Atlas $0 Standard Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW661-26 (PDF)
Atlas $700 Standard Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW662-26 (PDF)
Atlas $3,000 Standard Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW663-26 (PDF)
Atlas $6,800 Plus Bronze HSA SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW667-26 (PDF)
Atlas Zero Cost Share Bronze HSA (IW668) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW668-26 (PDF)
Atlas $6,800 Plus Limited Cost Share Bronze HSA SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW669-26 (PDF)
Atlas $7,500 Standard Bronze HSA SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW670-26 (PDF)
Atlas Zero Cost Share Bronze HSA (IW671) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW671-26 (PDF)
Atlas $7,500 Standard Limited Cost Share Bronze HSA SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW672-26 (PDF)
Atlas $3,800 HSA Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW623-26 (PDF)
Atlas Zero Cost Share Silver (IW624) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW624-26 (PDF)
Atlas $3,800 Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW625-26 (PDF)
Atlas $200 Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW626-26 (PDF)
Atlas $1,300 Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW627-26 (PDF)
Atlas $3,000 Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW628-26 (PDF)
Atlas $8,400 HSA Bronze SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW629-26 (PDF)
Atlas Zero Cost Share Bronze HSA (IW630) SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF) BCH-200.9-WI-IND-IW630-26 (PDF)
Atlas $8,400 Limited Cost Share Bronze HSA SBC (PDF) MGC-200.9-WI-IND-MK-26 (PDF)
BCH-200.9-WI-IND-IW631-26 (PDF)

Individual NE WI Select plans

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Individual NE WI Select $3,150 Plus Silver SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR122-26 (PDF)
Individual NE WI Select $4,300 Plus Silver SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR116-26 (PDF)
Individual NE WI Select $6,000 Standard Silver SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR123-26 (PDF)
Individual NE WI Select $6,800 Plus Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR124-26 (PDF)
Individual NE WI Select $7,500 Standard Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR125-26 (PDF)
Individual NE WI Select $3,800 HSA Silver SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF) BCH-200.9-WI-IND-IR119-26 (PDF)
Individual NE WI Select $8,400 HSA Bronze SBC (PDF) MGC-200.9-WI-IND-NES-OMK-26 (PDF)
BCH-200.9-WI-IND-IR120-26 (PDF)

Plan name

Summary of Benefits and Coverage Contract Benefit charts
Individual NE WI Select $3,150 Plus Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR660-26 (PDF)
Individual NE WI Select Zero Cost Share Silver (IR661) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR661-26 (PDF)
Individual NE WI Select $3,150 Plus Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR662-26 (PDF)
Individual NE WI Select $50 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR663-26 (PDF)
Individual NE WI Select $700 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR664-26 (PDF)
Individual NE WI Select $2,650 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR665-26 (PDF)
Individual NE WI Select $6,000 Standard Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR666-26 (PDF)
Individual NE WI Select Zero Cost Share Silver (IR667) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR667-26 (PDF)
Individual NE WI Select $6,000 Standard Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR668-26 (PDF)
Individual NE WI Select $0 Standard Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR669-26 (PDF)
Individual NE WI Select $700 Standard Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF) BCH-200.9-WI-IND-IR670-26 (PDF)
Individual NE WI Select $3,000 Standard Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR671-26 (PDF)
Individual NE WI Select $6,800 Plus Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR688-26 (PDF)
Individual NE WI Select Zero Cost Share Bronze HSA (IR689) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR689-26 (PDF)
Individual NE WI Select $6,800 Plus Limited Cost Share Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR690-26 (PDF)
Individual NE WI Select $7,500 Standard Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR691-26 (PDF)
Individual NE WI Select Zero Cost Share Bronze HSA (IR692) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR692-26 (PDF)
Individual NE WI Select $7,500 Standard Limited Cost Share Bronze HSA SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR693-26 (PDF)
Individual NE WI Select $3,800 HSA Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR678-26 (PDF)
Individual NE WI Select Zero Cost Share Silver (IR679) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR679-26 (PDF)
Individual NE WI Select $3,800 HSA Limited Cost Share Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR680-26 (PDF)
Individual NE WI Select $200 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR681-26 (PDF)
Individual NE WI Select $1,300 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR682-26 (PDF)
Individual NE WI Select $3,000 Cost Share Reduction Silver SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR683-26 (PDF)
Individual NE WI Select $8,400 HSA Bronze SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR684-26 (PDF)
Individual NE WI Select Zero Cost Share Bronze HSA (IR685) SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR685-26 (PDF)
Individual NE WI Select $8,400 HSA Limited Cost Share Bronze SBC (PDF) MGC-200.9-WI-IND-NES-MK-26 (PDF)
BCH-200.9-WI-IND-IR686-26 (PDF)